Minnesota Legislature
HF 1078
3rd Engrossment - 85th Legislature (2007 - 2008) Posted on 12/15/2009 12:00am
3.8 3.9
3.10 3.11 3.12 3.13 3.14 3.15 3.16 3.17 3.18 3.19 3.20 3.21 3.22 3.23 3.24 3.25 3.26 3.27 3.28 3.29 3.30 3.31 3.32 3.33 3.34 3.35 3.36 3.37 4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8 4.9 4.10 4.11 4.12 4.13 4.14 4.15 4.16 4.17 4.18 4.19 4.20 4.21 4.22 4.23 4.24 4.25 4.26 4.27 4.28 4.29 4.30 4.31 4.32 4.33 4.34 4.35 4.36 5.1 5.2 5.3 5.4 5.5 5.6 5.7 5.8 5.9 5.10 5.11 5.12 5.13 5.14 5.15 5.16 5.17 5.18 5.19 5.20 5.21 5.22 5.23 5.24 5.25 5.26 5.27 5.28 5.29 5.30 5.31 5.32 5.33 5.34 5.35 6.1 6.2 6.3 6.4 6.5 6.6 6.7 6.8 6.9 6.10 6.11 6.12 6.13 6.14 6.15 6.16 6.17 6.18 6.19 6.20 6.21 6.22 6.23 6.24 6.25 6.26 6.27 6.28 6.29 6.30 6.31 6.32 6.33 6.34 6.35 7.1 7.2 7.3 7.4 7.5 7.6 7.7 7.8 7.9 7.10 7.11 7.12 7.13 7.14 7.15 7.16 7.17 7.18 7.19 7.20 7.21 7.22 7.23 7.24 7.25 7.26 7.27 7.28 7.29 7.30 7.31 7.32 7.33 7.34 7.35 8.1 8.2 8.3 8.4 8.5 8.6 8.7 8.8 8.9 8.10 8.11 8.12 8.13 8.14 8.15 8.16 8.17 8.18 8.19 8.20 8.21 8.22 8.23 8.24 8.25 8.26 8.27 8.28 8.29 8.30 8.31 8.32 8.33 8.34 8.35 8.36 9.1 9.2 9.3 9.4 9.5 9.6 9.7 9.8 9.9 9.10 9.11 9.12 9.13 9.14 9.15 9.16 9.17 9.18 9.19 9.20 9.21 9.22 9.23 9.24 9.25 9.26 9.27 9.28 9.29 9.30 9.31 9.32 9.33 9.34 9.35 9.36 10.1 10.2 10.3 10.4 10.5 10.6 10.7 10.8 10.9 10.10 10.11 10.12 10.13 10.14 10.15 10.16 10.17 10.18 10.19 10.20 10.21 10.22 10.23 10.24 10.25 10.26 10.27 10.28 10.29 10.30 10.31 10.32 10.33 10.34 10.35 11.1 11.2 11.3 11.4 11.5 11.6 11.7 11.8 11.9 11.10 11.11 11.12 11.13
11.14 11.15 11.16 11.17 11.18 11.19 11.20 11.21
11.22 11.23 11.24 11.25 11.26 11.27 11.28 11.29 11.30 11.31 11.32 11.33 12.1 12.2 12.3 12.4 12.5 12.6 12.7 12.8 12.9 12.10 12.11 12.12 12.13 12.14
12.15 12.16 12.17 12.18 12.19 12.20 12.21 12.22 12.23 12.24 12.25 12.26 12.27 12.28 12.29 12.30 12.31 12.32 12.33 12.34 12.35
13.1 13.2 13.3 13.4 13.5 13.6 13.7 13.8 13.9 13.10 13.11 13.12 13.13 13.14 13.15 13.16 13.17 13.18 13.19 13.20 13.21 13.22 13.23 13.24 13.25 13.26 13.27 13.28 13.29 13.30 13.31 13.32 13.33 13.34 13.35 13.36 14.1 14.2 14.3 14.4
14.5 14.6 14.7 14.8 14.9 14.10 14.11 14.12 14.13 14.14 14.15 14.16 14.17
14.18 14.19 14.20 14.21 14.22 14.23 14.24 14.25 14.26 14.27 14.28 14.29 14.30 14.31 14.32 14.33 14.34 15.1 15.2 15.3 15.4 15.5 15.6 15.7 15.8 15.9 15.10 15.11 15.12 15.13 15.14 15.15 15.16 15.17 15.18 15.19 15.20 15.21 15.22 15.23 15.24 15.25 15.26 15.27 15.28 15.29 15.30 15.31 15.32 15.33 15.34 15.35 15.36 16.1 16.2 16.3 16.4 16.5 16.6 16.7 16.8 16.9 16.10 16.11 16.12 16.13 16.14 16.15 16.16 16.17 16.18 16.19 16.20 16.21 16.22 16.23 16.24 16.25 16.26 16.27 16.28 16.29 16.30 16.31 16.32 16.33 16.34 16.35 17.1 17.2 17.3 17.4 17.5 17.6 17.7 17.8 17.9 17.10 17.11 17.12 17.13 17.14 17.15 17.16 17.17 17.18 17.19 17.20 17.21 17.22 17.23 17.24 17.25 17.26 17.27 17.28 17.29 17.30 17.31 17.32 17.33 17.34 17.35 17.36
18.1 18.2 18.3 18.4 18.5 18.6
18.7 18.8 18.9 18.10 18.11 18.12 18.13
18.14 18.15 18.16 18.17
18.18 18.19 18.20 18.21
18.22 18.23 18.24 18.25 18.26 18.27 18.28 18.29
18.30 19.1 19.2 19.3 19.4 19.5 19.6 19.7 19.8 19.9 19.10 19.11
19.12 19.13 19.14 19.15 19.16 19.17 19.18 19.19 19.20 19.21 19.22 19.23 19.24 19.25 19.26 19.27 19.28 19.29 19.30 19.31 19.32 19.33 19.34 20.1 20.2 20.3 20.4 20.5 20.6 20.7 20.8 20.9 20.10 20.11 20.12 20.13 20.14 20.15 20.16 20.17 20.18 20.19 20.20 20.21 20.22 20.23 20.24 20.25 20.26 20.27 20.28 20.29 20.30 20.31 20.32 20.33 20.34 20.35 20.36 21.1 21.2 21.3 21.4 21.5 21.6 21.7 21.8 21.9 21.10 21.11 21.12
21.13 21.14 21.15 21.16 21.17 21.18 21.19 21.20 21.21 21.22 21.23 21.24 21.25 21.26 21.27 21.28 21.29 21.30 21.31 21.32 21.33 21.34 21.35 22.1 22.2 22.3 22.4 22.5 22.6 22.7 22.8 22.9 22.10 22.11 22.12 22.13
22.14 22.15 22.16 22.17 22.18 22.19 22.20 22.21 22.22
22.23 22.24 22.25 22.26 22.27 22.28 22.29 22.30 22.31 22.32 22.33 22.34 23.1 23.2 23.3 23.4 23.5 23.6 23.7 23.8 23.9 23.10 23.11 23.12 23.13 23.14 23.15
23.16 23.17 23.18 23.19 23.20 23.21 23.22 23.23 23.24 23.25 23.26 23.27 23.28 23.29 23.30 23.31 23.32 23.33 23.34 23.35 24.1 24.2 24.3 24.4 24.5 24.6 24.7 24.8 24.9 24.10 24.11 24.12 24.13 24.14 24.15 24.16 24.17 24.18 24.19 24.20 24.21 24.22 24.23 24.24 24.25 24.26 24.27 24.28 24.29 24.30 24.31 24.32 24.33 24.34 24.35 24.36 25.1 25.2 25.3 25.4 25.5 25.6 25.7 25.8 25.9 25.10 25.11 25.12 25.13 25.14 25.15 25.16 25.17 25.18 25.19 25.20 25.21 25.22 25.23 25.24 25.25 25.26 25.27 25.28 25.29 25.30 25.31 25.32 25.33 25.34 25.35 25.36 26.1 26.2 26.3 26.4 26.5 26.6 26.7 26.8 26.9 26.10 26.11 26.12 26.13 26.14 26.15 26.16 26.17 26.18 26.19 26.20 26.21 26.22 26.23 26.24 26.25 26.26 26.27 26.28 26.29 26.30 26.31 26.32 26.33 26.34 26.35 26.36 27.1 27.2 27.3 27.4 27.5 27.6 27.7 27.8 27.9 27.10 27.11 27.12 27.13 27.14 27.15 27.16 27.17 27.18 27.19 27.20 27.21 27.22 27.23 27.24 27.25 27.26 27.27 27.28 27.29 27.30 27.31 27.32 27.33 27.34 27.35 27.36 28.1 28.2 28.3 28.4 28.5 28.6 28.7 28.8 28.9 28.10 28.11 28.12 28.13 28.14 28.15 28.16 28.17 28.18 28.19 28.20 28.21 28.22 28.23 28.24 28.25 28.26 28.27 28.28 28.29 28.30 28.31 28.32 28.33 28.34 28.35 28.36 29.1 29.2 29.3 29.4 29.5 29.6 29.7 29.8 29.9 29.10 29.11 29.12 29.13 29.14 29.15 29.16 29.17 29.18 29.19 29.20 29.21 29.22 29.23 29.24 29.25 29.26 29.27 29.28 29.29 29.30 29.31 29.32 29.33 29.34 29.35 30.1 30.2 30.3 30.4 30.5 30.6 30.7 30.8 30.9 30.10 30.11 30.12 30.13 30.14 30.15 30.16 30.17 30.18
30.19 30.20 30.21 30.22 30.23 30.24 30.25 30.26 30.27 30.28 30.29 30.30 30.31 30.32 30.33 30.34 30.35 31.1 31.2 31.3 31.4 31.5 31.6 31.7 31.8 31.9 31.10 31.11 31.12 31.13 31.14 31.15 31.16 31.17 31.18 31.19 31.20 31.21 31.22 31.23 31.24 31.25 31.26 31.27 31.28 31.29 31.30 31.31 31.32 31.33 31.34 31.35 31.36 32.1 32.2 32.3 32.4 32.5 32.6 32.7 32.8 32.9 32.10 32.11 32.12 32.13 32.14 32.15 32.16 32.17 32.18 32.19 32.20 32.21 32.22 32.23 32.24 32.25 32.26 32.27 32.28 32.29 32.30 32.31 32.32 32.33 32.34 32.35 32.36 33.1 33.2 33.3 33.4 33.5 33.6 33.7 33.8 33.9
33.10 33.11 33.12 33.13 33.14 33.15 33.16 33.17 33.18 33.19 33.20 33.21 33.22 33.23 33.24 33.25 33.26 33.27 33.28 33.29 33.30 33.31 33.32 33.33 33.34 33.35 34.1 34.2 34.3 34.4 34.5 34.6 34.7 34.8 34.9 34.10 34.11 34.12 34.13 34.14 34.15 34.16 34.17 34.18 34.19 34.20 34.21 34.22 34.23 34.24 34.25 34.26 34.27 34.28 34.29 34.30 34.31 34.32 34.33 34.34 34.35 34.36 35.1 35.2 35.3 35.4 35.5 35.6 35.7 35.8 35.9 35.10 35.11 35.12 35.13 35.14 35.15 35.16 35.17 35.18 35.19 35.20 35.21 35.22 35.23 35.24 35.25 35.26 35.27 35.28 35.29 35.30 35.31 35.32
35.33 35.34 35.35 36.1 36.2 36.3 36.4 36.5 36.6 36.7 36.8 36.9 36.10 36.11 36.12 36.13 36.14 36.15 36.16 36.17 36.18 36.19 36.20 36.21 36.22 36.23
36.24 36.25 36.26 36.27 36.28 36.29 36.30 36.31 36.32 36.33 36.34 36.35 37.1 37.2 37.3 37.4 37.5 37.6 37.7 37.8 37.9 37.10 37.11 37.12 37.13 37.14 37.15 37.16 37.17 37.18 37.19 37.20
37.21 37.22 37.23 37.24 37.25 37.26 37.27 37.28 37.29 37.30 37.31 37.32 37.33 37.34 37.35 38.1 38.2 38.3 38.4 38.5 38.6 38.7 38.8 38.9 38.10 38.11 38.12 38.13 38.14 38.15 38.16 38.17 38.18 38.19 38.20 38.21 38.22 38.23 38.24 38.25 38.26 38.27 38.28 38.29 38.30 38.31 38.32 38.33 38.34
38.35 39.1 39.2 39.3 39.4 39.5 39.6 39.7 39.8 39.9 39.10 39.11 39.12 39.13 39.14 39.15 39.16 39.17 39.18 39.19 39.20 39.21 39.22 39.23 39.24 39.25 39.26 39.27 39.28 39.29 39.30 39.31 39.32 39.33 39.34 39.35 40.1 40.2 40.3 40.4 40.5 40.6 40.7 40.8 40.9 40.10 40.11 40.12 40.13 40.14 40.15 40.16 40.17 40.18 40.19 40.20 40.21 40.22 40.23 40.24 40.25 40.26 40.27 40.28 40.29 40.30 40.31 40.32 40.33 40.34 40.35 40.36 41.1 41.2 41.3 41.4 41.5 41.6 41.7 41.8 41.9 41.10 41.11 41.12 41.13 41.14 41.15 41.16 41.17 41.18 41.19 41.20 41.21 41.22 41.23 41.24 41.25 41.26 41.27 41.28 41.29 41.30 41.31 41.32 41.33 41.34 41.35 41.36 42.1 42.2 42.3 42.4 42.5 42.6 42.7 42.8 42.9 42.10 42.11 42.12 42.13 42.14 42.15 42.16 42.17 42.18 42.19 42.20 42.21 42.22 42.23 42.24 42.25 42.26 42.27 42.28 42.29 42.30 42.31 42.32 42.33 42.34 42.35 43.1 43.2 43.3 43.4 43.5 43.6 43.7 43.8 43.9 43.10 43.11 43.12 43.13 43.14 43.15 43.16 43.17 43.18 43.19 43.20
43.21 43.22 43.23 43.24 43.25 43.26 43.27 43.28 43.29 43.30 43.31 43.32 43.33 43.34 43.35 44.1 44.2 44.3 44.4 44.5 44.6 44.7 44.8 44.9 44.10 44.11 44.12 44.13 44.14 44.15 44.16 44.17 44.18 44.19 44.20 44.21 44.22 44.23 44.24 44.25 44.26 44.27 44.28 44.29 44.30 44.31 44.32 44.33 44.34 44.35 44.36 45.1 45.2 45.3 45.4
45.5 45.6 45.7 45.8 45.9 45.10 45.11
45.12 45.13 45.14 45.15 45.16 45.17 45.18
45.19 45.20 45.21 45.22 45.23 45.24 45.25 45.26 45.27 45.28 45.29 45.30 45.31 45.32 46.1 46.2 46.3 46.4 46.5 46.6 46.7 46.8 46.9 46.10 46.11 46.12 46.13 46.14 46.15 46.16 46.17 46.18 46.19 46.20 46.21 46.22 46.23 46.24 46.25 46.26 46.27 46.28 46.29 46.30 46.31 46.32 46.33 46.34 46.35 46.36 47.1 47.2 47.3 47.4 47.5 47.6 47.7 47.8 47.9 47.10 47.11 47.12 47.13 47.14 47.15 47.16 47.17 47.18 47.19 47.20 47.21 47.22 47.23 47.24 47.25 47.26 47.27 47.28 47.29 47.30 47.31 47.32 47.33 47.34 47.35 47.36 48.1 48.2 48.3 48.4 48.5 48.6 48.7 48.8 48.9 48.10 48.11 48.12 48.13 48.14 48.15 48.16 48.17 48.18 48.19 48.20 48.21 48.22 48.23 48.24 48.25 48.26 48.27 48.28 48.29 48.30 48.31 48.32 48.33 48.34 48.35 48.36 49.1 49.2 49.3 49.4 49.5 49.6 49.7 49.8 49.9 49.10 49.11 49.12 49.13 49.14 49.15 49.16 49.17 49.18 49.19 49.20 49.21 49.22 49.23 49.24 49.25 49.26 49.27 49.28 49.29 49.30 49.31 49.32 49.33 49.34 49.35 49.36 50.1 50.2 50.3 50.4 50.5 50.6 50.7 50.8 50.9 50.10 50.11 50.12 50.13 50.14 50.15 50.16 50.17 50.18 50.19 50.20 50.21 50.22 50.23 50.24 50.25 50.26 50.27 50.28 50.29 50.30 50.31 50.32 50.33 50.34 50.35 50.36 51.1 51.2 51.3 51.4 51.5 51.6 51.7 51.8 51.9 51.10 51.11 51.12 51.13 51.14 51.15 51.16
51.17 51.18 51.19 51.20 51.21 51.22 51.23 51.24 51.25 51.26 51.27 51.28 51.29 51.30 51.31 51.32 51.33
52.1 52.2 52.3 52.4 52.5 52.6 52.7 52.8 52.9 52.10 52.11 52.12 52.13
52.14 52.15 52.16 52.17 52.18 52.19 52.20 52.21 52.22 52.23 52.24 52.25 52.26 52.27 52.28 52.29 52.30 52.31 52.32 52.33 52.34 53.1 53.2
53.3 53.4 53.5 53.6 53.7 53.8 53.9
53.10 53.11
53.12 53.13 53.14 53.15 53.16 53.17 53.18 53.19 53.20 53.21 53.22 53.23 53.24 53.25 53.26 53.27 53.28 53.29 53.30 53.31 53.32 53.33 53.34 54.1 54.2 54.3 54.4 54.5 54.6 54.7 54.8 54.9 54.10 54.11 54.12 54.13 54.14 54.15 54.16 54.17 54.18 54.19 54.20 54.21 54.22 54.23 54.24 54.25 54.26 54.27 54.28 54.29 54.30 54.31 54.32 54.33 54.34 54.35 54.36 55.1 55.2 55.3 55.4 55.5 55.6 55.7 55.8 55.9 55.10 55.11 55.12 55.13 55.14 55.15 55.16 55.17 55.18 55.19 55.20 55.21 55.22 55.23 55.24 55.25 55.26 55.27 55.28 55.29 55.30 55.31 55.32 55.33 55.34 55.35 56.1 56.2 56.3 56.4 56.5 56.6 56.7 56.8 56.9 56.10 56.11 56.12 56.13 56.14 56.15 56.16 56.17 56.18 56.19 56.20 56.21 56.22 56.23 56.24 56.25 56.26 56.27 56.28 56.29 56.30 56.31 56.32 56.33 56.34 56.35 56.36 57.1 57.2 57.3 57.4 57.5 57.6 57.7 57.8 57.9 57.10 57.11 57.12 57.13 57.14 57.15 57.16
57.17 57.18 57.19 57.20 57.21 57.22 57.23
57.24 57.25 57.26 57.27
57.28 57.29 57.30 57.31 57.32 57.33 58.1 58.2 58.3 58.4 58.5 58.6 58.7
58.8 58.9 58.10 58.11 58.12 58.13 58.14 58.15 58.16 58.17 58.18 58.19 58.20 58.21 58.22 58.23 58.24 58.25 58.26 58.27 58.28
58.29 58.30 58.31 58.32 58.33 59.1 59.2 59.3 59.4 59.5 59.6 59.7 59.8 59.9 59.10
59.11 59.12 59.13 59.14 59.15 59.16 59.17 59.18 59.19
59.20 59.21 59.22 59.23 59.24 59.25 59.26 59.27
59.28 59.29 59.30 59.31 59.32 59.33 60.1 60.2 60.3 60.4 60.5 60.6 60.7 60.8 60.9 60.10 60.11 60.12 60.13 60.14 60.15 60.16 60.17 60.18 60.19 60.20 60.21 60.22 60.23 60.24 60.25 60.26 60.27 60.28 60.29 60.30 60.31 60.32 60.33 60.34 60.35 60.36 60.37 60.38 60.39 60.40 60.41 60.42 61.1 61.2 61.3 61.4 61.5 61.6 61.7 61.8 61.9 61.10 61.11 61.12
61.13 61.14 61.15 61.16
61.17 61.18 61.19 61.20 61.21 61.22 61.23 61.24 61.25 61.26 61.27 61.28 61.29 61.30 61.31 61.32 61.33 61.34 62.1 62.2 62.3 62.4 62.5 62.6 62.7 62.8 62.9 62.10 62.11 62.12 62.13 62.14 62.15 62.16 62.17 62.18 62.19 62.20 62.21 62.22 62.23 62.24 62.25 62.26 62.27 62.28 62.29 62.30 62.31 62.32 62.33 62.34 62.35 62.36 63.1 63.2 63.3 63.4 63.5 63.6 63.7 63.8 63.9 63.10 63.11 63.12 63.13 63.14 63.15 63.16 63.17 63.18 63.19 63.20 63.21 63.22 63.23 63.24 63.25 63.26 63.27 63.28 63.29 63.30 63.31 63.32 63.33 63.34 63.35 63.36 64.1 64.2 64.3 64.4 64.5 64.6 64.7 64.8 64.9 64.10 64.11 64.12 64.13 64.14 64.15 64.16 64.17 64.18 64.19 64.20 64.21 64.22 64.23 64.24 64.25 64.26 64.27 64.28 64.29 64.30 64.31 64.32 64.33 64.34 64.35 64.36 65.1 65.2 65.3 65.4 65.5
65.6 65.7 65.8 65.9 65.10 65.11 65.12 65.13 65.14 65.15 65.16 65.17 65.18 65.19 65.20 65.21 65.22 65.23 65.24 65.25 65.26 65.27 65.28 65.29 65.30 65.31 65.32 65.33 65.34 65.35
66.1 66.2 66.3 66.4 66.5 66.6 66.7 66.8 66.9 66.10 66.11 66.12 66.13 66.14 66.15 66.16 66.17
66.18 66.19 66.20 66.21 66.22 66.23 66.24 66.25 66.26 66.27 66.28 66.29 66.30 66.31 66.32 66.33 66.34 66.35 67.1 67.2 67.3 67.4 67.5 67.6 67.7 67.8 67.9 67.10 67.11 67.12 67.13 67.14 67.15 67.16 67.17 67.18 67.19 67.20 67.21 67.22 67.23 67.24 67.25 67.26
67.27 67.28 67.29 67.30 67.31 67.32 67.33 67.34 67.35 68.1 68.2 68.3 68.4 68.5 68.6 68.7 68.8 68.9 68.10 68.11 68.12 68.13 68.14 68.15 68.16 68.17 68.18 68.19 68.20 68.21
68.22 68.23 68.24 68.25 68.26 68.27 68.28 68.29 68.30 68.31 68.32 68.33 69.1 69.2 69.3 69.4 69.5 69.6 69.7 69.8 69.9 69.10 69.11 69.12 69.13 69.14 69.15 69.16 69.17 69.18 69.19 69.20 69.21 69.22 69.23 69.24 69.25 69.26 69.27 69.28 69.29 69.30 69.31 69.32 69.33 69.34 69.35 70.1 70.2 70.3 70.4 70.5 70.6 70.7
70.8 70.9 70.10 70.11 70.12 70.13 70.14 70.15 70.16 70.17 70.18 70.19 70.20 70.21 70.22 70.23 70.24 70.25 70.26 70.27 70.28 70.29 70.30 70.31 70.32
70.33 71.1 71.2 71.3 71.4 71.5 71.6 71.7 71.8 71.9 71.10 71.11 71.12 71.13 71.14 71.15 71.16
71.17 71.18 71.19 71.20 71.21 71.22 71.23 71.24 71.25 71.26 71.27 71.28 71.29 71.30 71.31 71.32
71.33 72.1 72.2 72.3 72.4 72.5 72.6 72.7 72.8 72.9 72.10 72.11 72.12 72.13
72.14 72.15 72.16 72.17 72.18 72.19 72.20 72.21 72.22 72.23 72.24
72.25 72.26 72.27 72.28 72.29 72.30 72.31 72.32 72.33 72.34 73.1 73.2
73.3 73.4
73.5 73.6 73.7 73.8 73.9
73.10 73.11 73.12 73.13 73.14 73.15
73.16 73.17 73.18 73.19 73.20 73.21
73.22 73.23 73.24 73.25 73.26 73.27 73.28 73.29 73.30 73.31 74.1 74.2 74.3 74.4 74.5 74.6 74.7 74.8 74.9 74.10 74.11 74.12 74.13
74.14 74.15 74.16 74.17 74.18 74.19 74.20 74.21 74.22 74.23 74.24 74.25 74.26 74.27 74.28 74.29 74.30 74.31 74.32 74.33 74.34 75.1 75.2 75.3 75.4 75.5 75.6
75.7
75.8 75.9 75.10 75.11 75.12 75.13 75.14 75.15 75.16 75.17 75.18 75.19 75.20 75.21 75.22 75.23 75.24 75.25 75.26 75.27 75.28 75.29 75.30 75.31 75.32 75.33 75.34 75.35 76.1 76.2 76.3 76.4 76.5 76.6 76.7 76.8 76.9 76.10 76.11 76.12 76.13 76.14 76.15 76.16 76.17 76.18 76.19 76.20 76.21 76.22 76.23 76.24 76.25 76.26 76.27 76.28 76.29 76.30 76.31 76.32 76.33 76.34 76.35 76.36 77.1 77.2 77.3 77.4
77.5 77.6 77.7 77.8 77.9 77.10 77.11 77.12 77.13 77.14 77.15 77.16 77.17 77.18 77.19 77.20 77.21 77.22 77.23 77.24 77.25 77.26 77.27 77.28 77.29 77.30 77.31 77.32 77.33 77.34 77.35 78.1 78.2 78.3 78.4 78.5 78.6 78.7 78.8 78.9 78.10 78.11 78.12 78.13 78.14 78.15 78.16 78.17 78.18 78.19 78.20 78.21 78.22 78.23 78.24 78.25 78.26 78.27 78.28 78.29 78.30 78.31 78.32 78.33 78.34 78.35 79.1 79.2 79.3 79.4 79.5 79.6 79.7 79.8 79.9 79.10 79.11 79.12 79.13 79.14 79.15 79.16 79.17 79.18 79.19 79.20 79.21 79.22 79.23 79.24 79.25 79.26 79.27 79.28 79.29 79.30 79.31 79.32 79.33 79.34 79.35 79.36 80.1 80.2 80.3 80.4 80.5 80.6 80.7 80.8 80.9 80.10 80.11
80.12 80.13 80.14 80.15 80.16 80.17 80.18 80.19 80.20 80.21 80.22 80.23
80.24 80.25 80.26 80.27 80.28 80.29 80.30 80.31 80.32 80.33 80.34 81.1 81.2 81.3 81.4 81.5 81.6 81.7 81.8 81.9
81.10
81.11 81.12 81.13 81.14 81.15 81.16 81.17
81.18 81.19 81.20 81.21 81.22 81.23 81.24 81.25 81.26 81.27 81.28 81.29 81.30 81.31 81.32 81.33 81.34 82.1 82.2 82.3 82.4 82.5 82.6 82.7 82.8 82.9 82.10 82.11 82.12 82.13 82.14 82.15 82.16 82.17 82.18 82.19 82.20 82.21 82.22 82.23 82.24 82.25 82.26
82.27 82.28 82.29 82.30 82.31 82.32 82.33 82.34 82.35 83.1 83.2 83.3 83.4 83.5 83.6 83.7 83.8 83.9 83.10 83.11 83.12 83.13 83.14 83.15 83.16 83.17 83.18 83.19 83.20 83.21 83.22 83.23 83.24 83.25 83.26 83.27 83.28 83.29 83.30 83.31 83.32 83.33 83.34 83.35 83.36 84.1 84.2 84.3 84.4 84.5
84.6 84.7 84.8 84.9 84.10 84.11 84.12 84.13 84.14 84.15 84.16 84.17 84.18 84.19 84.20 84.21 84.22 84.23 84.24 84.25 84.26 84.27 84.28 84.29 84.30 84.31 84.32 84.33 84.34 84.35 85.1 85.2 85.3 85.4 85.5 85.6 85.7 85.8 85.9 85.10 85.11 85.12 85.13 85.14 85.15 85.16 85.17 85.18 85.19 85.20 85.21 85.22 85.23 85.24 85.25 85.26 85.27 85.28 85.29 85.30 85.31
85.32 85.33 85.34 85.35 86.1 86.2 86.3 86.4 86.5 86.6 86.7 86.8 86.9 86.10 86.11 86.12 86.13 86.14 86.15 86.16 86.17 86.18 86.19 86.20 86.21 86.22 86.23 86.24 86.25
86.26 86.27 86.28 86.29 86.30 86.31 86.32 86.33 86.34 87.1 87.2 87.3 87.4 87.5 87.6 87.7 87.8 87.9 87.10 87.11 87.12 87.13 87.14 87.15 87.16 87.17
87.18 87.19 87.20 87.21 87.22 87.23 87.24 87.25 87.26 87.27 87.28 87.29 87.30 87.31 87.32 87.33 87.34 88.1 88.2 88.3 88.4 88.5 88.6 88.7 88.8 88.9 88.10 88.11 88.12 88.13 88.14 88.15 88.16 88.17 88.18 88.19 88.20 88.21 88.22 88.23 88.24 88.25 88.26 88.27 88.28 88.29 88.30 88.31 88.32 88.33 88.34 88.35 88.36 89.1 89.2 89.3 89.4 89.5 89.6 89.7 89.8 89.9 89.10 89.11 89.12 89.13 89.14 89.15 89.16 89.17 89.18 89.19 89.20 89.21 89.22 89.23 89.24 89.25 89.26 89.27 89.28 89.29 89.30 89.31 89.32 89.33 89.34 89.35 89.36 90.1 90.2 90.3 90.4 90.5 90.6 90.7 90.8 90.9 90.10 90.11 90.12 90.13 90.14 90.15 90.16 90.17 90.18 90.19 90.20 90.21 90.22 90.23 90.24 90.25 90.26 90.27 90.28 90.29 90.30 90.31 90.32 90.33 90.34 90.35 90.36 91.1 91.2 91.3 91.4 91.5 91.6 91.7 91.8 91.9 91.10 91.11 91.12 91.13 91.14 91.15 91.16 91.17 91.18 91.19 91.20 91.21 91.22 91.23
91.24
91.25 91.26 91.27 91.28 91.29 91.30 91.31 91.32 91.33 91.34 92.1 92.2 92.3 92.4 92.5 92.6 92.7 92.8 92.9 92.10 92.11 92.12
92.13
92.14 92.15 92.16 92.17 92.18 92.19 92.20 92.21 92.22
92.23 92.24 92.25 92.26 92.27 92.28 92.29 92.30 92.31 92.32 92.33 92.34 93.1 93.2 93.3 93.4 93.5 93.6 93.7 93.8 93.9 93.10 93.11 93.12 93.13 93.14 93.15 93.16 93.17 93.18 93.19 93.20 93.21 93.22 93.23 93.24 93.25 93.26 93.27 93.28 93.29 93.30 93.31 93.32 93.33
93.34 94.1 94.2 94.3 94.4 94.5 94.6
94.7 94.8 94.9 94.10 94.11 94.12 94.13 94.14 94.15 94.16 94.17 94.18 94.19 94.20 94.21 94.22 94.23 94.24 94.25 94.26 94.27 94.28 94.29 94.30 94.31 94.32 94.33 94.34 94.35 95.1 95.2 95.3 95.4 95.5 95.6
95.7 95.8 95.9 95.10 95.11 95.12 95.13 95.14
95.15 95.16 95.17 95.18 95.19 95.20 95.21 95.22 95.23 95.24 95.25 95.26 95.27 95.28 95.29 95.30 95.31 95.32 95.33 96.1 96.2 96.3 96.4 96.5 96.6 96.7 96.8 96.9 96.10 96.11 96.12 96.13 96.14 96.15 96.16 96.17 96.18 96.19 96.20 96.21 96.22 96.23 96.24 96.25 96.26 96.27 96.28 96.29 96.30 96.31 96.32 96.33 96.34 96.35 96.36 97.1 97.2 97.3 97.4 97.5 97.6 97.7 97.8 97.9 97.10 97.11 97.12 97.13 97.14
97.15 97.16 97.17 97.18 97.19 97.20 97.21 97.22 97.23 97.24 97.25 97.26 97.27 97.28 97.29 97.30 97.31 97.32 97.33 97.34 97.35 98.1 98.2 98.3 98.4 98.5 98.6 98.7 98.8 98.9 98.10 98.11 98.12 98.13 98.14 98.15 98.16 98.17 98.18 98.19 98.20 98.21 98.22 98.23 98.24 98.25 98.26 98.27 98.28 98.29 98.30 98.31 98.32 98.33 98.34 98.35 98.36 99.1 99.2 99.3 99.4 99.5 99.6 99.7 99.8 99.9 99.10 99.11 99.12 99.13 99.14 99.15 99.16 99.17 99.18 99.19 99.20 99.21 99.22
99.23 99.24 99.25 99.26 99.27 99.28 99.29 99.30 99.31 99.32 99.33 99.34 99.35 100.1 100.2 100.3 100.4 100.5 100.6
100.7 100.8 100.9 100.10 100.11 100.12 100.13 100.14 100.15 100.16 100.17 100.18 100.19 100.20 100.21 100.22 100.23 100.24 100.25 100.26 100.27 100.28 100.29 100.30 100.31
100.32 100.33 100.34 101.1 101.2 101.3 101.4 101.5 101.6 101.7 101.8 101.9 101.10 101.11 101.12 101.13 101.14 101.15 101.16 101.17 101.18 101.19 101.20 101.21 101.22 101.23 101.24 101.25 101.26 101.27 101.28 101.29
101.30
101.31 101.32 101.33 101.34 101.35 102.1 102.2 102.3
102.4 102.5 102.6 102.7 102.8 102.9 102.10 102.11 102.12 102.13 102.14 102.15 102.16 102.17 102.18 102.19 102.20 102.21 102.22 102.23 102.24 102.25 102.26 102.27 102.28 102.29 102.30 102.31 102.32 102.33 102.34 102.35 103.1 103.2 103.3 103.4 103.5
103.6 103.7 103.8 103.9 103.10 103.11 103.12 103.13 103.14 103.15 103.16 103.17 103.18 103.19 103.20 103.21 103.22 103.23 103.24 103.25 103.26 103.27 103.28 103.29 103.30 103.31 103.32 103.33 103.34 104.1 104.2 104.3 104.4 104.5 104.6 104.7 104.8
104.9 104.10 104.11 104.12 104.13 104.14 104.15 104.16 104.17 104.18 104.19 104.20
104.21 104.22 104.23 104.24 104.25 104.26 104.27 104.28 104.29 104.30 104.31 104.32 104.33 104.34 105.1 105.2 105.3 105.4 105.5 105.6 105.7 105.8
105.9 105.10 105.11 105.12 105.13 105.14 105.15 105.16 105.17 105.18 105.19 105.20
105.21
105.22 105.23 105.24 105.25 105.26 105.27
105.28 105.29 105.30 105.31 105.32 105.33 106.1 106.2 106.3 106.4 106.5 106.6 106.7 106.8 106.9 106.10 106.11 106.12 106.13 106.14 106.15 106.16 106.17 106.18 106.19 106.20 106.21 106.22 106.23 106.24 106.25 106.26 106.27 106.28 106.29 106.30 106.31 106.32 106.33 106.34 106.35 106.36 107.1 107.2 107.3 107.4
107.5 107.6 107.7 107.8 107.9 107.10 107.11 107.12 107.13 107.14 107.15 107.16 107.17 107.18 107.19 107.20 107.21 107.22 107.23 107.24 107.25 107.26 107.27 107.28 107.29 107.30 107.31 107.32 107.33 107.34 107.35 108.1 108.2 108.3 108.4 108.5 108.6 108.7 108.8 108.9 108.10 108.11 108.12 108.13 108.14 108.15 108.16 108.17 108.18 108.19 108.20 108.21 108.22 108.23 108.24 108.25 108.26 108.27 108.28 108.29 108.30 108.31 108.32 108.33 108.34 108.35 108.36 109.1 109.2 109.3 109.4 109.5 109.6 109.7 109.8 109.9 109.10 109.11 109.12 109.13 109.14 109.15 109.16 109.17 109.18 109.19 109.20 109.21 109.22 109.23 109.24 109.25 109.26 109.27 109.28 109.29 109.30
109.31 109.32 109.33 109.34 109.35 110.1 110.2 110.3 110.4 110.5 110.6 110.7 110.8 110.9 110.10 110.11 110.12 110.13 110.14 110.15 110.16 110.17 110.18 110.19 110.20 110.21 110.22 110.23 110.24 110.25 110.26 110.27 110.28 110.29 110.30 110.31 110.32 110.33 110.34 110.35 111.1 111.2 111.3 111.4 111.5 111.6 111.7 111.8 111.9 111.10 111.11 111.12 111.13 111.14 111.15 111.16 111.17
111.18
111.19 111.20 111.21 111.22 111.23 111.24 111.25 111.26 111.27 111.28 111.29 111.30
111.31 111.32 111.33 111.34 112.1 112.2 112.3 112.4
112.5 112.6 112.7 112.8
112.9 112.10 112.11 112.12 112.13 112.14 112.15 112.16 112.17 112.18 112.19 112.20 112.21 112.22 112.23 112.24 112.25 112.26 112.27 112.28 112.29 112.30 112.31 112.32 112.33 112.34 113.1 113.2 113.3 113.4 113.5 113.6 113.7 113.8 113.9 113.10 113.11 113.12 113.13 113.14 113.15 113.16 113.17 113.18 113.19 113.20 113.21 113.22 113.23 113.24 113.25 113.26 113.27 113.28 113.29 113.30 113.31
113.32
113.33 113.34 113.35 114.1 114.2 114.3 114.4
114.5 114.6 114.7 114.8
114.9 114.10
114.11 114.12 114.13 114.14 114.15 114.16 114.17 114.18 114.19 114.20 114.21 114.22 114.23 114.24 114.25 114.26 114.27 114.28 114.29 114.30 114.31 114.32 114.33 114.34 115.1 115.2 115.3 115.4 115.5 115.6 115.7 115.8 115.9 115.10 115.11 115.12 115.13 115.14 115.15 115.16 115.17 115.18 115.19 115.20 115.21 115.22 115.23 115.24 115.25 115.26 115.27 115.28 115.29 115.30 115.31 115.32 115.33 115.34 115.35 115.36 116.1 116.2 116.3 116.4 116.5 116.6 116.7 116.8 116.9 116.10 116.11 116.12 116.13 116.14 116.15 116.16 116.17 116.18 116.19 116.20 116.21 116.22 116.23 116.24 116.25 116.26 116.27 116.28 116.29 116.30 116.31
116.32 116.33 116.34 116.35 117.1 117.2 117.3 117.4 117.5 117.6 117.7 117.8 117.9 117.10 117.11 117.12 117.13 117.14 117.15 117.16 117.17 117.18
117.19
117.20 117.21 117.22 117.23 117.24 117.25 117.26 117.27 117.28 117.29 117.30 117.31 117.32 117.33 117.34 117.35 118.1 118.2 118.3 118.4 118.5 118.6 118.7 118.8 118.9 118.10 118.11 118.12 118.13 118.14 118.15 118.16 118.17 118.18 118.19 118.20 118.21 118.22 118.23 118.24
118.25 118.26 118.27 118.28 118.29 118.30 118.31 118.32
118.33 118.34 119.1 119.2
119.3 119.4 119.5 119.6 119.7 119.8 119.9 119.10 119.11 119.12 119.13 119.14 119.15 119.16 119.17 119.18 119.19 119.20 119.21 119.22 119.23 119.24 119.25 119.26 119.27 119.28 119.29 119.30 119.31 119.32 119.33 119.34 119.35 120.1 120.2 120.3 120.4 120.5 120.6 120.7 120.8 120.9 120.10
120.11 120.12 120.13 120.14 120.15 120.16 120.17 120.18 120.19 120.20 120.21 120.22 120.23 120.24 120.25 120.26 120.27 120.28 120.29 120.30 120.31
120.32 120.33 121.1 121.2 121.3
121.4 121.5 121.6 121.7 121.8 121.9 121.10 121.11
121.12 121.13 121.14 121.15 121.16 121.17 121.18 121.19 121.20 121.21 121.22 121.23 121.24 121.25 121.26 121.27 121.28 121.29
121.30 121.31 121.32 121.33 122.1 122.2 122.3 122.4 122.5 122.6 122.7 122.8 122.9 122.10 122.11 122.12 122.13 122.14 122.15 122.16 122.17 122.18 122.19 122.20 122.21 122.22 122.23
122.24 122.25 122.26 122.27 122.28 122.29 122.30 122.31 122.32 122.33 122.34 122.35 123.1 123.2 123.3 123.4 123.5 123.6 123.7 123.8 123.9 123.10 123.11 123.12 123.13 123.14
123.15 123.16 123.17 123.18 123.19 123.20 123.21 123.22 123.23 123.24 123.25 123.26 123.27 123.28 123.29 123.30 123.31 123.32 123.33 123.34
124.1 124.2 124.3 124.4 124.5 124.6 124.7 124.8 124.9
124.10 124.11 124.12 124.13 124.14 124.15 124.16 124.17
124.18 124.19 124.20 124.21 124.22 124.23 124.24 124.25
124.26 124.27 124.28 124.29 124.30 124.31 124.32 125.1 125.2 125.3 125.4 125.5
125.6 125.7 125.8 125.9 125.10 125.11 125.12 125.13 125.14 125.15 125.16 125.17 125.18 125.19 125.20 125.21 125.22 125.23 125.24 125.25 125.26 125.27 125.28 125.29 125.30 125.31 125.32
125.33 125.34 126.1 126.2 126.3 126.4
126.5 126.6 126.7 126.8 126.9 126.10 126.11 126.12 126.13 126.14 126.15 126.16 126.17
126.18 126.19 126.20 126.21 126.22 126.23 126.24 126.25 126.26 126.27 126.28 126.29 126.30 126.31 126.32 126.33 126.34 127.1 127.2 127.3 127.4 127.5 127.6 127.7
127.8 127.9 127.10 127.11 127.12 127.13 127.14 127.15 127.16 127.17 127.18 127.19 127.20 127.21 127.22 127.23 127.24 127.25 127.26 127.27
127.28 127.29 127.30 127.31 127.32 128.1 128.2 128.3 128.4 128.5 128.6 128.7 128.8 128.9 128.10 128.11 128.12 128.13 128.14 128.15 128.16 128.17 128.18 128.19 128.20
128.21 128.22 128.23 128.24 128.25 128.26 128.27 128.28 128.29
128.30 128.31 128.32 128.33 128.34 129.1 129.2 129.3 129.4 129.5
129.6 129.7 129.8 129.9 129.10 129.11 129.12 129.13 129.14 129.15 129.16 129.17 129.18 129.19 129.20 129.21 129.22 129.23 129.24 129.25 129.26 129.27 129.28 129.29 129.30 129.31 129.32 129.33 129.34 129.35 130.1 130.2 130.3 130.4 130.5 130.6 130.7 130.8 130.9 130.10 130.11 130.12 130.13 130.14 130.15 130.16 130.17 130.18 130.19 130.20 130.21 130.22 130.23 130.24 130.25 130.26 130.27 130.28 130.29 130.30 130.31 130.32 130.33 130.34 130.35 130.36 131.1 131.2 131.3 131.4 131.5 131.6 131.7 131.8 131.9 131.10 131.11 131.12 131.13 131.14 131.15 131.16 131.17 131.18 131.19 131.20 131.21 131.22 131.23 131.24 131.25 131.26 131.27 131.28 131.29 131.30 131.31 131.32 131.33 131.34 131.35 131.36 132.1 132.2 132.3 132.4 132.5 132.6 132.7 132.8 132.9 132.10 132.11 132.12 132.13 132.14 132.15 132.16 132.17 132.18 132.19 132.20 132.21 132.22 132.23 132.24 132.25 132.26 132.27 132.28 132.29 132.30 132.31 132.32 132.33 132.34
132.35 133.1 133.2 133.3 133.4 133.5 133.6 133.7 133.8 133.9 133.10 133.11 133.12 133.13 133.14 133.15 133.16 133.17 133.18 133.19 133.20 133.21 133.22 133.23 133.24 133.25 133.26 133.27 133.28 133.29 133.30 133.31 133.32 133.33 133.34 133.35 134.1 134.2 134.3 134.4 134.5
134.6 134.7 134.8 134.9 134.10 134.11 134.12 134.13 134.14 134.15 134.16 134.17 134.18 134.19 134.20 134.21 134.22 134.23 134.24 134.25 134.26 134.27 134.28 134.29 134.30 134.31 134.32 134.33
135.1 135.2 135.3 135.4 135.5 135.6 135.7 135.8 135.9 135.10 135.11 135.12 135.13 135.14 135.15 135.16 135.17 135.18 135.19 135.20 135.21 135.22 135.23 135.24 135.25 135.26 135.27 135.28 135.29 135.30 135.31 135.32 135.33 135.34 135.35 135.36 136.1 136.2 136.3 136.4 136.5 136.6 136.7 136.8 136.9 136.10 136.11 136.12 136.13 136.14 136.15 136.16 136.17 136.18 136.19 136.20 136.21 136.22 136.23 136.24 136.25 136.26 136.27 136.28 136.29 136.30 136.31 136.32 136.33 136.34 136.35 136.36 137.1 137.2 137.3 137.4 137.5 137.6
137.7 137.8 137.9 137.10 137.11 137.12 137.13 137.14 137.15 137.16 137.17 137.18 137.19 137.20 137.21 137.22 137.23 137.24 137.25 137.26 137.27 137.28 137.29 137.30 137.31 137.32 137.33 137.34 138.1 138.2 138.3
138.4 138.5 138.6 138.7 138.8 138.9
138.10 138.11
138.12 138.13 138.14 138.15 138.16 138.17 138.18 138.19
138.20
138.21 138.22
138.23 138.24 138.25 138.26 138.27 138.28 138.29 138.30 138.31 139.1 139.2 139.3 139.4 139.5
139.6 139.7 139.8 139.9 139.10 139.11 139.12 139.13
139.14 139.15 139.16 139.17 139.18 139.19 139.20 139.21 139.22 139.23 139.24 139.25 139.26 139.27 139.28 139.29
139.30 139.31 139.32 139.33 140.1 140.2
140.3 140.4 140.5 140.6 140.7 140.8 140.9 140.10 140.11 140.12 140.13 140.14 140.15 140.16 140.17 140.18 140.19 140.20 140.21 140.22 140.23
140.24 140.25 140.26 140.27 140.28 140.29 140.30 140.31 140.32 140.33 140.34 141.1 141.2 141.3 141.4 141.5 141.6 141.7 141.8 141.9 141.10 141.11
141.12
141.13 141.14 141.15 141.16 141.17 141.18 141.19 141.20 141.21 141.22 141.23 141.24 141.25
141.26 141.27 141.28 141.29 141.30 141.31 141.32 141.33 142.1 142.2 142.3 142.4 142.5 142.6 142.7 142.8 142.9 142.10 142.11 142.12 142.13 142.14 142.15 142.16 142.17 142.18 142.19 142.20 142.21 142.22 142.23 142.24
142.25 142.26 142.27 142.28 142.29
142.30 142.31 142.32 142.33 142.34 143.1 143.2 143.3 143.4 143.5 143.6 143.7 143.8 143.9 143.10
143.11 143.12
143.13 143.14 143.15 143.16 143.17 143.18 143.19 143.20 143.21 143.22 143.23 143.24 143.25 143.26
143.27 143.28 143.29 143.30 143.31 143.32 143.33 143.34 144.1 144.2 144.3 144.4 144.5 144.6 144.7 144.8 144.9 144.10 144.11 144.12 144.13 144.14 144.15 144.16 144.17 144.18 144.19 144.20 144.21 144.22 144.23 144.24 144.25 144.26 144.27 144.28 144.29 144.30 144.31 144.32 144.33 144.34 144.35 144.36 145.1 145.2 145.3 145.4 145.5 145.6 145.7 145.8 145.9 145.10 145.11 145.12 145.13 145.14 145.15 145.16 145.17 145.18 145.19 145.20 145.21 145.22 145.23 145.24 145.25 145.26 145.27 145.28 145.29 145.30 145.31 145.32 145.33 145.34 145.35 145.36 146.1 146.2 146.3 146.4 146.5 146.6 146.7
146.8 146.9 146.10 146.11 146.12 146.13 146.14 146.15 146.16 146.17 146.18 146.19 146.20 146.21 146.22 146.23 146.24 146.25 146.26 146.27 146.28 146.29 146.30 146.31 146.32 146.33 146.34 147.1 147.2 147.3 147.4 147.5 147.6
147.7 147.8 147.9 147.10 147.11 147.12 147.13 147.14 147.15 147.16 147.17 147.18 147.19 147.20 147.21 147.22 147.23 147.24 147.25 147.26 147.27 147.28 147.29 147.30 147.31 147.32 147.33 147.34 147.35 148.1 148.2 148.3 148.4 148.5 148.6 148.7 148.8 148.9 148.10 148.11 148.12 148.13 148.14 148.15 148.16 148.17 148.18 148.19 148.20 148.21 148.22 148.23 148.24 148.25 148.26 148.27 148.28 148.29 148.30 148.31 148.32 148.33 148.34 148.35 148.36 149.1 149.2 149.3 149.4 149.5 149.6 149.7 149.8 149.9 149.10 149.11 149.12 149.13 149.14 149.15 149.16 149.17 149.18 149.19 149.20 149.21 149.22 149.23 149.24 149.25 149.26 149.27 149.28 149.29 149.30 149.31 149.32 149.33 149.34 149.35
150.1
150.2 150.3 150.4 150.5 150.6 150.7 150.8 150.9 150.10 150.11 150.12 150.13 150.14 150.15 150.16 150.17 150.18 150.19 150.20 150.21 150.22 150.23 150.24 150.25 150.26 150.27 150.28 150.29 150.30 150.31 150.32 150.33 150.34 151.1 151.2 151.3 151.4 151.5 151.6 151.7 151.8 151.9 151.10 151.11 151.12 151.13 151.14 151.15 151.16 151.17 151.18 151.19 151.20 151.21 151.22 151.23 151.24 151.25 151.26 151.27 151.28 151.29 151.30 151.31 151.32 151.33 151.34 151.35 152.1 152.2 152.3
152.4 152.5 152.6 152.7 152.8 152.9 152.10 152.11 152.12 152.13 152.14 152.15 152.16 152.17 152.18 152.19 152.20 152.21 152.22 152.23 152.24 152.25 152.26 152.27 152.28 152.29 152.30
152.31 152.32 152.33 152.34 153.1 153.2 153.3 153.4 153.5 153.6 153.7 153.8 153.9 153.10 153.11
153.12 153.13 153.14 153.15 153.16 153.17 153.18 153.19 153.20 153.21 153.22 153.23 153.24 153.25 153.26 153.27 153.28
153.29 153.30 153.31 153.32 153.33
154.1 154.2 154.3 154.4 154.5 154.6 154.7 154.8 154.9 154.10 154.11 154.12 154.13 154.14 154.15 154.16 154.17 154.18 154.19 154.20 154.21 154.22 154.23 154.24
154.25 154.26 154.27 154.28 154.29 154.30 154.31 154.32 154.33 155.1 155.2 155.3
155.4 155.5 155.6 155.7 155.8 155.9 155.10 155.11 155.12 155.13 155.14 155.15 155.16 155.17 155.18 155.19 155.20 155.21 155.22 155.23 155.24 155.25 155.26 155.27 155.28 155.29 155.30 155.31 155.32 155.33 155.34 155.35 156.1 156.2 156.3 156.4 156.5 156.6 156.7 156.8 156.9 156.10 156.11 156.12 156.13 156.14
156.15 156.16 156.17 156.18 156.19 156.20 156.21 156.22 156.23 156.24 156.25 156.26 156.27 156.28 156.29 156.30 156.31 156.32 156.33 156.34 156.35 157.1 157.2 157.3 157.4 157.5 157.6 157.7 157.8 157.9 157.10 157.11
157.12
157.13 157.14 157.15 157.16 157.17 157.18 157.19 157.20 157.21 157.22 157.23 157.24 157.25 157.26 157.27 157.28 157.29 157.30 157.31 157.32 157.33 158.1 158.2 158.3 158.4 158.5 158.6 158.7 158.8 158.9 158.10 158.11 158.12 158.13 158.14 158.15 158.16 158.17 158.18 158.19 158.20 158.21 158.22 158.23 158.24 158.25 158.26 158.27 158.28 158.29 158.30 158.31 158.32 158.33 158.34 158.35 158.36 159.1 159.2 159.3 159.4 159.5 159.6 159.7 159.8 159.9 159.10 159.11 159.12 159.13 159.14 159.15 159.16 159.17 159.18 159.19 159.20 159.21 159.22 159.23 159.24 159.25 159.26 159.27 159.28 159.29 159.30 159.31 159.32 159.33 159.34 159.35 160.1 160.2 160.3 160.4 160.5 160.6 160.7 160.8 160.9 160.10 160.11 160.12 160.13 160.14 160.15 160.16 160.17 160.18 160.19
160.20 160.21 160.22 160.23 160.24
160.25 160.26 160.27 160.28 160.29 160.30 160.31 160.32 160.33 160.34 161.1 161.2 161.3 161.4 161.5 161.6 161.7 161.8 161.9 161.10 161.11 161.12 161.13 161.14 161.15 161.16 161.17 161.18 161.19 161.20 161.21 161.22 161.23 161.24 161.25 161.26 161.27 161.28 161.29 161.30 161.31 161.32 161.33 161.34 161.35 161.36 162.1 162.2 162.3 162.4 162.5 162.6 162.7 162.8 162.9 162.10 162.11 162.12 162.13 162.14 162.15 162.16 162.17 162.18 162.19 162.20 162.21 162.22 162.23 162.24 162.25 162.26 162.27 162.28 162.29 162.30 162.31 162.32 162.33 162.34 162.35 163.1 163.2 163.3 163.4 163.5 163.6 163.7 163.8 163.9 163.10 163.11 163.12 163.13 163.14 163.15 163.16 163.17 163.18 163.19 163.20 163.21 163.22 163.23 163.24 163.25 163.26 163.27 163.28 163.29 163.30 163.31 163.32 163.33 163.34 163.35 163.36 164.1 164.2 164.3 164.4 164.5 164.6 164.7 164.8 164.9
164.10
164.11 164.12 164.13 164.14 164.15 164.16 164.17 164.18 164.19 164.20 164.21 164.22 164.23 164.24 164.25 164.26 164.27 164.28 164.29 164.30 164.31 164.32 164.33 164.34 165.1 165.2 165.3 165.4 165.5 165.6 165.7 165.8 165.9 165.10 165.11 165.12 165.13 165.14 165.15 165.16 165.17 165.18 165.19 165.20 165.21 165.22 165.23 165.24 165.25 165.26 165.27 165.28 165.29 165.30 165.31 165.32 165.33 165.34 165.35 166.1 166.2 166.3 166.4 166.5 166.6 166.7 166.8 166.9 166.10 166.11 166.12 166.13 166.14 166.15 166.16 166.17 166.18 166.19 166.20 166.21 166.22 166.23 166.24 166.25 166.26 166.27 166.28 166.29 166.30 166.31 166.32 166.33 166.34 166.35 166.36 167.1 167.2 167.3 167.4 167.5 167.6 167.7 167.8 167.9 167.10 167.11 167.12 167.13 167.14 167.15 167.16 167.17 167.18 167.19 167.20 167.21 167.22 167.23 167.24 167.25 167.26 167.27 167.28 167.29 167.30 167.31 167.32 167.33 167.34 168.1 168.2 168.3 168.4 168.5 168.6 168.7 168.8 168.9 168.10 168.11 168.12 168.13 168.14 168.15 168.16 168.17 168.18 168.19 168.20 168.21 168.22 168.23
168.24 168.25
168.26 168.27 168.28
168.29 168.30 168.31 168.32 168.33 169.1 169.2 169.3 169.4 169.5 169.6 169.7 169.8 169.9
169.10 169.11
169.12 169.13 169.14 169.15 169.16 169.17 169.18 169.19 169.20 169.21 169.22 169.23 169.24 169.25 169.26 169.27 169.28 169.29 169.30 169.31
169.32
169.33 170.1 170.2 170.3 170.4 170.5 170.6 170.7 170.8 170.9 170.10 170.11 170.12 170.13 170.14 170.15 170.16 170.17 170.18 170.19
170.20
170.21 170.22 170.23 170.24 170.25 170.26 170.27 170.28 170.29 170.30 170.31 170.32 170.33 170.34 170.35 171.1 171.2 171.3 171.4 171.5 171.6 171.7 171.8 171.9 171.10 171.11 171.12 171.13 171.14 171.15 171.16 171.17 171.18
171.19
171.20 171.21 171.22 171.23 171.24 171.25 171.26
171.27
171.28 171.29 171.30 171.31 171.32 171.33 172.1 172.2 172.3 172.4 172.5 172.6 172.7
172.8 172.9 172.10 172.11 172.12 172.13 172.14
172.15 172.16 172.17 172.18 172.19 172.20 172.21 172.22 172.23 172.24 172.25 172.26 172.27 172.28 172.29 172.30
172.31 173.1 173.2 173.3 173.4 173.5 173.6 173.7 173.8 173.9 173.10 173.11 173.12 173.13 173.14 173.15 173.16
173.17 173.18
173.19 173.20 173.21 173.22 173.23 173.24 173.25 173.26 173.27 173.28 173.29 173.30 173.31 173.32 173.33 173.34 173.35 174.1 174.2 174.3 174.4 174.5 174.6 174.7 174.8 174.9 174.10 174.11 174.12 174.13 174.14 174.15 174.16 174.17
174.18 174.19
174.20 174.21 174.22 174.23 174.24
174.25 174.26 174.27 174.28 174.29 174.30 174.31 174.32 174.33 174.34 175.1 175.2 175.3 175.4 175.5 175.6 175.7 175.8 175.9 175.10 175.11 175.12
175.13 175.14 175.15 175.16 175.17 175.18 175.19 175.20 175.21 175.22
175.23 175.24 175.25 175.26 175.27 175.28 175.29 175.30 175.31 175.32 175.33 175.34 176.1 176.2 176.3 176.4
176.5 176.6 176.7
176.8 176.9 176.10 176.11 176.12 176.13 176.14 176.15 176.16 176.17 176.18 176.19 176.20 176.21 176.22 176.23 176.24 176.25 176.26 176.27 176.28 176.29 176.30 176.31 176.32 176.33 176.34 176.35 177.1 177.2 177.3 177.4 177.5 177.6
177.7 177.8
177.9 177.10 177.11 177.12 177.13 177.14
177.15
177.16 177.17 177.18 177.19 177.20 177.21 177.22 177.23 177.24 177.25 177.26 177.27
177.28 177.29
177.30 177.31 177.32 178.1 178.2
178.3 178.4 178.5 178.6 178.7 178.8 178.9 178.10 178.11 178.12
178.13 178.14 178.15 178.16 178.17 178.18 178.19 178.20 178.21 178.22 178.23 178.24 178.25 178.26 178.27 178.28 178.29 178.30 178.31 178.32 178.33 178.34
179.1
179.2 179.3 179.4 179.5 179.6 179.7
179.8 179.9 179.10 179.11 179.12 179.13 179.14
179.15 179.16 179.17 179.18 179.19 179.20 179.21 179.22
179.23 179.24
179.25 179.26 179.27 179.28 179.29 179.30 179.31 180.1 180.2 180.3 180.4 180.5 180.6 180.7 180.8 180.9
180.10 180.11 180.12 180.13 180.14 180.15 180.16 180.17 180.18 180.19 180.20 180.21 180.22 180.23 180.24 180.25 180.26 180.27 180.28 180.29 180.30 180.31 180.32 180.33 180.34 181.1 181.2
181.3 181.4 181.5 181.6 181.7 181.8 181.9 181.10 181.11 181.12 181.13 181.14 181.15
181.16 181.17 181.18 181.19 181.20 181.21 181.22 181.23 181.24 181.25 181.26 181.27 181.28 181.29 181.30 181.31 181.32 181.33 181.34 182.1 182.2 182.3 182.4 182.5 182.6 182.7 182.8 182.9 182.10 182.11 182.12 182.13 182.14 182.15 182.16 182.17 182.18 182.19 182.20 182.21 182.22 182.23
182.24 182.25 182.26 182.27 182.28 182.29 182.30 182.31 182.32 182.33 183.1 183.2 183.3 183.4 183.5 183.6 183.7 183.8 183.9 183.10 183.11 183.12 183.13 183.14 183.15 183.16 183.17 183.18 183.19 183.20 183.21 183.22
183.23 183.24 183.25 183.26 183.27 183.28 183.29 183.30 183.31 183.32 183.33 183.34 183.35 184.1 184.2 184.3 184.4 184.5 184.6 184.7 184.8 184.9 184.10 184.11 184.12 184.13 184.14 184.15 184.16 184.17 184.18 184.19 184.20 184.21 184.22 184.23 184.24 184.25 184.26 184.27 184.28 184.29 184.30 184.31 184.32 184.33 184.34 184.35 185.1 185.2 185.3 185.4 185.5 185.6 185.7 185.8 185.9 185.10 185.11 185.12 185.13 185.14 185.15 185.16
185.17 185.18 185.19 185.20 185.21 185.22 185.23 185.24 185.25 185.26 185.27 185.28 185.29 185.30 185.31 185.32 185.33 185.34 185.35 186.1 186.2 186.3 186.4 186.5 186.6 186.7 186.8 186.9 186.10 186.11 186.12 186.13 186.14 186.15 186.16 186.17
186.18 186.19 186.20 186.21 186.22 186.23 186.24 186.25 186.26 186.27 186.28 186.29 186.30
186.31 186.32 186.33 187.1 187.2 187.3 187.4 187.5 187.6 187.7 187.8 187.9 187.10
187.11 187.12 187.13 187.14 187.15
187.16 187.17 187.18 187.19 187.20 187.21
187.22 187.23 187.24 187.25 187.26 187.27 187.28 187.29 187.30
187.31 188.1 188.2 188.3 188.4 188.5 188.6 188.7 188.8 188.9 188.10 188.11 188.12 188.13 188.14 188.15 188.16 188.17 188.18 188.19 188.20 188.21 188.22
188.23 188.24 188.25 188.26 188.27 188.28 188.29 188.30 188.31 188.32 188.33 188.34 188.35 189.1 189.2 189.3 189.4 189.5
189.6 189.7 189.8 189.9 189.10 189.11
189.12 189.13 189.14 189.15 189.16 189.17 189.18 189.19 189.20 189.21 189.22 189.23 189.24 189.25 189.26 189.27 189.28 189.29 189.30 189.31 189.32 189.33 189.34 190.1 190.2
190.3 190.4 190.5 190.6 190.7 190.8 190.9 190.10 190.11 190.12 190.13 190.14 190.15 190.16 190.17 190.18 190.19
190.20 190.21 190.22 190.23 190.24 190.25 190.26 190.27 190.28
190.29 190.30 190.31 191.1 191.2 191.3 191.4 191.5 191.6 191.7 191.8 191.9 191.10 191.11 191.12 191.13 191.14 191.15 191.16 191.17 191.18 191.19 191.20 191.21 191.22 191.23 191.24 191.25 191.26 191.27 191.28 191.29 191.30
191.31 191.32 191.33 191.34 192.1 192.2 192.3 192.4 192.5 192.6 192.7 192.8 192.9 192.10 192.11 192.12 192.13 192.14 192.15 192.16 192.17 192.18 192.19 192.20
192.21 192.22 192.23 192.24 192.25 192.26 192.27 192.28 192.29 192.30 192.31 192.32 192.33 192.34 193.1 193.2
193.3 193.4 193.5 193.6 193.7 193.8 193.9 193.10 193.11 193.12 193.13 193.14 193.15 193.16 193.17 193.18 193.19 193.20 193.21 193.22 193.23 193.24 193.25 193.26 193.27 193.28 193.29 193.30 193.31 193.32 193.33 193.34 193.35 194.1
194.2 194.3 194.4 194.5 194.6 194.7 194.8 194.9 194.10 194.11 194.12 194.13 194.14 194.15 194.16 194.17 194.18 194.19 194.20 194.21 194.22 194.23 194.24 194.25
194.26 194.27 194.28 194.29 194.30 194.31 194.32 194.33 194.34 195.1 195.2 195.3 195.4 195.5 195.6 195.7 195.8 195.9 195.10 195.11 195.12 195.13 195.14 195.15 195.16 195.17 195.18 195.19 195.20 195.21 195.22 195.23 195.24 195.25 195.26 195.27 195.28 195.29 195.30 195.31 195.32 195.33 195.34 195.35 195.36 196.1 196.2 196.3 196.4 196.5 196.6 196.7 196.8 196.9 196.10 196.11 196.12 196.13 196.14 196.15 196.16 196.17 196.18
196.19 196.20 196.21 196.22 196.23 196.24 196.25 196.26 196.27 196.28 196.29 196.30 196.31 196.32 196.33 196.34 197.1 197.2 197.3 197.4 197.5 197.6 197.7 197.8 197.9 197.10
197.11 197.12 197.13 197.14 197.15 197.16 197.17 197.18 197.19 197.20 197.21 197.22 197.23 197.24 197.25 197.26 197.27 197.28 197.29 197.30 197.31 197.32 197.33 197.34 197.35 198.1 198.2 198.3 198.4 198.5 198.6 198.7 198.8 198.9 198.10 198.11
198.12 198.13 198.14 198.15 198.16 198.17 198.18 198.19
198.20 198.21 198.22 198.23 198.24 198.25 198.26 198.27 198.28 198.29 198.30 198.31 198.32 198.33 199.1 199.2 199.3 199.4 199.5 199.6 199.7
199.8 199.9 199.10 199.11 199.12 199.13 199.14 199.15 199.16 199.17 199.18 199.19 199.20 199.21 199.22 199.23 199.24 199.25 199.26 199.27 199.28 199.29 199.30 199.31 199.32 199.33 199.34 199.35 200.1 200.2 200.3 200.4 200.5 200.6 200.7 200.8 200.9 200.10 200.11 200.12 200.13 200.14 200.15 200.16 200.17 200.18 200.19 200.20 200.21 200.22 200.23 200.24 200.25 200.26 200.27 200.28 200.29 200.30 200.31 200.32 200.33 200.34 200.35 200.36 201.1 201.2
201.3 201.4 201.5 201.6 201.7 201.8 201.9 201.10 201.11 201.12 201.13 201.14 201.15 201.16 201.17 201.18 201.19 201.20 201.21 201.22 201.23 201.24 201.25 201.26 201.27 201.28 201.29 201.30 201.31 201.32 201.33 201.34 201.35 202.1 202.2 202.3 202.4 202.5 202.6 202.7 202.8 202.9 202.10 202.11 202.12
202.13 202.14 202.15 202.16 202.17 202.18 202.19 202.20 202.21 202.22 202.23 202.24 202.25 202.26 202.27 202.28 202.29 202.30 202.31 202.32 202.33 202.34 202.35 203.1 203.2 203.3 203.4 203.5 203.6 203.7 203.8
203.9 203.10 203.11 203.12 203.13 203.14 203.15 203.16 203.17 203.18 203.19 203.20 203.21 203.22 203.23 203.24 203.25 203.26 203.27 203.28 203.29 203.30 203.31 203.32 203.33
204.1 204.2 204.3 204.4 204.5 204.6 204.7 204.8 204.9 204.10 204.11 204.12 204.13 204.14 204.15 204.16 204.17 204.18 204.19
204.20 204.21 204.22 204.23 204.24 204.25 204.26 204.27 204.28 204.29 204.30 204.31 204.32 204.33 204.34 204.35 205.1 205.2 205.3 205.4 205.5 205.6 205.7 205.8 205.9 205.10 205.11 205.12
205.13 205.14 205.15 205.16 205.17 205.18 205.19 205.20 205.21 205.22 205.23 205.24 205.25 205.26 205.27 205.28 205.29 205.30 205.31 205.32 205.33 205.34 205.35 206.1 206.2 206.3 206.4 206.5 206.6 206.7 206.8 206.9 206.10 206.11
206.12 206.13 206.14 206.15 206.16 206.17 206.18 206.19 206.20 206.21 206.22 206.23 206.24 206.25 206.26 206.27 206.28 206.29 206.30 206.31 206.32 206.33 206.34 207.1 207.2 207.3 207.4 207.5 207.6 207.7 207.8 207.9 207.10 207.11 207.12 207.13 207.14 207.15 207.16 207.17 207.18 207.19 207.20 207.21 207.22 207.23 207.24 207.25 207.26 207.27 207.28 207.29 207.30 207.31 207.32 207.33 207.34 207.35 207.36 208.1 208.2 208.3
208.4 208.5 208.6 208.7 208.8 208.9 208.10
208.11 208.12 208.13 208.14 208.15 208.16 208.17 208.18 208.19 208.20 208.21 208.22 208.23 208.24 208.25 208.26 208.27 208.28 208.29 208.30 208.31 208.32 208.33 209.1 209.2
209.3 209.4 209.5 209.6 209.7 209.8 209.9 209.10 209.11 209.12 209.13 209.14 209.15
209.16 209.17 209.18 209.19 209.20 209.21 209.22 209.23 209.24 209.25 209.26 209.27 209.28 209.29 209.30 209.31 209.32 209.33
210.1 210.2 210.3 210.4 210.5 210.6 210.7 210.8 210.9 210.10 210.11 210.12 210.13 210.14 210.15
210.16 210.17 210.18 210.19 210.20 210.21 210.22 210.23 210.24 210.25 210.26 210.27 210.28 210.29 210.30 210.31 210.32 210.33 210.34 210.35 211.1 211.2 211.3 211.4 211.5 211.6 211.7 211.8 211.9 211.10 211.11 211.12 211.13 211.14 211.15 211.16 211.17 211.18 211.19 211.20 211.21 211.22 211.23 211.24 211.25 211.26 211.27 211.28 211.29 211.30 211.31 211.32 211.33 211.34 211.35 211.36 212.1 212.2 212.3 212.4 212.5
212.6 212.7 212.8 212.9 212.10 212.11 212.12 212.13 212.14 212.15 212.16 212.17 212.18
212.19 212.20 212.21 212.22 212.23 212.24 212.25 212.26 212.27 212.28 212.29 212.30 212.31 212.32 212.33 212.34 213.1 213.2 213.3 213.4 213.5 213.6 213.7 213.8 213.9 213.10 213.11 213.12 213.13 213.14 213.15 213.16 213.17 213.18 213.19 213.20 213.21 213.22 213.23 213.24 213.25 213.26 213.27 213.28 213.29
213.30 213.31
213.32 213.33 213.34 213.35 214.1 214.2 214.3 214.4 214.5 214.6 214.7 214.8 214.9 214.10 214.11 214.12 214.13 214.14 214.15 214.16 214.17 214.18 214.19 214.20 214.21 214.22 214.23 214.24 214.25 214.26 214.27
214.28 214.29 214.30 214.31 214.32 214.33 214.34
215.1 215.2
215.3 215.4 215.5 215.6 215.7 215.8 215.9 215.10 215.11 215.12 215.13 215.14 215.15 215.16 215.17 215.18 215.19 215.20 215.21 215.22 215.23 215.24 215.25
215.26 215.27
215.28 215.29 215.30 215.31 215.32 215.33 216.1 216.2 216.3 216.4 216.5 216.6 216.7 216.8 216.9 216.10 216.11 216.12 216.13 216.14 216.15 216.16 216.17 216.18 216.19 216.20 216.21 216.22 216.23 216.24 216.25 216.26 216.27 216.28 216.29 216.30 216.31 216.32 216.33 216.34 216.35 217.1 217.2 217.3 217.4 217.5 217.6 217.7
217.8
217.9 217.10 217.11 217.12 217.13 217.14 217.15 217.16 217.17 217.18 217.19 217.20 217.21 217.22 217.23 217.24 217.25 217.26 217.27 217.28 217.29 217.30 217.31 217.32 217.33 217.34 217.35 218.1 218.2 218.3 218.4 218.5 218.6 218.7 218.8 218.9 218.10 218.11 218.12 218.13 218.14 218.15 218.16 218.17 218.18 218.19 218.20 218.21 218.22 218.23 218.24 218.25 218.26 218.27 218.28 218.29 218.30 218.31 218.32 218.33 218.34 218.35 218.36 219.1 219.2 219.3 219.4 219.5 219.6 219.7 219.8 219.9 219.10 219.11 219.12 219.13 219.14 219.15 219.16 219.17 219.18 219.19 219.20 219.21 219.22 219.23 219.24 219.25 219.26 219.27 219.28 219.29 219.30 219.31 219.32 219.33 219.34 219.35
220.1 220.2 220.3 220.4 220.5 220.6 220.7 220.8 220.9 220.10 220.11 220.12 220.13 220.14 220.15 220.16 220.17 220.18 220.19 220.20
220.21 220.22 220.23 220.24 220.25 220.26 220.27 220.28 220.29 220.30 220.31
220.32 220.33 220.34 221.1 221.2 221.3 221.4 221.5 221.6 221.7 221.8 221.9 221.10 221.11 221.12 221.13 221.14 221.15 221.16 221.17 221.18 221.19 221.20 221.21 221.22 221.23 221.24 221.25 221.26 221.27 221.28 221.29 221.30 221.31 221.32 221.33 221.34 221.35 221.36 222.1 222.2 222.3
222.4
222.5 222.6 222.7 222.8 222.9 222.10 222.11 222.12 222.13 222.14 222.15 222.16 222.17 222.18
222.19 222.20 222.21 222.22 222.23
222.24 222.25 222.26
222.27 222.28 222.29 222.30 222.31 222.32 223.1 223.2 223.3 223.4 223.5 223.6 223.7 223.8 223.9 223.10
223.11 223.12 223.13 223.14 223.15 223.16 223.17 223.18 223.19 223.20 223.21 223.22 223.23 223.24 223.25 223.26 223.27 223.28 223.29 223.30 223.31 223.32 223.33 223.34 223.35 224.1 224.2 224.3 224.4 224.5
224.6 224.7 224.8 224.9 224.10 224.11 224.12 224.13 224.14 224.15 224.16 224.17 224.18 224.19 224.20 224.21 224.22 224.23 224.24 224.25 224.26 224.27 224.28 224.29 224.30 224.31 224.32 224.33 224.34 225.1 225.2 225.3 225.4 225.5
225.6 225.7 225.8 225.9 225.10 225.11 225.12 225.13 225.14 225.15 225.16 225.17 225.18 225.19 225.20 225.21 225.22
225.23 225.24 225.25 225.26 225.27 225.28 225.29 225.30 225.31 225.32 225.33 226.1 226.2 226.3 226.4 226.5 226.6 226.7 226.8 226.9 226.10 226.11 226.12 226.13 226.14 226.15 226.16 226.17 226.18 226.19 226.20 226.21 226.22 226.23 226.24 226.25 226.26 226.27 226.28 226.29 226.30 226.31 226.32 226.33 226.34 226.35 226.36 227.1 227.2 227.3 227.4 227.5 227.6 227.7 227.8 227.9 227.10 227.11 227.12 227.13 227.14 227.15 227.16 227.17 227.18 227.19 227.20 227.21 227.22 227.23 227.24 227.25 227.26 227.27 227.28 227.29 227.30 227.31 227.32 227.33 227.34 227.35 228.1 228.2 228.3 228.4 228.5 228.6 228.7 228.8 228.9 228.10 228.11 228.12 228.13 228.14 228.15 228.16 228.17 228.18 228.19 228.20 228.21 228.22 228.23 228.24 228.25 228.26 228.27 228.28 228.29 228.30 228.31 228.32 228.33 228.34 229.1 229.2 229.3 229.4 229.5 229.6 229.7 229.8 229.9 229.10 229.11 229.12 229.13 229.14 229.15 229.16 229.17 229.18 229.19 229.20 229.21 229.22 229.23 229.24 229.25 229.26 229.27 229.28 229.29 229.30 229.31 229.32 229.33 229.34 229.35 230.1 230.2 230.3 230.4 230.5 230.6 230.7 230.8 230.9 230.10 230.11 230.12 230.13 230.14 230.15 230.16 230.17 230.18 230.19 230.20 230.21 230.22 230.23 230.24 230.25 230.26 230.27 230.28 230.29 230.30 230.31 230.32 230.33
230.34 230.35 231.1 231.2
231.3 231.4 231.5 231.6 231.7 231.8 231.9 231.10 231.11 231.12 231.13 231.14 231.15 231.16 231.17 231.18 231.19 231.20 231.21 231.22 231.23 231.24 231.25 231.26 231.27 231.28 231.29 231.30 231.31 231.32 231.33 231.34 232.1 232.2 232.3 232.4 232.5 232.6 232.7 232.8 232.9 232.10 232.11 232.12 232.13 232.14 232.15 232.16 232.17 232.18 232.19 232.20 232.21 232.22 232.23 232.24
232.25 232.26 232.27 232.28 232.29 232.30 232.31 232.32 232.33 232.34 232.35 233.1 233.2 233.3 233.4 233.5 233.6 233.7 233.8 233.9 233.10 233.11 233.12 233.13 233.14 233.15 233.16 233.17 233.18 233.19 233.20
233.21
233.22 233.23 233.24 233.25 233.26 233.27 233.28 233.29 233.30 233.31 233.32 233.33 233.34 234.1 234.2 234.3 234.4 234.5 234.6 234.7 234.8 234.9 234.10 234.11 234.12 234.13 234.14 234.15 234.16 234.17 234.18 234.19 234.20 234.21 234.22 234.23 234.24 234.25 234.26 234.27 234.28 234.29 234.30 234.31 234.32 234.33 234.34 234.35 235.1 235.2 235.3 235.4 235.5 235.6 235.7 235.8 235.9 235.10 235.11 235.12 235.13 235.14 235.15 235.16 235.17 235.18 235.19 235.20 235.21 235.22 235.23 235.24 235.25 235.26 235.27 235.28 235.29 235.30 235.31 235.32 235.33 235.34 235.35 235.36 236.1 236.2 236.3 236.4 236.5 236.6 236.7 236.8 236.9 236.10 236.11 236.12 236.13 236.14 236.15 236.16 236.17 236.18 236.19 236.20 236.21 236.22 236.23 236.24 236.25 236.26 236.27 236.28 236.29 236.30 236.31 236.32 236.33 236.34 236.35 236.36 237.1 237.2 237.3 237.4 237.5 237.6 237.7 237.8 237.9 237.10 237.11 237.12 237.13 237.14 237.15 237.16 237.17 237.18 237.19 237.20 237.21 237.22 237.23 237.24 237.25 237.26 237.27 237.28 237.29 237.30 237.31 237.32 237.33 237.34 237.35 238.1 238.2 238.3 238.4 238.5 238.6 238.7 238.8 238.9 238.10 238.11 238.12 238.13 238.14 238.15 238.16 238.17 238.18 238.19 238.20 238.21 238.22 238.23 238.24 238.25 238.26 238.27 238.28 238.29 238.30 238.31 238.32 238.33 238.34 238.35 238.36 239.1 239.2 239.3 239.4 239.5 239.6 239.7 239.8 239.9 239.10 239.11 239.12 239.13 239.14 239.15 239.16 239.17 239.18 239.19 239.20 239.21 239.22 239.23 239.24 239.25 239.26 239.27 239.28 239.29 239.30 239.31 239.32 239.33 239.34 239.35 239.36 240.1 240.2 240.3 240.4 240.5 240.6 240.7 240.8 240.9 240.10 240.11 240.12 240.13 240.14 240.15 240.16 240.17 240.18 240.19 240.20 240.21 240.22 240.23 240.24 240.25 240.26 240.27 240.28 240.29 240.30 240.31 240.32 240.33 240.34 240.35 240.36 241.1 241.2 241.3 241.4 241.5 241.6 241.7 241.8 241.9 241.10 241.11 241.12
241.13
241.14 241.15 241.16 241.17 241.18 241.19 241.20 241.21 241.22 241.23 241.24 241.25 241.26 241.27 241.28 241.29 241.30 241.31 241.32 241.33 241.34 242.1 242.2 242.3 242.4 242.5 242.6 242.7 242.8 242.9
242.10 242.11 242.12 242.13 242.14 242.15 242.16 242.17 242.18 242.19 242.20 242.21 242.22 242.23 242.24
242.25 242.26 242.27 242.28 242.29 242.30 242.31 242.32 242.33 242.34 243.1 243.2 243.3 243.4 243.5 243.6 243.7 243.8 243.9 243.10 243.11 243.12 243.13 243.14 243.15 243.16 243.17 243.18 243.19 243.20 243.21 243.22 243.23 243.24 243.25 243.26 243.27 243.28 243.29 243.30 243.31 243.32 243.33 243.34 243.35 243.36 244.1 244.2 244.3 244.4 244.5
244.6 244.7 244.8 244.9 244.10 244.11 244.12 244.13 244.14 244.15 244.16 244.17 244.18 244.19 244.20 244.21 244.22 244.23 244.24 244.25 244.26 244.27 244.28 244.29 244.30 244.31 244.32 244.33 244.34 245.1 245.2 245.3 245.4 245.5 245.6
245.7 245.8 245.9 245.10 245.11 245.12 245.13 245.14 245.15 245.16 245.17 245.18 245.19 245.20 245.21 245.22 245.23 245.24 245.25
245.26
245.27 245.28 245.29 245.30 245.31 245.32 245.33 245.34 246.1 246.2 246.3 246.4 246.5 246.6 246.7 246.8 246.9 246.10 246.11 246.12 246.13 246.14 246.15 246.16 246.17 246.18 246.19 246.20 246.21 246.22 246.23 246.24 246.25 246.26 246.27 246.28 246.29 246.30 246.31 246.32 246.33 246.34 246.35 246.36 247.1 247.2 247.3 247.4 247.5 247.6 247.7 247.8 247.9 247.10 247.11 247.12 247.13 247.14 247.15 247.16 247.17 247.18 247.19 247.20 247.21 247.22 247.23 247.24 247.25 247.26 247.27 247.28 247.29 247.30 247.31 247.32
247.33 247.34 248.1 248.2 248.3 248.4 248.5 248.6 248.7 248.8 248.9 248.10 248.11 248.12 248.13 248.14 248.15 248.16 248.17 248.18 248.19 248.20 248.21 248.22 248.23 248.24 248.25 248.26 248.27 248.28 248.29 248.30 248.31 248.32 248.33 248.34 248.35 248.36 249.1 249.2 249.3 249.4 249.5 249.6 249.7 249.8 249.9 249.10 249.11 249.12 249.13 249.14 249.15 249.16 249.17 249.18 249.19 249.20 249.21 249.22 249.23 249.24 249.25 249.26 249.27 249.28 249.29 249.30 249.31 249.32 249.33 249.34 249.35 249.36 250.1 250.2 250.3 250.4 250.5 250.6 250.7 250.8 250.9 250.10 250.11 250.12 250.13
250.14 250.15 250.16 250.17 250.18 250.19 250.20 250.21 250.22 250.23 250.24 250.25 250.26 250.27 250.28
250.29 250.30 250.31 250.32 250.33 250.34
251.1 251.2 251.3 251.4 251.5 251.6 251.7 251.8 251.9 251.10 251.11 251.12 251.13 251.14 251.15 251.16 251.17 251.18 251.19 251.20 251.21 251.22 251.23 251.24 251.25 251.26 251.27 251.28 251.29 251.30 251.31 251.32 251.33 251.34
251.35 252.1 252.2
252.3 252.4 252.5 252.6 252.7 252.8 252.9 252.10 252.11 252.12 252.13 252.14 252.15 252.16
252.17 252.18 252.19 252.20 252.21 252.22 252.23 252.24
252.25 252.26 252.27 252.28 252.29 252.30 252.31 252.32 253.1 253.2
253.3 253.4 253.5 253.6 253.7 253.8 253.9 253.10 253.11 253.12 253.13 253.14 253.15 253.16 253.17
253.18 253.19 253.20 253.21 253.22 253.23 253.24 253.25 253.26
253.27 253.28 253.29 253.30 253.31 253.32 253.33 254.1 254.2 254.3 254.4 254.5 254.6 254.7
254.8 254.9 254.10 254.11 254.12 254.13 254.14
254.15 254.16 254.17 254.18 254.19 254.20
254.21 254.22 254.23 254.24 254.25 254.26 254.27
254.28 254.29 254.30 254.31 254.32 255.1 255.2 255.3
255.4 255.5 255.6 255.7 255.8 255.9
255.10 255.11 255.12 255.13 255.14 255.15 255.16 255.17 255.18 255.19 255.20 255.21 255.22 255.23 255.24 255.25
255.26 255.27 255.28 255.29 255.30 255.31 255.32 255.33
256.1 256.2 256.3 256.4 256.5
256.6 256.7 256.8 256.9 256.10 256.11 256.12 256.13 256.14 256.15 256.16 256.17 256.18 256.19 256.20 256.21 256.22 256.23 256.24 256.25
256.26 256.27 256.28 256.29 256.30 256.31
256.32 256.33 257.1 257.2 257.3
257.4 257.5 257.6 257.7 257.8 257.9 257.10 257.11 257.12 257.13 257.14 257.15 257.16 257.17 257.18
257.19 257.20 257.21 257.22 257.23 257.24 257.25 257.26 257.27
257.28 257.29 257.30 257.31 257.32
258.1 258.2 258.3 258.4 258.5 258.6 258.7 258.8 258.9 258.10 258.11 258.12 258.13 258.14 258.15 258.16 258.17 258.18 258.19 258.20 258.21 258.22 258.23 258.24
258.25 258.26 258.27 258.28 258.29 258.30 258.31 258.32 258.33 258.34 258.35 259.1 259.2
259.3 259.4 259.5 259.6 259.7 259.8
259.9 259.10 259.11 259.12 259.13 259.14 259.15 259.16 259.17 259.18 259.19 259.20 259.21 259.22 259.23 259.24
259.25 259.26 259.27 259.28 259.29 259.30 259.31 259.32
260.1 260.2 260.3 260.4 260.5 260.6 260.7 260.8 260.9 260.10 260.11 260.12 260.13 260.14 260.15 260.16 260.17 260.18 260.19 260.20 260.21 260.22 260.23 260.24 260.25 260.26 260.27 260.28 260.29 260.30 260.31 260.32 260.33 260.34 260.35 260.36
261.1 261.2 261.3 261.4 261.5 261.6 261.7 261.8 261.9 261.10
261.11 261.12 261.13 261.14 261.15 261.16 261.17 261.18 261.19 261.20 261.21 261.22 261.23 261.24 261.25 261.26 261.27 261.28 261.29 261.30 261.31 261.32 261.33 261.34 261.35 262.1 262.2 262.3 262.4 262.5 262.6 262.7 262.8 262.9 262.10 262.11 262.12 262.13 262.14 262.15 262.16 262.17
262.18 262.19 262.20 262.21 262.22 262.23
262.24 262.25 262.26 262.27
262.28 262.29 262.30 262.31 262.32 262.33 263.1 263.2 263.3 263.4 263.5
263.6 263.7 263.8 263.9 263.10 263.11 263.12 263.13 263.14 263.15 263.16 263.17 263.18 263.19 263.20 263.21 263.22 263.23 263.24 263.25 263.26 263.27 263.28 263.29 263.30 263.31 263.32 263.33 263.34 263.35 264.1 264.2 264.3 264.4 264.5 264.6 264.7 264.8 264.9 264.10 264.11 264.12 264.13 264.14 264.15 264.16 264.17 264.18 264.19 264.20 264.21 264.22 264.23 264.24
264.25
264.26 264.27 264.28 264.29 264.30 264.31 264.32 264.33 264.34 265.1 265.2 265.3 265.4 265.5 265.6 265.7 265.8 265.9 265.10 265.11 265.12 265.13 265.14 265.15 265.16 265.17 265.18 265.19 265.20 265.21 265.22 265.23 265.24 265.25 265.26 265.27 265.28 265.29 265.30 265.31 265.32 265.33 265.34 265.35 265.36 266.1 266.2 266.3 266.4 266.5 266.6 266.7 266.8 266.9 266.10 266.11 266.12 266.13 266.14 266.15 266.16 266.17 266.18 266.19 266.20 266.21 266.22 266.23 266.24 266.25 266.26 266.27 266.28 266.29 266.30 266.31 266.32 266.33 266.34 266.35 267.1 267.2 267.3 267.4 267.5 267.6 267.7 267.8 267.9 267.10 267.11 267.12 267.13 267.14 267.15 267.16 267.17
267.18 267.19 267.20 267.21 267.22 267.23 267.24 267.25 267.26 267.27 267.28 267.29 267.30 267.31 267.32 267.33 267.34 267.35 268.1 268.2 268.3 268.4 268.5 268.6 268.7 268.8 268.9 268.10 268.11 268.12 268.13 268.14 268.15 268.16 268.17 268.18 268.19 268.20 268.21 268.22 268.23 268.24 268.25 268.26 268.27 268.28 268.29 268.30 268.31 268.32 268.33 268.34 268.35 268.36 269.1 269.2 269.3 269.4 269.5 269.6 269.7 269.8 269.9 269.10 269.11 269.12 269.13 269.14 269.15 269.16 269.17 269.18 269.19 269.20 269.21 269.22 269.23 269.24 269.25 269.26 269.27 269.28 269.29 269.30 269.31 269.32 269.33 269.34 269.35 269.36 270.1 270.2 270.3 270.4 270.5 270.6 270.7 270.8 270.9 270.10 270.11
270.12 270.13 270.14 270.15 270.16 270.17 270.18 270.19 270.20 270.21 270.22 270.23 270.24 270.25 270.26 270.27 270.28 270.29 270.30 270.31
270.32 270.33 270.34 271.1 271.2 271.3 271.4 271.5 271.6 271.7 271.8 271.9 271.10 271.11 271.12 271.13 271.14 271.15 271.16 271.17 271.18 271.19 271.20 271.21 271.22 271.23 271.24 271.25 271.26 271.27 271.28 271.29 271.30 271.31 271.32 271.33 271.34 271.35 271.36 272.1 272.2 272.3 272.4 272.5 272.6 272.7 272.8 272.9 272.10 272.11 272.12 272.13 272.14 272.15 272.16 272.17 272.18 272.19 272.20 272.21 272.22 272.23 272.24 272.25 272.26 272.27 272.28 272.29 272.30 272.31 272.32 272.33 272.34
273.1 273.2 273.3 273.4 273.5 273.6 273.7 273.8 273.9 273.10 273.11 273.12
273.13 273.14 273.15 273.16 273.17 273.18 273.19 273.20 273.21
273.22
273.23 273.24 273.25 273.26 273.27 273.28 273.29 273.30 273.31 273.32
274.1 274.2 274.3 274.4 274.5 274.6 274.7 274.8 274.9 274.10
274.11 274.12 274.13 274.14 274.15 274.16 274.17 274.18 274.19 274.20
274.21 274.22 274.23 274.24 274.25 274.26 274.27 274.28 274.29 274.30 274.31 274.32 274.33 275.1 275.2
275.3
275.4 275.5 275.6 275.7 275.8 275.9 275.10 275.11 275.12
275.13
275.14 275.15 275.16 275.17 275.18 275.19 275.20 275.21 275.22 275.23 275.24 275.25
275.26 275.27 275.28 275.29 275.30 275.31 275.32 276.1 276.2 276.3 276.4 276.5 276.6 276.7 276.8 276.9 276.10 276.11 276.12 276.13 276.14 276.15 276.16 276.17 276.18 276.19 276.20 276.21 276.22 276.23 276.24 276.25 276.26 276.27 276.28 276.29 276.30 276.31 276.32 276.33 276.34 276.35 277.1 277.2 277.3 277.4 277.5 277.6 277.7 277.8 277.9 277.10 277.11 277.12 277.13 277.14 277.15 277.16 277.17 277.18 277.19 277.20 277.21 277.22 277.23 277.24 277.25 277.26 277.27 277.28 277.29 277.30 277.31 277.32 277.33 277.34 277.35 277.36 278.1 278.2 278.3 278.4 278.5 278.6 278.7 278.8 278.9 278.10 278.11 278.12 278.13 278.14 278.15 278.16 278.17 278.18 278.19 278.20 278.21 278.22 278.23 278.24 278.25 278.26 278.27 278.28 278.29 278.30 278.31 278.32 278.33 278.34 278.35 279.1 279.2 279.3 279.4 279.5 279.6 279.7 279.8 279.9 279.10 279.11 279.12 279.13 279.14 279.15 279.16 279.17 279.18 279.19 279.20 279.21
279.22 279.23 279.24 279.25 279.26
279.27 279.28 279.29 279.30 279.31 279.32 279.33 279.34 280.1 280.2 280.3 280.4 280.5 280.6 280.7
280.8 280.9 280.10 280.11
280.12 280.13 280.14 280.15 280.16 280.17 280.18 280.19 280.20 280.21 280.22
280.23 280.24 280.25 280.26
280.27 280.28
280.29 280.30 280.31 280.32 280.33 280.34 281.1 281.2 281.3
281.4 281.5 281.6 281.7 281.8 281.9 281.10 281.11 281.12 281.13 281.14 281.15 281.16 281.17 281.18 281.19 281.20 281.21 281.22 281.23 281.24 281.25 281.26 281.27 281.28 281.29 281.30 281.31 281.32 281.33 281.34 281.35
282.1 282.2 282.3 282.4 282.5 282.6 282.7 282.8 282.9 282.10 282.11 282.12 282.13 282.14 282.15 282.16 282.17 282.18 282.19 282.20 282.21 282.22 282.23 282.24 282.25 282.26 282.27 282.28 282.29 282.30 282.31 282.32 282.33 282.34 282.35 283.1 283.2
283.3 283.4 283.5 283.6 283.7
283.8 283.9 283.10 283.11 283.12 283.13 283.14 283.15 283.16 283.17 283.18 283.19 283.20 283.21 283.22 283.23 283.24 283.25 283.26 283.27 283.28 283.29 283.30 283.31 283.32 283.33 283.34 284.1 284.2 284.3 284.4 284.5 284.6 284.7 284.8 284.9 284.10 284.11 284.12 284.13 284.14 284.15 284.16 284.17 284.18 284.19 284.20 284.21 284.22 284.23 284.24 284.25 284.26 284.27 284.28 284.29 284.30 284.31 284.32 284.33 284.34 284.35 284.36 285.1 285.2 285.3 285.4 285.5 285.6 285.7 285.8 285.9 285.10 285.11 285.12 285.13 285.14 285.15 285.16 285.17 285.18 285.19 285.20 285.21 285.22 285.23 285.24 285.25 285.26 285.27 285.28 285.29 285.30 285.31 285.32 285.33 285.34 285.35 286.1 286.2 286.3 286.4 286.5 286.6 286.7 286.8 286.9 286.10 286.11 286.12 286.13 286.14 286.15 286.16 286.17 286.18 286.19 286.20 286.21 286.22 286.23 286.24 286.25 286.26 286.27
286.28 286.29 286.30 286.31 286.32 286.33 286.34 286.35 287.1 287.2 287.3 287.4 287.5 287.6 287.7 287.8 287.9 287.10 287.11 287.12 287.13 287.14 287.15 287.16 287.17 287.18 287.19 287.20 287.21 287.22 287.23 287.24 287.25 287.26 287.27
287.28 287.29 287.30 287.31 287.32 287.33 287.34 288.1 288.2 288.3 288.4 288.5 288.6 288.7 288.8 288.9 288.10 288.11 288.12 288.13 288.14 288.15 288.16 288.17 288.18 288.19 288.20 288.21 288.22 288.23 288.24 288.25 288.26 288.27 288.28 288.29 288.30 288.31 288.32 288.33 288.34 288.35 289.1 289.2 289.3 289.4 289.5 289.6 289.7 289.8 289.9 289.10 289.11 289.12 289.13 289.14 289.15 289.16 289.17 289.18 289.19 289.20 289.21 289.22 289.23 289.24 289.25 289.26 289.27 289.28 289.29 289.30 289.31 289.32 289.33 289.34
289.35 290.1 290.2 290.3 290.4 290.5 290.6 290.7 290.8 290.9 290.10 290.11 290.12 290.13 290.14 290.15 290.16 290.17 290.18 290.19 290.20 290.21 290.22 290.23 290.24
290.25 290.26 290.27 290.28 290.29 290.30 290.31 290.32 290.33 290.34 290.35 291.1 291.2 291.3 291.4 291.5 291.6 291.7 291.8 291.9 291.10 291.11 291.12 291.13 291.14 291.15 291.16 291.17 291.18 291.19 291.20 291.21 291.22 291.23 291.24 291.25 291.26 291.27 291.28 291.29 291.30 291.31 291.32
291.33 291.34 291.35 292.1 292.2 292.3 292.4 292.5 292.6 292.7 292.8 292.9 292.10 292.11 292.12 292.13 292.14 292.15
292.16 292.17 292.18 292.19 292.20 292.21 292.22 292.23
292.24 292.25 292.26 292.27 292.28 292.29 292.30 292.31 292.32 292.33 292.34 293.1 293.2 293.3 293.4 293.5 293.6 293.7 293.8 293.9 293.10 293.11
293.12
293.13 293.14 293.15 293.16 293.17 293.18 293.19 293.20 293.21 293.22 293.23 293.24 293.25 293.26 293.27 293.28 293.29 293.30 293.31 293.32 293.33
294.1 294.2 294.3 294.4 294.5 294.6 294.7 294.8 294.9 294.10 294.11 294.12 294.13 294.14
294.15 294.16 294.17 294.18
294.19 294.20 294.21 294.22 294.23 294.24 294.25 294.26 294.27 294.28 294.29 294.30 294.31 294.32 295.1 295.2 295.3 295.4 295.5 295.6 295.7 295.8 295.9 295.10 295.11 295.12 295.13 295.14 295.15 295.16 295.17 295.18
295.19 295.20 295.21 295.22 295.23 295.24 295.25 295.26 295.27 295.28 295.29 295.30 295.31 295.32 295.33 295.34 295.35 296.1 296.2 296.3 296.4 296.5 296.6 296.7 296.8 296.9 296.10 296.11 296.12 296.13 296.14
296.15 296.16 296.17 296.18 296.19 296.20 296.21 296.22 296.23 296.24 296.25 296.26 296.27 296.28 296.29 296.30 296.31 296.32 296.33 296.34 296.35 297.1 297.2 297.3 297.4 297.5 297.6 297.7 297.8 297.9 297.10 297.11 297.12 297.13 297.14 297.15 297.16 297.17 297.18 297.19 297.20 297.21 297.22 297.23 297.24 297.25 297.26 297.27 297.28 297.29 297.30
297.31 297.32 297.33 297.34 297.35 298.1 298.2 298.3 298.4
298.5 298.6 298.7
298.8 298.9 298.10 298.11 298.12 298.13 298.14 298.15 298.16 298.17 298.18 298.19 298.20 298.21 298.22 298.23 298.24 298.25 298.26 298.27 298.28 298.29 298.30 298.31 298.32 298.33 299.1 299.2 299.3 299.4 299.5 299.6 299.7 299.8 299.9 299.10 299.11 299.12 299.13 299.14 299.15 299.16 299.17 299.18 299.19 299.20 299.21 299.22 299.23 299.24 299.25 299.26 299.27 299.28 299.29 299.30 299.31 299.32 299.33 299.34 299.35 299.36 300.1 300.2 300.3 300.4 300.5 300.6 300.7 300.8 300.9 300.10 300.11 300.12 300.13 300.14 300.15 300.16 300.17 300.18 300.19 300.20 300.21 300.22 300.23 300.24 300.25 300.26 300.27 300.28 300.29 300.30 300.31 300.32 300.33 300.34 300.35 300.36 301.1 301.2 301.3 301.4 301.5 301.6 301.7 301.8 301.9 301.10 301.11 301.12 301.13 301.14 301.15
301.16 301.17
301.18 301.19 301.20 301.21 301.22
301.23 301.24 301.25 301.26 301.27 301.28 301.29 301.30 301.31 301.32 301.33 302.1 302.2 302.3 302.4 302.5 302.6 302.7 302.8 302.9 302.10 302.11 302.12 302.13 302.14 302.15 302.16 302.17 302.18 302.19 302.20 302.21 302.22 302.23 302.24 302.25
302.26 302.27 302.28 302.29 302.30 302.31 302.32 302.33 302.34 302.35 303.1 303.2 303.3 303.4 303.5 303.6 303.7 303.8
303.9
303.10 303.11 303.12 303.13 303.14 303.15 303.16 303.17 303.18 303.19 303.20 303.21 303.22 303.23 303.24 303.25 303.26 303.27 303.28 303.29 303.30 303.31 303.32 303.33 303.34 304.1 304.2 304.3 304.4 304.5 304.6 304.7 304.8 304.9 304.10 304.11 304.12 304.13 304.14 304.15 304.16 304.17 304.18 304.19 304.20 304.21 304.22 304.23 304.24 304.25 304.26 304.27 304.28 304.29 304.30 304.31 304.32 304.33
304.34
305.1 305.2 305.3 305.4 305.5 305.6 305.7 305.8
305.9 305.10 305.11 305.12 305.13 305.14 305.15 305.16
305.17 305.18 305.19 305.20 305.21 305.22 305.23 305.24 305.25 305.26 305.27 305.28 305.29 305.30 305.31 305.32 305.33 306.1 306.2 306.3 306.4 306.5 306.6 306.7 306.8 306.9 306.10 306.11 306.12 306.13 306.14 306.15 306.16 306.17 306.18 306.19 306.20
306.21
306.22 306.23 306.24 306.25 306.26 306.27 306.28 306.29 306.30 306.31 306.32 306.33 306.34 306.35 307.1 307.2 307.3 307.4 307.5 307.6 307.7 307.8 307.9 307.10 307.11 307.12 307.13 307.14 307.15 307.16 307.17 307.18 307.19 307.20 307.21 307.22 307.23 307.24 307.25 307.26 307.27 307.28 307.29 307.30 307.31 307.32 307.33 307.34 307.35 307.36 308.1 308.2 308.3 308.4 308.5 308.6 308.7 308.8 308.9 308.10 308.11 308.12 308.13 308.14 308.15 308.16 308.17 308.18 308.19 308.20 308.21 308.22 308.23 308.24 308.25 308.26 308.27 308.28 308.29 308.30 308.31 308.32 308.33 308.34 308.35 308.36 309.1 309.2 309.3 309.4 309.5 309.6 309.7 309.8 309.9 309.10 309.11 309.12 309.13 309.14 309.15 309.16 309.17 309.18 309.19 309.20 309.21 309.22 309.23 309.24 309.25 309.26 309.27 309.28 309.29 309.30 309.31 309.32 309.33 309.34 309.35 310.1 310.2
310.3 310.4
310.5 310.6 310.7 310.8 310.9 310.10 310.11 310.12 310.13 310.14 310.15 310.16 310.17 310.18 310.19 310.20 310.21 310.22 310.23 310.24
310.25 310.26
310.27 310.28 310.29 310.30 310.31 310.32 310.33 311.1 311.2 311.3 311.4 311.5 311.6 311.7 311.8 311.9 311.10 311.11 311.12 311.13 311.14 311.15 311.16 311.17 311.18 311.19 311.20 311.21 311.22 311.23 311.24 311.25 311.26
311.27 311.28 311.29 311.30 311.31
311.32 311.33 311.34 312.1 312.2 312.3 312.4 312.5 312.6 312.7 312.8 312.9 312.10 312.11 312.12 312.13 312.14 312.15 312.16 312.17 312.18 312.19 312.20 312.21 312.22
312.23 312.24 312.25 312.26 312.27 312.28 312.29 312.30 312.31 312.32
312.33 313.1 313.2 313.3 313.4
313.5 313.6 313.7 313.8 313.9 313.10 313.11 313.12 313.13 313.14 313.15 313.16 313.17 313.18 313.19 313.20 313.21 313.22 313.23 313.24 313.25 313.26 313.27 313.28 313.29 313.30 313.31 313.32 313.33 313.34 313.35 314.1 314.2 314.3 314.4 314.5 314.6 314.7 314.8 314.9 314.10 314.11 314.12 314.13 314.14 314.15 314.16 314.17 314.18 314.19 314.20 314.21 314.22 314.23 314.24 314.25 314.26 314.27 314.28
314.29 314.30 314.31 314.32 314.33 314.34 315.1 315.2 315.3 315.4 315.5 315.6 315.7 315.8 315.9 315.10 315.11 315.12 315.13 315.14 315.15 315.16 315.17 315.18 315.19 315.20 315.21 315.22 315.23 315.24 315.25 315.26 315.27 315.28 315.29 315.30 315.31 315.32 315.33 315.34 315.35 315.36 316.1 316.2 316.3 316.4 316.5 316.6 316.7 316.8
316.9 316.10 316.11 316.12 316.13 316.14 316.15 316.16 316.17 316.18 316.19 316.20 316.21 316.22 316.23 316.24 316.25 316.26 316.27 316.28 316.29 316.30 316.31 316.32 316.33 316.34 317.1 317.2 317.3 317.4 317.5 317.6
317.7 317.8 317.9 317.10 317.11
317.12 317.13
317.14 317.15
317.16 317.17 317.18 317.19 317.20 317.21 317.22 317.23 317.24 317.25 317.26 317.27 317.28 317.29 317.30 317.31 317.32 318.1 318.2 318.3 318.4 318.5 318.6 318.7 318.8 318.9 318.10 318.11 318.12 318.13 318.14 318.15 318.16 318.17 318.18 318.19 318.20 318.21 318.22 318.23 318.24 318.25 318.26 318.27 318.28 318.29 318.30 318.31 318.32 318.33 318.34 318.35 319.1 319.2 319.3 319.4 319.5 319.6 319.7 319.8 319.9 319.10
319.11 319.12 319.13 319.14 319.15 319.16 319.17 319.18 319.19 319.20 319.21 319.22 319.23 319.24 319.25 319.26 319.27 319.28 319.29 319.30 319.31 319.32 319.33 319.34 320.1 320.2 320.3 320.4 320.5 320.6 320.7 320.8 320.9 320.10 320.11 320.12 320.13 320.14 320.15 320.16 320.17 320.18 320.19 320.20 320.21 320.22 320.23 320.24 320.25 320.26 320.27 320.28 320.29 320.30
320.31 320.32 320.33 320.34 321.1 321.2 321.3 321.4 321.5 321.6 321.7 321.8 321.9 321.10 321.11 321.12 321.13 321.14 321.15 321.16 321.17 321.18 321.19 321.20 321.21 321.22 321.23 321.24 321.25 321.26
321.27 321.28 321.29 321.30 321.31 321.32 321.33 322.1 322.2 322.3 322.4 322.5 322.6 322.7 322.8 322.9 322.10 322.11 322.12 322.13 322.14 322.15 322.16 322.17 322.18 322.19 322.20
322.21 322.22 322.23 322.24 322.25 322.26 322.27 322.28 322.29 322.30 322.31 322.32 322.33 322.34 322.35 323.1 323.2 323.3 323.4 323.5 323.6 323.7 323.8 323.9 323.10 323.11
323.12 323.13 323.14 323.15 323.16 323.17 323.18 323.19 323.20 323.21 323.22 323.23 323.24 323.25 323.26 323.27 323.28 323.29 323.30 323.31 323.32 323.33 323.34 323.35 324.1 324.2 324.3 324.4 324.5 324.6 324.7 324.8
324.9 324.10 324.11 324.12 324.13 324.14 324.15 324.16 324.17 324.18 324.19 324.20 324.21 324.22 324.23 324.24 324.25 324.26 324.27 324.28 324.29
324.30 324.31 324.32 324.33 324.34 325.1 325.2 325.3 325.4 325.5 325.6 325.7 325.8 325.9 325.10 325.11 325.12 325.13 325.14 325.15 325.16 325.17
325.18 325.19 325.20 325.21 325.22 325.23 325.24 325.25 325.26 325.27 325.28 325.29 325.30 325.31 325.32 325.33 326.1 326.2 326.3 326.4 326.5 326.6 326.7 326.8 326.9 326.10 326.11 326.12 326.13 326.14 326.15 326.16 326.17 326.18 326.19 326.20 326.21 326.22 326.23 326.24 326.25 326.26 326.27 326.28 326.29 326.30 326.31 326.32 326.33 326.34 326.35 327.1 327.2 327.3 327.4 327.5 327.6 327.7 327.8 327.9 327.10 327.11 327.12 327.13 327.14 327.15
327.16 327.17 327.18 327.19 327.20 327.21 327.22 327.23 327.24 327.25 327.26 327.27 327.28 327.29 327.30 327.31 327.32 327.33 327.34
328.1 328.2 328.3 328.4 328.5 328.6 328.7 328.8 328.9 328.10 328.11 328.12 328.13
328.14 328.15 328.16 328.17 328.18 328.19 328.20 328.21 328.22 328.23 328.24 328.25 328.26 328.27 328.28 328.29 328.30 328.31 328.32 328.33 328.34 328.35 329.1 329.2 329.3 329.4 329.5 329.6 329.7 329.8 329.9 329.10 329.11 329.12 329.13 329.14 329.15
329.16 329.17
329.18 329.19 329.20 329.21 329.22 329.23 329.24 329.25 329.26 329.27 329.28 329.29 329.30 329.31 329.32 329.33 330.1 330.2 330.3 330.4 330.5 330.6 330.7 330.8 330.9 330.10 330.11 330.12 330.13 330.14 330.15 330.16 330.17 330.18 330.19 330.20 330.21 330.22 330.23 330.24 330.25 330.26 330.27 330.28 330.29 330.30 330.31 330.32 330.33 330.34 330.35 331.1 331.2
331.3 331.4 331.5 331.6 331.7 331.8 331.9 331.10 331.11 331.12 331.13 331.14 331.15 331.16 331.17 331.18 331.19 331.20 331.21 331.22 331.23 331.24 331.25 331.26 331.27 331.28 331.29 331.30 331.31 331.32 331.33 331.34 332.1 332.2 332.3 332.4 332.5 332.6 332.7 332.8 332.9 332.10 332.11 332.12 332.13 332.14 332.15 332.16 332.17 332.18 332.19 332.20 332.21 332.22 332.23 332.24 332.25 332.26 332.27 332.28 332.29 332.30 332.31 332.32 332.33 332.34 332.35 332.36 333.1 333.2 333.3 333.4 333.5 333.6 333.7 333.8 333.9 333.10 333.11 333.12 333.13 333.14 333.15 333.16 333.17 333.18 333.19 333.20 333.21 333.22 333.23
333.24 333.25 333.26 333.27 333.28 333.29 333.30 333.31 333.32 333.33 333.34 333.35 334.1 334.2 334.3 334.4 334.5 334.6 334.7 334.8 334.9 334.10 334.11 334.12 334.13 334.14 334.15 334.16 334.17 334.18 334.19 334.20 334.21 334.22 334.23 334.24 334.25 334.26 334.27 334.28 334.29 334.30 334.31 334.32 334.33 334.34 334.35 334.36 335.1 335.2 335.3 335.4 335.5 335.6 335.7 335.8 335.9 335.10 335.11 335.12 335.13 335.14 335.15 335.16 335.17 335.18 335.19 335.20 335.21 335.22 335.23 335.24 335.25 335.26 335.27 335.28 335.29 335.30 335.31 335.32 335.33 335.34 335.35 336.1 336.2 336.3 336.4 336.5
336.6 336.7 336.8 336.9 336.10 336.11 336.12 336.13 336.14 336.15 336.16 336.17 336.18 336.19 336.20 336.21 336.22
336.23 336.24 336.25 336.26 336.27 336.28 336.29 336.30 336.31 336.32 336.33 336.34 337.1 337.2 337.3 337.4 337.5
337.6 337.7 337.8 337.9 337.10 337.11 337.12 337.13 337.14 337.15 337.16 337.17 337.18 337.19 337.20 337.21 337.22 337.23 337.24 337.25 337.26 337.27 337.28 337.29 337.30 337.31 337.32 337.33 337.34 338.1 338.2 338.3 338.4 338.5 338.6 338.7 338.8 338.9 338.10 338.11 338.12 338.13 338.14 338.15 338.16 338.17 338.18 338.19 338.20 338.21
338.22 338.23 338.24 338.25 338.26 338.27 338.28 338.29 338.30 338.31 338.32 338.33 338.34 338.35 339.1 339.2 339.3 339.4 339.5 339.6 339.7 339.8 339.9 339.10 339.11 339.12 339.13 339.14
339.15 339.16 339.17 339.18 339.19 339.20 339.21 339.22 339.23 339.24 339.25 339.26 339.27 339.28 339.29 339.30 339.31 339.32 339.33 339.34 340.1 340.2 340.3 340.4 340.5
340.6 340.7 340.8 340.9 340.10 340.11 340.12 340.13 340.14 340.15 340.16 340.17 340.18 340.19 340.20 340.21 340.22 340.23 340.24 340.25 340.26 340.27 340.28 340.29 340.30 340.31 340.32 340.33 340.34 340.35 341.1 341.2 341.3 341.4 341.5 341.6 341.7 341.8 341.9 341.10 341.11 341.12 341.13 341.14 341.15 341.16 341.17 341.18 341.19 341.20 341.21
341.22 341.23 341.24 341.25 341.26 341.27 341.28 341.29 341.30 341.31
341.32 341.33 341.34 342.1 342.2
342.3 342.4 342.5 342.6
342.7 342.8 342.9 342.10 342.11 342.12 342.13 342.14 342.15 342.16 342.17 342.18 342.19 342.20
342.21 342.22 342.23 342.24 342.25 342.26 342.27 342.28 342.29 342.30 342.31
342.32
343.1 343.2 343.3 343.4 343.5 343.6 343.7 343.8 343.9 343.10 343.11 343.12 343.13 343.14 343.15 343.16 343.17 343.18 343.19 343.20 343.21
343.22
343.23 343.24 343.25 343.26 343.27 343.28
343.29
343.30 343.31 343.32 343.33 344.1 344.2 344.3 344.4 344.5 344.6 344.7 344.8 344.9 344.10 344.11 344.12 344.13 344.14 344.15 344.16 344.17
344.18 344.19 344.20 344.21 344.22 344.23 344.24 344.25 344.26 344.27 344.28 344.29 344.30 344.31 344.32 344.33 344.34 344.35 345.1 345.2 345.3
345.4 345.5 345.6 345.7 345.8 345.9 345.10 345.11 345.12 345.13 345.14 345.15 345.16 345.17 345.18 345.19
345.20 345.21 345.22 345.23 345.24 345.25 345.26 345.27 345.28 345.29 345.30 345.31 345.32 345.33 345.34 346.1 346.2 346.3
346.4 346.5 346.6 346.7 346.8 346.9 346.10 346.11 346.12 346.13 346.14 346.15 346.16 346.17 346.18
346.19 346.20 346.21 346.22
346.23 346.24 346.25 346.26
346.27 346.28 346.29 346.30
346.31 347.1
347.2 347.3
347.4 347.5 347.6 347.7 347.8 347.9 347.10
347.11 347.12 347.13 347.14 347.15 347.16 347.17 347.18 347.19 347.20 347.21 347.22 347.23 347.24 347.25 347.26 347.27 347.28 347.29 347.30 347.31 347.32 347.33 347.34 348.1 348.2 348.3 348.4 348.5 348.6 348.7 348.8 348.9 348.10 348.11 348.12 348.13 348.14 348.15 348.16 348.17 348.18 348.19 348.20 348.21 348.22 348.23
348.24 348.25 348.26 348.27 348.28 348.29 348.30 348.31 348.32 348.33 348.34 349.1 349.2 349.3 349.4 349.5 349.6 349.7 349.8 349.9 349.10 349.11 349.12 349.13 349.14 349.15 349.16 349.17 349.18 349.19 349.20 349.21 349.22 349.23 349.24 349.25 349.26 349.27 349.28 349.29 349.30 349.31 349.32 349.33 349.34 349.35 350.1 350.2 350.3 350.4 350.5 350.6 350.7 350.8 350.9 350.10 350.11 350.12 350.13 350.14 350.15 350.16 350.17 350.18 350.19 350.20 350.21 350.22 350.23 350.24 350.25
350.26 350.27 350.28 350.29 350.30 350.31 350.32 350.33 350.34 351.1 351.2 351.3 351.4 351.5 351.6 351.7 351.8 351.9 351.10 351.11 351.12 351.13 351.14 351.15 351.16 351.17 351.18 351.19 351.20 351.21 351.22 351.23 351.24 351.25 351.26 351.27 351.28 351.29 351.30 351.31 351.32 351.33 351.34 351.35 352.1 352.2 352.3 352.4 352.5 352.6 352.7 352.8 352.9 352.10 352.11 352.12 352.13 352.14 352.15 352.16 352.17 352.18 352.19 352.20 352.21 352.22 352.23 352.24 352.25 352.26 352.27 352.28 352.29 352.30 352.31 352.32 352.33 352.34 352.35 352.36 353.1 353.2 353.3 353.4 353.5 353.6 353.7 353.8 353.9 353.10 353.11 353.12 353.13 353.14 353.15 353.16 353.17 353.18 353.19 353.20 353.21 353.22 353.23 353.24 353.25 353.26 353.27 353.28 353.29 353.30
353.31 353.32 353.33 353.34 353.35 354.1 354.2 354.3 354.4 354.5 354.6 354.7 354.8 354.9 354.10 354.11 354.12 354.13 354.14 354.15 354.16 354.17 354.18 354.19 354.20 354.21 354.22 354.23 354.24 354.25 354.26 354.27 354.28 354.29 354.30 354.31 354.32 354.33 354.34 354.35 355.1 355.2 355.3 355.4 355.5 355.6 355.7 355.8 355.9 355.10 355.11
355.12 355.13 355.14 355.15 355.16 355.17 355.18 355.19 355.20 355.21 355.22 355.23 355.24 355.25 355.26 355.27 355.28 355.29 355.30 355.31 355.32 355.33 355.34 355.35 356.1 356.2 356.3 356.4 356.5 356.6 356.7 356.8 356.9
356.10 356.11 356.12 356.13 356.14
356.15 356.16 356.17 356.18 356.19
356.20 356.21 356.22 356.23 356.24 356.25 356.26 356.27 356.28 356.29 356.30 356.31 356.32 357.1 357.2 357.3 357.4 357.5
357.6 357.7 357.8 357.9 357.10 357.11 357.12 357.13 357.14 357.15 357.16 357.17 357.18 357.19 357.20 357.21 357.22 357.23 357.24 357.25 357.26 357.27 357.28 357.29 357.30 357.31 357.32 357.33 357.34 358.1 358.2 358.3 358.4 358.5 358.6 358.7 358.8 358.9 358.10 358.11 358.12 358.13 358.14 358.15 358.16 358.17 358.18 358.19 358.20 358.21 358.22 358.23 358.24 358.25 358.26 358.27 358.28 358.29 358.30 358.31 358.32 358.33 358.34 358.35 358.36 359.1 359.2 359.3 359.4 359.5 359.6 359.7 359.8 359.9 359.10 359.11 359.12 359.13 359.14 359.15 359.16 359.17 359.18 359.19 359.20 359.21 359.22 359.23 359.24 359.25 359.26 359.27 359.28 359.29 359.30 359.31 359.32 359.33 359.34 359.35 360.1 360.2 360.3 360.4 360.5 360.6 360.7 360.8 360.9 360.10 360.11 360.12 360.13 360.14 360.15 360.16 360.17 360.18 360.19 360.20
360.21 360.22 360.23 360.24 360.25 360.26 360.27 360.28 360.29
360.30 360.31 360.32 360.33 361.1 361.2 361.3 361.4 361.5 361.6 361.7 361.8 361.9 361.10 361.11 361.12 361.13
361.14 361.15 361.16 361.17 361.18 361.19 361.20 361.21 361.22 361.23 361.24 361.25 361.26 361.27
361.28 361.29 361.30 361.31 361.32 361.33 361.34 362.1 362.2 362.3 362.4 362.5 362.6
362.7 362.8 362.9 362.10 362.11 362.12 362.13 362.14 362.15 362.16 362.17 362.18 362.19 362.20 362.21 362.22 362.23
362.24 362.25 362.26
362.27 362.28
362.29 362.30 362.31 362.32
362.33 362.34 363.1 363.2 363.3 363.4 363.5 363.6 363.7 363.8 363.9 363.10 363.11 363.12 363.13 363.14 363.15 363.16
363.17 363.18 363.19 363.20 363.21 363.22 363.23 363.24
363.25 363.26 363.27 363.28 363.29 363.30 363.31 363.32 363.33 363.34 364.1 364.2 364.3 364.4 364.5 364.6 364.7 364.8 364.9 364.10 364.11 364.12 364.13 364.14 364.15 364.16 364.17 364.18 364.19
364.20 364.21 364.22 364.23 364.24 364.25 364.26 364.27 364.28 364.29 364.30 364.31 364.32 364.33 364.34 364.35 365.1 365.2 365.3 365.4 365.5 365.6 365.7 365.8 365.9 365.10 365.11 365.12 365.13 365.14 365.15 365.16 365.17 365.18 365.19 365.20 365.21 365.22 365.23 365.24 365.25 365.26 365.27 365.28 365.29 365.30 365.31 365.32 365.33 365.34 365.35 365.36 366.1 366.2 366.3 366.4 366.5 366.6 366.7 366.8 366.9 366.10 366.11 366.12 366.13 366.14 366.15 366.16 366.17 366.18 366.19 366.20 366.21 366.22 366.23 366.24 366.25 366.26 366.27 366.28 366.29 366.30 366.31 366.32
366.33 366.34 367.1 367.2 367.3 367.4 367.5 367.6
367.7 367.8 367.9 367.10 367.11 367.12 367.13 367.14 367.15 367.16 367.17 367.18 367.19 367.20 367.21 367.22 367.23 367.24 367.25 367.26 367.27 367.28 367.29 367.30 367.31 367.32 367.33 367.34 367.35 368.1 368.2 368.3 368.4 368.5 368.6 368.7 368.8 368.9 368.10 368.11 368.12 368.13 368.14 368.15 368.16 368.17 368.18 368.19 368.20 368.21 368.22 368.23 368.24 368.25 368.26 368.27 368.28 368.29 368.30 368.31 368.32 368.33 368.34 368.35 369.1 369.2 369.3 369.4 369.5 369.6 369.7 369.8 369.9 369.10 369.11 369.12 369.13 369.14 369.15 369.16 369.17 369.18 369.19 369.20 369.21 369.22 369.23 369.24 369.25 369.26 369.27 369.28 369.29 369.30 369.31 369.32 369.33 369.34 369.35 369.36 370.1 370.2 370.3 370.4 370.5 370.6 370.7 370.8 370.9 370.10 370.11 370.12 370.13 370.14 370.15 370.16 370.17 370.18 370.19 370.20 370.21 370.22 370.23 370.24 370.25 370.26 370.27 370.28 370.29 370.30 370.31 370.32 370.33 370.34 370.35 370.36 371.1 371.2 371.3 371.4 371.5 371.6 371.7 371.8 371.9 371.10 371.11 371.12 371.13 371.14 371.15 371.16 371.17 371.18 371.19 371.20 371.21 371.22 371.23 371.24 371.25 371.26 371.27 371.28 371.29 371.30 371.31 371.32 371.33
371.34 371.35 371.36 372.1 372.2 372.3
372.4 372.5 372.6 372.7 372.8 372.9 372.10 372.11 372.12 372.13 372.14 372.15 372.16 372.17 372.18 372.19 372.20 372.21 372.22 372.23 372.24 372.25 372.26 372.27 372.28 372.29 372.30 372.31 372.32 372.33 372.34 372.35 373.1 373.2 373.3 373.4 373.5 373.6 373.7 373.8 373.9 373.10 373.11 373.12 373.13 373.14 373.15 373.16 373.17 373.18 373.19 373.20 373.21 373.22 373.23 373.24 373.25 373.26 373.27 373.28 373.29 373.30 373.31 373.32 373.33 373.34 373.35 374.1 374.2 374.3 374.4 374.5 374.6 374.7
374.8 374.9 374.10 374.11 374.12 374.13 374.14 374.15 374.16 374.17 374.18 374.19 374.20
374.21 374.22 374.23 374.24 374.25 374.26 374.27 374.28
374.29 374.30 374.31 374.32 374.33 375.1 375.2 375.3
375.4 375.5 375.6 375.7 375.8 375.9 375.10 375.11 375.12 375.13 375.14 375.15 375.16 375.17 375.18 375.19 375.20 375.21 375.22 375.23 375.24 375.25 375.26 375.27 375.28 375.29 375.30 375.31 375.32 375.33 375.34 376.1 376.2 376.3 376.4 376.5 376.6 376.7 376.8 376.9 376.10 376.11 376.12 376.13 376.14 376.15 376.16 376.17 376.18
376.19 376.20 376.21 376.22 376.23 376.24 376.25 376.26 376.27 376.28 376.29
376.30 376.31 376.32 376.33 376.34 377.1 377.2 377.3 377.4 377.5 377.6 377.7 377.8 377.9 377.10 377.11 377.12 377.13 377.14 377.15 377.16 377.17 377.18 377.19 377.20 377.21
377.22 377.23 377.24 377.25 377.26 377.27 377.28 377.29 377.30 377.31
377.32 377.33 377.34 378.1 378.2 378.3 378.4 378.5 378.6 378.7 378.8 378.9 378.10 378.11
378.12 378.13 378.14 378.15 378.16 378.17 378.18 378.19 378.20
378.21 378.22 378.23 378.24 378.25 378.26 378.27 378.28 378.29 378.30 378.31 378.32 378.33 378.34 379.1 379.2 379.3 379.4 379.5 379.6 379.7 379.8 379.9 379.10 379.11 379.12 379.13 379.14 379.15 379.16 379.17 379.18 379.19 379.20 379.21 379.22 379.23 379.24 379.25 379.26 379.27 379.28 379.29 379.30 379.31 379.32 379.33 379.34 380.1 380.2 380.3 380.4 380.5 380.6 380.7 380.8 380.9 380.10 380.11 380.12 380.13 380.14 380.15 380.16 380.17 380.18 380.19 380.20 380.21 380.22 380.23 380.24 380.25 380.26 380.27 380.28 380.29 380.30 380.31 380.32 380.33 380.34 380.35 380.36 381.1 381.2 381.3 381.4 381.5 381.6 381.7 381.8 381.9 381.10 381.11 381.12 381.13 381.14 381.15 381.16 381.17 381.18 381.19 381.20 381.21 381.22 381.23 381.24 381.25 381.26
381.27 381.28 381.29 381.30 381.31 381.32 381.33 381.34 381.35 382.1 382.2 382.3 382.4 382.5 382.6 382.7 382.8 382.9 382.10 382.11 382.12 382.13 382.14 382.15 382.16 382.17 382.18 382.19 382.20 382.21 382.22 382.23 382.24 382.25 382.26 382.27 382.28 382.29 382.30 382.31 382.32 382.33 382.34 382.35 383.1 383.2 383.3 383.4 383.5 383.6 383.7 383.8 383.9 383.10 383.11 383.12 383.13 383.14 383.15 383.16 383.17 383.18 383.19 383.20 383.21 383.22 383.23 383.24 383.25 383.26 383.27 383.28 383.29 383.30 383.31 383.32 383.33 383.34 383.35 383.36 384.1 384.2
384.3 384.4 384.5 384.6 384.7 384.8 384.9 384.10 384.11 384.12 384.13 384.14 384.15 384.16 384.17 384.18 384.19 384.20 384.21 384.22 384.23
384.24 384.25 384.26 384.27 384.28 384.29 384.30 384.31 384.32 385.1 385.2 385.3 385.4 385.5 385.6 385.7 385.8 385.9 385.10 385.11 385.12 385.13 385.14 385.15 385.16 385.17 385.18 385.19
385.20 385.21 385.22 385.23 385.24 385.25 385.26 385.27 385.28 385.29 385.30 385.31 385.32 385.33 385.34 386.1 386.2 386.3 386.4 386.5 386.6 386.7 386.8 386.9 386.10 386.11 386.12 386.13
386.14 386.15 386.16 386.17
386.18
386.19 386.20 386.21
386.22
386.23 386.24 386.25 386.26
386.27
386.28 386.29 386.30 386.31 387.1 387.2
387.3 387.4 387.5 387.6 387.7
387.8 387.9
387.10 387.11 387.12 387.13 387.14 387.15 387.16 387.17 387.18 387.19 387.20 387.21 387.22 387.23 387.24 387.25 387.26 387.27 387.28 387.29 387.30 387.31 387.32 387.33 387.34 388.1 388.2 388.3 388.4 388.5 388.6 388.7 388.8
388.9
388.10 388.11 388.12 388.13
388.14 388.15
388.16 388.17 388.18 388.19 388.20 388.21 388.22 388.23 388.24 388.25 388.26 388.27 388.28 388.29 388.30 388.31 388.32 388.33 389.1 389.2 389.3 389.4 389.5 389.6 389.7
389.8
389.9 389.10 389.11 389.12 389.13 389.14 389.15 389.16 389.17 389.18
389.19 389.20 389.21 389.22 389.23 389.24 389.25 389.26 389.27 389.28 389.29 389.30 389.31
389.32 390.1 390.2 390.3 390.4 390.5 390.6 390.7 390.8
390.9 390.10
390.11 390.12 390.13 390.14 390.15 390.16 390.17 390.18 390.19 390.20 390.21 390.22 390.23 390.24 390.25 390.26 390.27 390.28 390.29 390.30 390.31 390.32 390.33 390.34 390.35 391.1 391.2 391.3 391.4 391.5 391.6 391.7 391.8 391.9 391.10 391.11 391.12 391.13
391.14 391.15 391.16 391.17 391.18 391.19 391.20 391.21 391.22 391.23 391.24 391.25 391.26 391.27
391.28 391.29 391.30 391.31 391.32 391.33 391.34 392.1 392.2 392.3 392.4 392.5 392.6 392.7 392.8 392.9 392.10 392.11 392.12 392.13 392.14
392.15
392.16 392.17 392.18 392.19 392.20 392.21 392.22 392.23 392.24 392.25 392.26 392.27 392.28 392.29 392.30 392.31 392.32 392.33 392.34 392.35 393.1 393.2 393.3 393.4 393.5 393.6 393.7 393.8 393.9 393.10 393.11 393.12 393.13 393.14
393.15 393.16
393.17 393.18 393.19 393.20 393.21 393.22 393.23 393.24 393.25 393.26 393.27 393.28
393.29 393.30 393.31 393.32 393.33 394.1 394.2 394.3 394.4 394.5 394.6 394.7 394.8 394.9 394.10 394.11 394.12 394.13
394.14
394.15 394.16 394.17 394.18 394.19 394.20 394.21 394.22 394.23 394.24 394.25 394.26 394.27 394.28 394.29
394.30
394.31 394.32 394.33 395.1 395.2 395.3 395.4 395.5 395.6 395.7 395.8 395.9 395.10 395.11 395.12 395.13 395.14 395.15 395.16 395.17 395.18 395.19 395.20 395.21 395.22 395.23 395.24 395.25 395.26
395.27
395.28 395.29 395.30 395.31 395.32 395.33 395.34 395.35 396.1 396.2 396.3 396.4 396.5 396.6 396.7 396.8 396.9 396.10 396.11 396.12 396.13 396.14 396.15 396.16 396.17 396.18 396.19 396.20 396.21 396.22 396.23 396.24 396.25 396.26 396.27 396.28 396.29 396.30 396.31 396.32 396.33 396.34 397.1 397.2 397.3 397.4 397.5 397.6 397.7 397.8 397.9 397.10 397.11 397.12 397.13 397.14 397.15 397.16
397.17 397.18
397.19 397.20
397.21 397.22 397.23 397.24 397.25 397.26 397.27 397.28 397.29
397.30 397.31
397.32 398.1 398.2 398.3 398.4 398.5 398.6 398.7 398.8 398.9 398.10 398.11 398.12 398.13 398.14 398.15 398.16 398.17 398.18 398.19 398.20
398.21 398.22
398.23 398.24 398.25 398.26 398.27
398.28 398.29
398.30 398.31 398.32 398.33
399.1 399.2
399.3 399.4 399.5 399.6 399.7 399.8 399.9 399.10 399.11 399.12
399.13 399.14
399.15 399.16 399.17 399.18 399.19 399.20 399.21 399.22 399.23 399.24 399.25
399.26 399.27
399.28 399.29 399.30 399.31 399.32 400.1 400.2 400.3
400.4 400.5
400.6 400.7
400.8 400.9 400.10 400.11 400.12 400.13 400.14 400.15 400.16 400.17 400.18 400.19 400.20 400.21 400.22 400.23 400.24 400.25 400.26 400.27 400.28 400.29 400.30 400.31
401.1 401.2
401.3 401.4 401.5 401.6 401.7 401.8 401.9 401.10 401.11 401.12 401.13 401.14 401.15 401.16
401.17 401.18 401.19 401.20 401.21 401.22 401.23 401.24 401.25 401.26 401.27 401.28 401.29 401.30 401.31 401.32 401.33 401.34 402.1 402.2 402.3 402.4 402.5 402.6 402.7 402.8 402.9 402.10 402.11 402.12 402.13 402.14 402.15 402.16 402.17 402.18 402.19 402.20 402.21 402.22 402.23 402.24 402.25
402.26 402.27 402.28 402.29 402.30 402.31 402.32 402.33 402.34 403.1 403.2 403.3 403.4 403.5 403.6 403.7 403.8 403.9 403.10 403.11 403.12 403.13 403.14 403.15 403.16 403.17 403.18 403.19 403.20 403.21 403.22 403.23 403.24 403.25 403.26 403.27 403.28 403.29 403.30 403.31 403.32 403.33 403.34 403.35 404.1 404.2 404.3 404.4 404.5 404.6
404.7 404.8 404.9 404.10 404.11 404.12 404.13 404.14 404.15 404.16 404.17 404.18 404.19 404.20 404.21 404.22 404.23 404.24 404.25 404.26 404.27 404.28 404.29 404.30 404.31 404.32 404.33 404.34 404.35 405.1 405.2 405.3 405.4 405.5 405.6 405.7 405.8 405.9 405.10 405.11 405.12 405.13 405.14 405.15 405.16 405.17 405.18 405.19 405.20 405.21 405.22 405.23 405.24 405.25 405.26 405.27 405.28 405.29 405.30 405.31 405.32 405.33
405.34 406.1 406.2 406.3 406.4 406.5 406.6 406.7 406.8 406.9 406.10 406.11 406.12 406.13 406.14 406.15 406.16 406.17 406.18 406.19 406.20 406.21 406.22 406.23 406.24 406.25 406.26 406.27 406.28 406.29
406.30
406.31 406.32 406.33 406.34 406.35 407.1 407.2 407.3 407.4 407.5 407.6 407.7 407.8 407.9 407.10 407.11 407.12 407.13 407.14 407.15 407.16 407.17 407.18 407.19 407.20 407.21 407.22 407.23 407.24 407.25 407.26 407.27 407.28 407.29 407.30 407.31 407.32 407.33 407.34 407.35 407.36 408.1 408.2 408.3 408.4 408.5 408.6 408.7 408.8 408.9 408.10 408.11 408.12 408.13 408.14 408.15 408.16 408.17 408.18 408.19 408.20 408.21 408.22 408.23 408.24 408.25 408.26 408.27 408.28
408.29
408.30 408.31 408.32 408.33 408.34 408.35 409.1 409.2 409.3 409.4 409.5 409.6 409.7 409.8 409.9 409.10 409.11 409.12 409.13 409.14 409.15 409.16 409.17 409.18 409.19 409.20 409.21 409.22
409.23
409.24 409.25 409.26 409.27 409.28 409.29 409.30 409.31 409.32 409.33 410.1 410.2 410.3
410.4
410.5 410.6 410.7 410.8 410.9 410.10 410.11 410.12 410.13 410.14 410.15 410.16 410.17 410.18 410.19 410.20 410.21 410.22 410.23 410.24 410.25 410.26 410.27 410.28 410.29 410.30 410.31 410.32 410.33
410.34
411.1 411.2 411.3 411.4 411.5 411.6 411.7 411.8
411.9 411.10 411.11 411.12 411.13 411.14 411.15 411.16 411.17
411.18
411.19 411.20 411.21 411.22 411.23 411.24 411.25 411.26 411.27 411.28
411.29
411.30 411.31 411.32 412.1 412.2 412.3 412.4 412.5 412.6 412.7 412.8 412.9 412.10 412.11 412.12 412.13 412.14 412.15 412.16 412.17 412.18 412.19 412.20 412.21
412.22 412.23 412.24 412.25 412.26 412.27 412.28 412.29 412.30 412.31 412.32 412.33
412.34 413.1 413.2 413.3 413.4 413.5 413.6 413.7 413.8 413.9 413.10 413.11 413.12 413.13 413.14 413.15 413.16 413.17 413.18 413.19
413.20 413.21 413.22 413.23 413.24 413.25 413.26 413.27 413.28 413.29 413.30 413.31 413.32 413.33 413.34
413.35
414.1 414.2 414.3 414.4 414.5 414.6 414.7 414.8 414.9 414.10 414.11 414.12 414.13 414.14 414.15 414.16 414.17 414.18 414.19 414.20
414.21
414.22 414.23 414.24 414.25 414.26 414.27 414.28 414.29 414.30 414.31 414.32 414.33 414.34 414.35 415.1 415.2 415.3 415.4 415.5 415.6 415.7 415.8 415.9 415.10 415.11 415.12 415.13 415.14 415.15 415.16 415.17 415.18 415.19 415.20 415.21 415.22 415.23 415.24 415.25 415.26 415.27 415.28 415.29 415.30 415.31 415.32 415.33 415.34 415.35 415.36
416.1 416.2 416.3 416.4 416.5 416.6 416.7 416.8 416.9 416.10 416.11 416.12 416.13 416.14 416.15 416.16 416.17 416.18 416.19 416.20 416.21 416.22 416.23 416.24 416.25 416.26 416.27 416.28 416.29 416.30 416.31 416.32 416.33 416.34 416.35 417.1 417.2 417.3 417.4 417.5 417.6 417.7 417.8 417.9 417.10 417.11 417.12 417.13 417.14 417.15 417.16 417.17 417.18 417.19 417.20 417.21 417.22 417.23 417.24 417.25 417.26 417.27
417.28 417.29 417.30 417.31 417.32 417.33 417.34 417.35
418.1 418.2 418.3 418.4 418.5 418.6 418.7 418.8 418.9 418.10 418.11 418.12 418.13 418.14 418.15 418.16 418.17 418.18 418.19 418.20 418.21 418.22 418.23 418.24 418.25 418.26 418.27 418.28 418.29 418.30 418.31 418.32 418.33 418.34 418.35 418.36 419.1 419.2 419.3 419.4 419.5 419.6 419.7 419.8 419.9 419.10 419.11 419.12 419.13 419.14
419.15 419.16 419.17 419.18 419.19
419.20 419.21
419.22 419.23 419.24 419.25 419.26 419.27 419.28 419.29 419.30 419.31 419.32 419.33 420.1 420.2
420.3 420.4 420.5 420.6
420.7
420.8 420.9 420.10 420.11 420.12 420.13 420.14 420.15 420.16 420.17 420.18 420.19 420.20
420.21
420.22 420.23 420.24 420.25 420.26 420.27 420.28 420.29 420.30 420.31 420.32 421.1 421.2 421.3 421.4 421.5 421.6 421.7 421.8 421.9 421.10 421.11
421.12
421.13 421.14 421.15 421.16 421.17 421.18 421.19 421.20 421.21 421.22 421.23 421.24 421.25 421.26 421.27 421.28 421.29 421.30 421.31 421.32 421.33 421.34 421.35 422.1 422.2 422.3 422.4 422.5 422.6 422.7 422.8 422.9 422.10 422.11 422.12 422.13 422.14 422.15 422.16 422.17 422.18 422.19 422.20 422.21 422.22 422.23 422.24 422.25 422.26 422.27 422.28 422.29 422.30 422.31 422.32 422.33 422.34 422.35 422.36 423.1 423.2 423.3 423.4 423.5 423.6 423.7 423.8 423.9 423.10 423.11 423.12 423.13 423.14 423.15 423.16 423.17 423.18 423.19 423.20 423.21 423.22 423.23 423.24 423.25 423.26
423.27
423.28 423.29 423.30 423.31 423.32 423.33 423.34 424.1 424.2 424.3 424.4 424.5 424.6 424.7 424.8 424.9 424.10 424.11 424.12 424.13 424.14 424.15 424.16
424.17 424.18 424.19 424.20 424.21 424.22 424.23 424.24 424.25 424.26 424.27 424.28 424.29 424.30 424.31 424.32 424.33 424.34 425.1 425.2 425.3 425.4 425.5 425.6 425.7 425.8 425.9 425.10 425.11 425.12 425.13 425.14 425.15 425.16 425.17 425.18 425.19 425.20 425.21 425.22 425.23 425.24 425.25
425.26 425.27 425.28 425.29 425.30
425.31 425.32 425.33 425.34 426.1 426.2 426.3 426.4 426.5 426.6 426.7 426.8 426.9 426.10 426.11 426.12 426.13 426.14 426.15 426.16 426.17 426.18 426.19 426.20 426.21 426.22 426.23 426.24 426.25 426.26 426.27 426.28 426.29 426.30 426.31 426.32 426.33 426.34 426.35 426.36 427.1 427.2 427.3 427.4 427.5 427.6 427.7 427.8 427.9 427.10 427.11 427.12 427.13 427.14 427.15 427.16 427.17 427.18 427.19 427.20 427.21 427.22 427.23 427.24 427.25 427.26 427.27 427.28 427.29 427.30 427.31 427.32 427.33 427.34 427.35 427.36 428.1 428.2 428.3 428.4 428.5 428.6 428.7 428.8 428.9 428.10 428.11 428.12 428.13 428.14 428.15 428.16 428.17 428.18 428.19 428.20 428.21 428.22 428.23 428.24 428.25 428.26 428.27 428.28 428.29 428.30 428.31 428.32 428.33 428.34 428.35 428.36 429.1 429.2 429.3 429.4 429.5 429.6 429.7 429.8 429.9 429.10 429.11 429.12 429.13 429.14 429.15 429.16 429.17 429.18 429.19 429.20 429.21 429.22 429.23 429.24 429.25 429.26 429.27 429.28 429.29 429.30 429.31 429.32 429.33 429.34 429.35 429.36 430.1 430.2 430.3 430.4 430.5 430.6 430.7 430.8 430.9 430.10 430.11 430.12 430.13 430.14 430.15 430.16 430.17 430.18 430.19 430.20 430.21 430.22 430.23 430.24 430.25 430.26 430.27 430.28 430.29 430.30 430.31 430.32 430.33
430.34 430.35 431.1 431.2 431.3 431.4 431.5 431.6 431.7 431.8 431.9 431.10 431.11 431.12 431.13 431.14 431.15 431.16 431.17 431.18 431.19 431.20 431.21 431.22 431.23 431.24 431.25 431.26 431.27 431.28 431.29 431.30 431.31 431.32 431.33 431.34 431.35 432.1 432.2 432.3 432.4 432.5 432.6 432.7 432.8 432.9 432.10 432.11 432.12 432.13 432.14 432.15 432.16 432.17 432.18 432.19 432.20 432.21 432.22 432.23 432.24 432.25 432.26 432.27 432.28 432.29 432.30 432.31 432.32 432.33 432.34 432.35 432.36 433.1 433.2 433.3 433.4 433.5 433.6 433.7 433.8 433.9 433.10 433.11 433.12 433.13 433.14 433.15 433.16 433.17 433.18 433.19 433.20 433.21 433.22 433.23 433.24 433.25 433.26 433.27 433.28 433.29 433.30 433.31 433.32 433.33 433.34 433.35 433.36 434.1 434.2 434.3 434.4 434.5 434.6 434.7 434.8 434.9 434.10 434.11 434.12 434.13 434.14 434.15 434.16 434.17
434.18
434.19 434.20 434.21 434.22 434.23 434.24 434.25 434.26 434.27 434.28 434.29 434.30 434.31 434.32 434.33 434.34 434.35 435.1 435.2 435.3 435.4 435.5 435.6 435.7 435.8 435.9
435.10 435.11 435.12 435.13 435.14 435.15 435.16 435.17 435.18 435.19 435.20 435.21 435.22 435.23 435.24 435.25
435.26 435.27 435.28 435.29 435.30 435.31 435.32 435.33 435.34 436.1 436.2
436.3 436.4 436.5 436.6 436.7 436.8 436.9 436.10 436.11
436.12 436.13 436.14 436.15 436.16 436.17 436.18 436.19
436.20 436.21 436.22 436.23 436.24 436.25 436.26 436.27 436.28 436.29 436.30 436.31 436.32 436.33 437.1 437.2 437.3 437.4 437.5 437.6 437.7 437.8 437.9 437.10 437.11 437.12 437.13 437.14 437.15 437.16 437.17 437.18 437.19
437.20 437.21 437.22 437.23 437.24 437.25 437.26 437.27 437.28 437.29 437.30 437.31 437.32 437.33 437.34 437.35 437.36 438.1 438.2 438.3 438.4 438.5 438.6 438.7 438.8 438.9 438.10 438.11 438.12 438.13 438.14 438.15 438.16 438.17 438.18 438.19 438.20 438.21 438.22
438.23 438.24 438.25 438.26 438.27 438.28 438.29 438.30 438.31 438.32 438.33 438.34 439.1 439.2 439.3 439.4 439.5 439.6 439.7
439.8 439.9 439.10 439.11 439.12 439.13 439.14 439.15 439.16 439.17 439.18 439.19 439.20 439.21 439.22 439.23 439.24
439.25 439.26 439.27 439.28
439.29 439.30
440.1 440.2
440.3 440.4 440.5 440.6 440.7 440.8 440.9 440.10 440.11 440.12 440.13 440.14 440.15 440.16 440.17 440.18 440.19 440.20 440.21 440.22 440.23 440.24 440.25 440.26 440.27 440.28 440.29 440.30 440.31 440.32 440.33 440.34 440.35 441.1 441.2 441.3 441.4 441.5 441.6 441.7 441.8 441.9 441.10 441.11 441.12 441.13 441.14 441.15 441.16 441.17 441.18 441.19 441.20 441.21 441.22 441.23 441.24 441.25 441.26 441.27 441.28 441.29 441.30 441.31 441.32 441.33 441.34 441.35 442.1 442.2 442.3 442.4 442.5 442.6 442.7 442.8 442.9 442.10 442.11 442.12 442.13 442.14 442.15 442.16 442.17 442.18 442.19 442.20 442.21 442.22 442.23 442.24 442.25 442.26 442.27 442.28 442.29 442.30 442.31 442.32 442.33 442.34 442.35 443.1 443.2 443.3 443.4 443.5 443.6 443.7 443.8 443.9 443.10 443.11 443.12 443.13 443.14 443.15 443.16 443.17 443.18 443.19 443.20 443.21 443.22 443.23 443.24 443.25 443.26 443.27 443.28 443.29 443.30 443.31 443.32 443.33 443.34 443.35 443.36 444.1 444.2 444.3 444.4 444.5 444.6 444.7 444.8 444.9 444.10 444.11 444.12 444.13
444.14 444.15 444.16 444.17 444.18 444.19 444.20 444.21 444.22 444.23 444.24 444.25 444.26 444.27 444.28 444.29 444.30 444.31
444.32 444.33 444.34 445.1 445.2 445.3 445.4 445.5 445.6
445.7
445.8 445.9 445.10 445.11 445.12 445.13 445.14 445.15 445.16 445.17 445.18 445.19
445.20
445.21 445.22 445.23
445.24 445.25
445.26 445.27 445.28 445.29 445.30 445.31 446.1 446.2 446.3 446.4 446.5 446.6 446.7
446.8 446.9 446.10 446.11 446.12 446.13 446.14 446.15 446.16 446.17 446.18 446.19 446.20 446.21 446.22 446.23 446.24 446.25 446.26 446.27 446.28 446.29 446.30 446.31 446.32 446.33 446.34 446.35 447.1 447.2 447.3 447.4 447.5 447.6 447.7 447.8 447.9 447.10 447.11 447.12 447.13 447.14 447.15 447.16 447.17 447.18 447.19 447.20 447.21
447.22 447.23
447.24 447.25
447.26 447.27 447.28 447.29 447.30 447.31 447.32 448.1 448.2 448.3 448.4
448.5 448.6 448.7 448.8 448.9 448.10 448.11 448.12 448.13 448.14 448.15 448.16 448.17
448.18 448.19 448.20 448.21 448.22 448.23 448.24 448.25 448.26 448.27 448.28 448.29 448.30 448.31 448.32 448.33 448.34 448.35 448.36 449.1 449.2 449.3 449.4 449.5 449.6 449.7 449.8 449.9 449.10 449.11 449.12 449.13 449.14 449.15 449.16 449.17 449.18 449.19 449.20 449.21 449.22 449.23 449.24 449.25 449.26 449.27 449.28 449.29 449.30 449.31 449.32 449.33 449.34 449.35 450.1 450.2 450.3 450.4 450.5 450.6 450.7 450.8 450.9 450.10 450.11 450.12 450.13 450.14 450.15 450.16 450.17 450.18 450.19 450.20 450.21 450.22 450.23 450.24 450.25 450.26 450.27 450.28 450.29 450.30 450.31 450.32 450.33 450.34 451.1 451.2 451.3 451.4 451.5 451.6 451.7 451.8 451.9 451.10 451.11 451.12 451.13 451.14 451.15 451.16 451.17 451.18 451.19 451.20 451.21 451.22 451.23 451.24 451.25 451.26 451.27 451.28 451.29 451.30 451.31 451.32 451.33 451.34 451.35 452.1 452.2 452.3 452.4 452.5 452.6 452.7 452.8 452.9 452.10 452.11 452.12 452.13 452.14 452.15 452.16 452.17 452.18 452.19 452.20 452.21 452.22 452.23 452.24 452.25 452.26 452.27 452.28 452.29 452.30 452.31 452.32 452.33 452.34 453.1 453.2 453.3 453.4 453.5 453.6 453.7 453.8 453.9 453.10 453.11 453.12 453.13 453.14 453.15 453.16 453.17 453.18 453.19 453.20 453.21 453.22 453.23 453.24 453.25 453.26 453.27 453.28 453.29 453.30 453.31 453.32 453.33 453.34 454.1 454.2 454.3 454.4 454.5 454.6 454.7 454.8 454.9 454.10 454.11 454.12 454.13 454.14 454.15 454.16 454.17 454.18 454.19 454.20 454.21 454.22 454.23 454.24 454.25 454.26 454.27 454.28 454.29 454.30 454.31 454.32 454.33 454.34 455.1 455.2 455.3 455.4 455.5 455.6 455.7 455.8 455.9 455.10 455.11 455.12 455.13 455.14 455.15 455.16 455.17 455.18 455.19 455.20 455.21 455.22 455.23 455.24 455.25 455.26 455.27 455.28 455.29 455.30 455.31 455.32 455.33 455.34 456.1 456.2 456.3 456.4 456.5 456.6 456.7 456.8 456.9 456.10 456.11 456.12 456.13 456.14 456.15 456.16 456.17 456.18 456.19 456.20 456.21 456.22 456.23 456.24 456.25 456.26 456.27 456.28 456.29 456.30 456.31 456.32 456.33 456.34 457.1 457.2 457.3 457.4 457.5 457.6 457.7 457.8 457.9 457.10 457.11 457.12 457.13 457.14 457.15 457.16 457.17 457.18 457.19 457.20 457.21 457.22 457.23 457.24 457.25 457.26 457.27 457.28 457.29 457.30 457.31 457.32 457.33 458.1 458.2 458.3 458.4 458.5 458.6 458.7 458.8 458.9 458.10 458.11 458.12 458.13 458.14 458.15 458.16 458.17 458.18 458.19 458.20 458.21 458.22 458.23 458.24 458.25 458.26 458.27 458.28 458.29 458.30 458.31 458.32 458.33 458.34 459.1 459.2 459.3 459.4 459.5 459.6 459.7 459.8 459.9 459.10 459.11 459.12 459.13 459.14 459.15 459.16 459.17 459.18 459.19 459.20 459.21 459.22 459.23 459.24 459.25 459.26 459.27 459.28 459.29 459.30 459.31 459.32 459.33 459.34 459.35 460.1 460.2 460.3 460.4 460.5 460.6 460.7 460.8 460.9 460.10 460.11 460.12 460.13 460.14 460.15 460.16 460.17 460.18 460.19 460.20 460.21 460.22 460.23 460.24 460.25 460.26 460.27 460.28 460.29 460.30 460.31 460.32 460.33 460.34 460.35 461.1 461.2 461.3 461.4 461.5 461.6 461.7 461.8 461.9 461.10 461.11 461.12 461.13 461.14 461.15 461.16 461.17 461.18 461.19 461.20 461.21 461.22 461.23 461.24 461.25 461.26 461.27 461.28 461.29 461.30 461.31 461.32 461.33 461.34 461.35 462.1 462.2 462.3 462.4 462.5 462.6 462.7 462.8 462.9 462.10 462.11 462.12 462.13 462.14 462.15 462.16 462.17 462.18 462.19 462.20 462.21 462.22 462.23 462.24 462.25 462.26 462.27 462.28 462.29 462.30 462.31 462.32 462.33 462.34 462.35 463.1 463.2 463.3 463.4 463.5 463.6 463.7 463.8 463.9 463.10 463.11 463.12 463.13 463.14 463.15 463.16 463.17 463.18 463.19 463.20 463.21 463.22 463.23 463.24 463.25 463.26 463.27 463.28 463.29 463.30 463.31 463.32 463.33 463.34 463.35 464.1 464.2 464.3 464.4 464.5 464.6 464.7 464.8 464.9 464.10 464.11 464.12 464.13 464.14 464.15 464.16 464.17 464.18 464.19 464.20 464.21 464.22 464.23 464.24 464.25 464.26 464.27 464.28 464.29 464.30 464.31 464.32 464.33 464.34 465.1 465.2 465.3 465.4 465.5 465.6 465.7 465.8 465.9 465.10 465.11 465.12 465.13 465.14 465.15 465.16 465.17 465.18 465.19 465.20 465.21 465.22 465.23 465.24 465.25 465.26 465.27 465.28 465.29 465.30 465.31 465.32 465.33 465.34 466.1 466.2 466.3 466.4 466.5 466.6 466.7 466.8 466.9 466.10 466.11 466.12 466.13 466.14 466.15 466.16 466.17 466.18 466.19 466.20 466.21 466.22 466.23 466.24 466.25 466.26 466.27 466.28 466.29 466.30 466.31 466.32 466.33 466.34 467.1 467.2 467.3 467.4 467.5 467.6 467.7 467.8 467.9 467.10 467.11 467.12 467.13 467.14 467.15 467.16 467.17 467.18 467.19 467.20 467.21 467.22 467.23 467.24 467.25 467.26 467.27 467.28 467.29 467.30 467.31 467.32 467.33 467.34 468.1 468.2 468.3 468.4 468.5 468.6 468.7 468.8 468.9 468.10 468.11 468.12 468.13 468.14 468.15 468.16 468.17 468.18 468.19 468.20 468.21 468.22 468.23 468.24 468.25 468.26 468.27 468.28 468.29 468.30 468.31 468.32 468.33 468.34 468.35 469.1 469.2 469.3 469.4 469.5 469.6 469.7 469.8 469.9 469.10 469.11 469.12 469.13 469.14 469.15 469.16 469.17 469.18 469.19 469.20 469.21 469.22 469.23 469.24 469.25 469.26 469.27 469.28 469.29 469.30 469.31 469.32 469.33 470.1 470.2 470.3 470.4 470.5 470.6 470.7 470.8 470.9 470.10 470.11 470.12 470.13 470.14 470.15 470.16 470.17 470.18 470.19 470.20 470.21 470.22 470.23 470.24 470.25 470.26 470.27 470.28 470.29 470.30 470.31 470.32 470.33 470.34 470.35 471.1 471.2 471.3 471.4 471.5 471.6 471.7 471.8 471.9 471.10 471.11 471.12 471.13 471.14 471.15 471.16 471.17 471.18 471.19 471.20 471.21 471.22 471.23 471.24 471.25 471.26 471.27 471.28 471.29 471.30 471.31 471.32 471.33 471.34 472.1 472.2 472.3 472.4 472.5 472.6 472.7 472.8 472.9 472.10 472.11 472.12 472.13 472.14 472.15 472.16 472.17 472.18 472.19 472.20 472.21 472.22 472.23 472.24 472.25 472.26 472.27 472.28 472.29 472.30 472.31 472.32 472.33 472.34 472.35 473.1 473.2 473.3 473.4 473.5 473.6 473.7 473.8 473.9 473.10 473.11 473.12 473.13 473.14 473.15 473.16 473.17 473.18 473.19 473.20 473.21 473.22 473.23 473.24 473.25 473.26 473.27 473.28 473.29 473.30 473.31 473.32 473.33 473.34 473.35 474.1 474.2 474.3 474.4 474.5 474.6 474.7 474.8 474.9 474.10 474.11 474.12 474.13 474.14 474.15 474.16 474.17 474.18 474.19 474.20 474.21 474.22 474.23 474.24 474.25 474.26 474.27 474.28 474.29 474.30 474.31 474.32 474.33 474.34 475.1 475.2 475.3 475.4 475.5 475.6 475.7 475.8 475.9 475.10 475.11 475.12 475.13 475.14 475.15 475.16 475.17 475.18 475.19 475.20 475.21 475.22 475.23 475.24 475.25 475.26 475.27 475.28 475.29 475.30 475.31 475.32 475.33 475.34 475.35 475.36 476.1 476.2 476.3 476.4 476.5 476.6 476.7 476.8 476.9 476.10 476.11 476.12 476.13 476.14 476.15 476.16 476.17 476.18 476.19 476.20 476.21 476.22 476.23 476.24 476.25 476.26 476.27 476.28 476.29 476.30 476.31 476.32 476.33 476.34 477.1 477.2 477.3 477.4 477.5 477.6 477.7 477.8 477.9 477.10 477.11 477.12 477.13 477.14 477.15 477.16 477.17 477.18 477.19 477.20 477.21 477.22 477.23 477.24 477.25 477.26 477.27 477.28 477.29 477.30 477.31 477.32 477.33 477.34 477.35 478.1 478.2 478.3 478.4 478.5 478.6 478.7 478.8 478.9 478.10 478.11 478.12 478.13 478.14 478.15 478.16 478.17 478.18 478.19 478.20 478.21 478.22 478.23 478.24 478.25 478.26 478.27 478.28 478.29 478.30 478.31 478.32 478.33 478.34 479.1 479.2 479.3 479.4 479.5 479.6 479.7 479.8 479.9 479.10 479.11 479.12 479.13 479.14 479.15 479.16 479.17 479.18 479.19 479.20 479.21 479.22 479.23 479.24 479.25 479.26 479.27 479.28 479.29 479.30 479.31 479.32 479.33 479.34 480.1 480.2 480.3 480.4 480.5 480.6 480.7 480.8 480.9 480.10 480.11 480.12 480.13 480.14 480.15 480.16 480.17 480.18 480.19 480.20 480.21 480.22 480.23 480.24 480.25 480.26 480.27 480.28 480.29 480.30 480.31 480.32 480.33 480.34 480.35 481.1 481.2 481.3 481.4 481.5 481.6 481.7 481.8 481.9 481.10 481.11 481.12 481.13 481.14 481.15 481.16 481.17 481.18 481.19 481.20 481.21 481.22 481.23 481.24 481.25 481.26 481.27 481.28 481.29 481.30 481.31 481.32 481.33 482.1 482.2 482.3 482.4 482.5 482.6 482.7 482.8 482.9 482.10 482.11 482.12 482.13 482.14 482.15 482.16 482.17 482.18 482.19 482.20 482.21 482.22 482.23 482.24 482.25 482.26 482.27 482.28 482.29 482.30 482.31 482.32 482.33 482.34 482.35 483.1 483.2 483.3 483.4 483.5 483.6 483.7 483.8 483.9 483.10 483.11 483.12 483.13 483.14 483.15 483.16 483.17 483.18 483.19 483.20 483.21 483.22 483.23 483.24 483.25 483.26 483.27 483.28 483.29 483.30 483.31 483.32 483.33 483.34 483.35 484.1 484.2 484.3 484.4 484.5 484.6 484.7 484.8 484.9 484.10 484.11 484.12 484.13 484.14 484.15 484.16 484.17 484.18 484.19 484.20 484.21 484.22 484.23 484.24 484.25 484.26 484.27 484.28 484.29 484.30 484.31 484.32 484.33 484.34 484.35 484.36 485.1 485.2 485.3 485.4 485.5 485.6 485.7 485.8 485.9 485.10 485.11 485.12 485.13 485.14 485.15 485.16 485.17 485.18 485.19 485.20 485.21 485.22 485.23 485.24 485.25 485.26 485.27 485.28 485.29 485.30 485.31 485.32 486.1 486.2 486.3 486.4 486.5 486.6 486.7 486.8 486.9 486.10 486.11 486.12 486.13 486.14 486.15 486.16 486.17 486.18 486.19 486.20 486.21 486.22 486.23 486.24 486.25 486.26 486.27 486.28 486.29 486.30 486.31 486.32 486.33 486.34 486.35 486.36 487.1 487.2 487.3 487.4 487.5 487.6 487.7 487.8 487.9 487.10 487.11 487.12 487.13 487.14 487.15 487.16 487.17 487.18 487.19 487.20 487.21 487.22 487.23 487.24 487.25 487.26 487.27 487.28 487.29 487.30 487.31 487.32 487.33 487.34 488.1 488.2 488.3 488.4 488.5 488.6 488.7 488.8 488.9 488.10 488.11 488.12 488.13 488.14 488.15 488.16 488.17 488.18 488.19 488.20 488.21 488.22 488.23 488.24 488.25 488.26 488.27 488.28 488.29 488.30 488.31 488.32 488.33 489.1 489.2 489.3 489.4 489.5 489.6 489.7 489.8 489.9 489.10 489.11 489.12 489.13 489.14 489.15 489.16
489.17 489.18 489.19 489.20 489.21 489.22 489.23 489.24 489.25 489.26 489.27 489.28 489.29 489.30 489.31 489.32 489.33 489.34 489.35 490.1 490.2 490.3 490.4 490.5 490.6 490.7 490.8 490.9 490.10 490.11 490.12 490.13 490.14 490.15 490.16 490.17 490.18 490.19 490.20 490.21 490.22 490.23 490.24 490.25 490.26 490.27 490.28 490.29 490.30 490.31 490.32 490.33 490.34 491.1 491.2 491.3 491.4 491.5 491.6 491.7 491.8 491.9 491.10 491.11 491.12 491.13 491.14 491.15 491.16 491.17 491.18 491.19 491.20 491.21 491.22 491.23 491.24 491.25 491.26 491.27 491.28 491.29 491.30 491.31 491.32 491.33 491.34 491.35 491.36 492.1 492.2 492.3 492.4 492.5 492.6 492.7 492.8 492.9 492.10 492.11 492.12 492.13 492.14 492.15 492.16 492.17 492.18 492.19 492.20 492.21 492.22 492.23 492.24 492.25 492.26 492.27 492.28 492.29 492.30 492.31 492.32 492.33 492.34 492.35 493.1 493.2 493.3 493.4 493.5 493.6 493.7 493.8 493.9 493.10 493.11 493.12 493.13 493.14 493.15 493.16 493.17 493.18 493.19 493.20 493.21 493.22 493.23 493.24 493.25 493.26 493.27 493.28 493.29 493.30 493.31 493.32 493.33 493.34 493.35 494.1 494.2 494.3 494.4 494.5 494.6 494.7 494.8 494.9 494.10 494.11 494.12 494.13 494.14 494.15 494.16 494.17 494.18 494.19 494.20 494.21 494.22 494.23 494.24 494.25 494.26 494.27 494.28 494.29 494.30 494.31 494.32 494.33 494.34 495.1 495.2 495.3 495.4 495.5 495.6 495.7 495.8 495.9 495.10 495.11 495.12 495.13 495.14 495.15 495.16 495.17 495.18 495.19 495.20 495.21 495.22 495.23 495.24 495.25 495.26 495.27 495.28 495.29 495.30 495.31 495.32 495.33 495.34 495.35 495.36 496.1 496.2 496.3 496.4 496.5 496.6 496.7 496.8 496.9 496.10 496.11 496.12 496.13 496.14 496.15 496.16 496.17 496.18 496.19 496.20 496.21 496.22 496.23 496.24 496.25 496.26 496.27 496.28 496.29 496.30 496.31 496.32 496.33 496.34 496.35 497.1 497.2 497.3 497.4 497.5 497.6 497.7 497.8 497.9 497.10 497.11 497.12 497.13 497.14 497.15 497.16 497.17 497.18 497.19 497.20 497.21 497.22 497.23 497.24 497.25 497.26 497.27 497.28 497.29 497.30 497.31 497.32 497.33 497.34 497.35 498.1 498.2 498.3 498.4 498.5 498.6 498.7 498.8 498.9 498.10 498.11 498.12 498.13 498.14 498.15 498.16 498.17 498.18 498.19 498.20 498.21 498.22 498.23 498.24 498.25 498.26 498.27 498.28 498.29 498.30 498.31 498.32 498.33 498.34 498.35 499.1 499.2 499.3 499.4 499.5 499.6 499.7 499.8 499.9 499.10 499.11 499.12 499.13 499.14 499.15 499.16 499.17 499.18 499.19 499.20 499.21 499.22 499.23 499.24 499.25 499.26 499.27 499.28 499.29
499.30 499.31 499.32 499.33 499.34 499.35 500.1 500.2 500.3 500.4 500.5 500.6 500.7 500.8 500.9 500.10 500.11 500.12 500.13 500.14 500.15 500.16 500.17 500.18 500.19 500.20 500.21 500.22 500.23 500.24 500.25 500.26 500.27 500.28 500.29 500.30 500.31 500.32 500.33 500.34 501.1 501.2
501.3 501.4 501.5 501.6 501.7 501.8 501.9 501.10 501.11 501.12 501.13 501.14 501.15 501.16 501.17 501.18 501.19 501.20 501.21 501.22 501.23 501.24 501.25 501.26 501.27 501.28 501.29 501.30 501.31 501.32 501.33 502.1 502.2 502.3 502.4 502.5 502.6 502.7 502.8 502.9 502.10 502.11
502.12 502.13 502.14 502.15 502.16 502.17 502.18 502.19 502.20 502.21 502.22 502.23 502.24 502.25 502.26 502.27 502.28 502.29 502.30 502.31 502.32 502.33 502.34 503.1 503.2 503.3 503.4 503.5 503.6 503.7 503.8 503.9 503.10 503.11 503.12 503.13 503.14
503.15 503.16 503.17 503.18 503.19 503.20 503.21 503.22 503.23 503.24 503.25 503.26 503.27 503.28 503.29 503.30
503.31 503.32 503.33
503.34
504.1 504.2 504.3 504.4 504.5 504.6 504.7
504.8 504.9 504.10 504.11 504.12
504.13 504.14 504.15 504.16 504.17 504.18 504.19 504.20 504.21 504.22 504.23 504.24 504.25 504.26 504.27 504.28 504.29 504.30 504.31
504.32 504.33 505.1 505.2 505.3 505.4 505.5 505.6
505.7 505.8 505.9 505.10 505.11 505.12 505.13
505.14 505.15 505.16 505.17 505.18 505.19 505.20
505.21 505.22 505.23 505.24 505.25 505.26 505.27 505.28 505.29 505.30 505.31 505.32 505.33 506.1 506.2
506.3 506.4 506.5 506.6 506.7 506.8 506.9 506.10
506.11 506.12 506.13 506.14 506.15 506.16 506.17
506.18 506.19 506.20 506.21 506.22 506.23 506.24 506.25 506.26 506.27 506.28 506.29 506.30 506.31 507.1 507.2 507.3 507.4 507.5 507.6 507.7
507.8
507.9 507.10 507.11 507.12 507.13 507.14 507.15 507.16 507.17 507.18 507.19 507.20 507.21 507.22 507.23
507.24 507.25 507.26
507.27 507.28 507.29
507.30 507.31 507.32
A bill for an act
relating to state government; making changes to health and human services
programs; changing children and family provisions; amending child welfare
provisions; establishing prekindergarten exploratory projects; modifying
licensing provisions; amending health care programs and policy; modifying
continuing care programs and policy; amending mental and chemical health
provisions; changing Department of Health provisions and policy; establishing
a children's health program; changing public health provisions and policy;
amending MinnesotaCare, medical assistance, and general assistance medical
care; instituting health care reform; modifying health insurance provisions;
establishing family supportive services; providing rate increases for certain
providers and nursing facilities; changing health records information provisions;
making technical changes; providing penalties; establishing task forces; changing
certain fees; requiring reports; making forecast adjustments; appropriating
money for human services and health; appropriating money for various state
boards and councils; amending Minnesota Statutes 2006, sections 13.381,
by adding a subdivision; 13.46, subdivision 2; 16A.724, subdivision 2, by
adding subdivisions; 16B.61, by adding a subdivision; 16D.13, subdivision 3;
43A.23, subdivision 1; 62E.02, subdivision 7; 62H.02; 62J.07, subdivisions
1, 3; 62J.17, subdivisions 2, 4a, 6a, 7; 62J.41, subdivision 1; 62J.495; 62J.52,
subdivisions 1, 2; 62J.60, subdivisions 2, 3; 62J.692, subdivisions 1, 4, 5, 8;
62J.81, subdivision 1; 62J.82; 62L.02, subdivision 11; 62Q.165, subdivisions 1,
2; 62Q.80, subdivisions 3, 4, 13, 14, by adding a subdivision; 69.021, subdivision
11; 103I.101, subdivision 6; 103I.208, subdivisions 1, 2; 103I.235, subdivision
1; 119B.011, by adding a subdivision; 119B.035, subdivision 1; 119B.05,
subdivision 1; 119B.09, subdivision 7, by adding subdivisions; 119B.12;
119B.125, subdivision 2; 119B.13, subdivisions 1, 3a, 7; 119B.21, subdivision
5; 144.123; 144.125; 144.3345; 144.5509; 144.552; 144.553, subdivision 3;
144.565; 144.651, subdivisions 9, 10, 26; 144.698, subdivision 1; 144.699, by
adding a subdivision; 144.9507, by adding a subdivision; 144.9512; 144A.073,
subdivision 4; 144A.351; 144D.03, subdivision 1; 144E.101, subdivision 6;
144E.127; 144E.35, subdivision 1; 145A.17; 145C.05; 145C.07, by adding
a subdivision; 148.235, by adding a subdivision; 148.6445, subdivisions 1,
2; 148B.53, subdivision 3; 148C.11, subdivision 1; 149A.52, subdivision 3;
149A.97, subdivision 7; 151.19, subdivision 2; 151.37, subdivision 2; 152.11, by
adding a subdivision; 157.16, subdivision 1; 169A.70, subdivision 4; 198.075;
245.462, subdivision 20; 245.465, by adding a subdivision; 245.4712, subdivision
1; 245.4874; 245.50, subdivision 5; 245.771, by adding a subdivision; 245.98,
subdivision 2; 245A.035; 245A.10, subdivision 2; 245A.16, subdivisions 1, 3;
245C.02, by adding a subdivision; 245C.04, subdivision 1; 245C.05, subdivisions
1, 4, 5, 7, by adding a subdivision; 245C.08, subdivisions 1, 2; 245C.10, by
adding a subdivision; 245C.11, subdivisions 1, 2; 245C.12; 245C.16, subdivision
1; 245C.17, by adding a subdivision; 245C.21, by adding a subdivision;
245C.23, subdivision 2; 246.54, subdivisions 1, 2; 252.27, subdivision 2a;
252.32, subdivision 3; 253B.185, subdivision 2, by adding a subdivision;
254A.03, subdivision 3; 254A.16, subdivision 2; 254B.02, subdivisions 1, 5;
254B.03, subdivisions 1, 3; 254B.06, subdivision 3; 256.01, subdivisions 2,
2b, 4, by adding subdivisions; 256.015, subdivision 7; 256.017, subdivisions
1, 9; 256.476, subdivisions 1, 2, 3, 4, 5, 10; 256.969, subdivisions 9, 27;
256.974; 256.9741, subdivisions 1, 3; 256.9742, subdivisions 3, 4, 6; 256.9744,
subdivision 1; 256.975, subdivision 7, by adding a subdivision; 256.984,
subdivision 1; 256B.04, subdivision 14, by adding a subdivision; 256B.055,
subdivision 14; 256B.056, subdivision 10, by adding a subdivision; 256B.057,
by adding a subdivision; 256B.0621, subdivision 11; 256B.0622, subdivision 2;
256B.0623, subdivision 5; 256B.0625, subdivisions 3f, 13c, 13d, 18a, 20, 23, 47,
by adding subdivisions; 256B.0631, subdivisions 1, 3; 256B.0644; 256B.0651,
subdivision 7; 256B.0655, subdivisions 1b, 1f, 3, 8, by adding subdivisions;
256B.0911, subdivisions 3a, 3b, 4b, 4c, 6, 7, by adding subdivisions; 256B.0913,
subdivisions 4, 5, 5a, 8, 9, 10, 11, 12, 13, 14; 256B.0915; 256B.0919, subdivision
3; 256B.0943, subdivisions 6, 8, 9, 11, 12; 256B.0945, subdivision 4; 256B.095;
256B.0951, subdivision 1; 256B.199; 256B.27, subdivision 2a; 256B.431,
subdivisions 1, 2e, 3f, 17a, 17e, 41; 256B.434, subdivision 4, by adding
subdivisions; 256B.437, by adding a subdivision; 256B.441, subdivisions 1, 2, 5,
6, 10, 11, 13, 14, 17, 20, 24, 30, 31, 34, 38, by adding subdivisions; 256B.49,
subdivision 11, by adding a subdivision; 256B.5012, by adding a subdivision;
256B.69, subdivisions 4, 5g, 5h, 23; 256B.76; 256B.763; 256D.03, subdivisions
3, 4; 256E.35, subdivision 2; 256I.04, subdivision 3; 256I.05, by adding
subdivisions; 256J.01, by adding a subdivision; 256J.02, subdivisions 1, 4, by
adding a subdivision; 256J.021; 256J.08, subdivision 65; 256J.20, subdivision 3;
256J.21, subdivision 2; 256J.32, subdivision 6; 256J.42, subdivision 1; 256J.46,
by adding a subdivision; 256J.49, subdivision 13; 256J.521, subdivisions 1, 2;
256J.53, subdivision 2; 256J.55, subdivision 1; 256J.626, subdivisions 1, 2, 3, 4,
5, 6, 7; 256J.751, subdivisions 2, 5; 256J.77; 256J.95, subdivision 3; 256K.45,
by adding a subdivision; 256L.01, subdivisions 1, 4; 256L.03, subdivisions
1, 3, 5; 256L.04, subdivisions 1, 7, 12; 256L.05, subdivisions 1, 1b, 2, 3a;
256L.07, subdivisions 1, 6, by adding a subdivision; 256L.09, subdivision 4;
256L.11, subdivision 7; 256L.12, subdivision 9a; 256L.15, subdivisions 1, 2, 4;
256L.17, subdivisions 2, 3, 7; 259.20, subdivision 2; 259.24, subdivision 3;
259.29, subdivision 1; 259.41; 259.53, subdivisions 1, 2; 259.57, subdivisions
1, 2; 259.67, subdivisions 4, 7; 259.75, subdivision 8; 260.012; 260.755,
subdivisions 12, 20; 260.761, subdivision 7; 260.765, subdivision 5; 260.771,
subdivisions 1, 2; 260B.157, subdivision 1; 260C.152, subdivision 5; 260C.163,
subdivision 1; 260C.201, subdivision 11; 260C.209; 260C.212, subdivisions 1, 2,
4, 9; 260C.317, subdivision 3; 260C.331, subdivision 1; 270B.14, subdivision
1; 518A.56, by adding a subdivision; 609.115, subdivisions 8, 9; 626.556,
subdivisions 2, 3, 10, 10a, 10c, 10f, by adding subdivisions; Laws 2000, chapter
340, section 19; Laws 2005, chapter 98, article 3, section 25; Laws 2005, First
Special Session chapter 4, article 9, section 3, subdivision 2; Laws 2006, chapter
282, article 20, section 37; proposing coding for new law in Minnesota Statutes,
chapters 16C; 62J; 62Q; 144; 145; 148; 149A; 151; 152; 156; 245; 245A; 245C;
252; 254A; 256; 256B; 256C; 256D; 256J; 256L; 260; repealing Minnesota
Statutes 2006, sections 62A.301; 62J.052, subdivision 1; 62J.692, subdivision
10; 119B.08, subdivision 4; 144.335; 252.21; 252.22; 252.23; 252.24; 252.25;
252.261; 252.275, subdivision 5; 254A.02, subdivisions 7, 9, 12, 14, 15, 16;
254A.085; 254A.086; 254A.12; 254A.14; 254A.15; 254A.16, subdivision 5;
254A.175; 254A.18; 256.956; 256.9743; 256B.0625, subdivisions 5a, 5b, 5c,
5d, 5e, 5f, 5g, 5h, 5i, 5j, 5k; 256B.0631, subdivision 4; 256B.0913, subdivisions
5b, 5c, 5d, 5e, 5f, 5g, 5h; 256B.441, subdivisions 12, 16, 21, 26, 28, 42, 45;
256J.29; 256J.37, subdivision 3b; 256J.561, subdivision 1; 256J.62, subdivision
9; 256J.626, subdivision 9; 256J.65; 256L.035; 256L.07, subdivision 2a; Laws
1997, chapter 8, section 1; Laws 2004, chapter 288, article 6, section 27; Laws
2006, chapter 249, section 6; Minnesota Rules, parts 4610.2800; 9503.0035,
subpart 2; 9560.0102, subpart 2, item C; 9585.0030.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
ARTICLE 1
CHILD WELFARE POLICY
Section 1.
Minnesota Statutes 2006, section 256.01, subdivision 2, is amended to read:
Subd. 2.
Specific powers.
Subject to the provisions of section 241.021, subdivision
2, the commissioner of human services shall carry out the specific duties in paragraphs (a)
through (cc):
(a) Administer and supervise all forms of public assistance provided for by state law
and other welfare activities or services as are vested in the commissioner. Administration
and supervision of human services activities or services includes, but is not limited to,
assuring timely and accurate distribution of benefits, completeness of service, and quality
program management. In addition to administering and supervising human services
activities vested by law in the department, the commissioner shall have the authority to:
(1) require county agency participation in training and technical assistance programs
to promote compliance with statutes, rules, federal laws, regulations, and policies
governing human services;
(2) monitor, on an ongoing basis, the performance of county agencies in the
operation and administration of human services, enforce compliance with statutes, rules,
federal laws, regulations, and policies governing welfare services and promote excellence
of administration and program operation;
(3) develop a quality control program or other monitoring program to review county
performance and accuracy of benefit determinations;
(4) require county agencies to make an adjustment to the public assistance benefits
issued to any individual consistent with federal law and regulation and state law and rule
and to issue or recover benefits as appropriate;
(5) delay or deny payment of all or part of the state and federal share of benefits and
administrative reimbursement according to the procedures set forth in section 256.017;
(6) make contracts with and grants to public and private agencies and organizations,
both profit and nonprofit, and individuals, using appropriated funds; and
(7) enter into contractual agreements with federally recognized Indian tribes with
a reservation in Minnesota to the extent necessary for the tribe to operate a federally
approved family assistance program or any other program under the supervision of the
commissioner. The commissioner shall consult with the affected county or counties in
the contractual agreement negotiations, if the county or counties wish to be included,
in order to avoid the duplication of county and tribal assistance program services. The
commissioner may establish necessary accounts for the purposes of receiving and
disbursing funds as necessary for the operation of the programs.
(b) Inform county agencies, on a timely basis, of changes in statute, rule, federal law,
regulation, and policy necessary to county agency administration of the programs.
(c) Administer and supervise all child welfare activities; promote the enforcement of
laws protecting disabled, dependent, neglected and delinquent children, and children born
to mothers who were not married to the children's fathers at the times of the conception
nor at the births of the children; license and supervise child-caring and child-placing
agencies and institutions; supervise the care of children in boarding and foster homes or
in private institutions; and generally perform all functions relating to the field of child
welfare now vested in the State Board of Control.
(d) Administer and supervise all noninstitutional service to disabled persons,
including those who are visually impaired, hearing impaired, or physically impaired
or otherwise disabled. The commissioner may provide and contract for the care and
treatment of qualified indigent children in facilities other than those located and available
at state hospitals when it is not feasible to provide the service in state hospitals.
(e) Assist and actively cooperate with other departments, agencies and institutions,
local, state, and federal, by performing services in conformity with the purposes of Laws
1939, chapter 431.
(f) Act as the agent of and cooperate with the federal government in matters of
mutual concern relative to and in conformity with the provisions of Laws 1939, chapter
431, including the administration of any federal funds granted to the state to aid in the
performance of any functions of the commissioner as specified in Laws 1939, chapter 431,
and including the promulgation of rules making uniformly available medical care benefits
to all recipients of public assistance, at such times as the federal government increases its
participation in assistance expenditures for medical care to recipients of public assistance,
the cost thereof to be borne in the same proportion as are grants of aid to said recipients.
(g) Establish and maintain any administrative units reasonably necessary for the
performance of administrative functions common to all divisions of the department.
(h) Act as designated guardian of both the estate and the person of all the wards of
the state of Minnesota, whether by operation of law or by an order of court, without any
further act or proceeding whatever, except as to persons committed as developmentally
disabled. For children under the guardianship of the commissioner new text begin or a tribe in Minnesota
recognized by the Secretary of the Interior new text end whose interests would be best served by
adoptive placement, the commissioner may contract with a licensed child-placing agency
or a Minnesota tribal social services agency to provide adoption services. A contract
with a licensed child-placing agency must be designed to supplement existing county
efforts and may not replace existing county programsnew text begin or tribal social servicesnew text end , unless the
replacement is agreed to by the county board and the appropriate exclusive bargaining
representativenew text begin , tribal governing body,new text end or the commissioner has evidence that child
placements of the county continue to be substantially below that of other counties. Funds
encumbered and obligated under an agreement for a specific child shall remain available
until the terms of the agreement are fulfilled or the agreement is terminated.
(i) Act as coordinating referral and informational center on requests for service for
newly arrived immigrants coming to Minnesota.
(j) The specific enumeration of powers and duties as hereinabove set forth shall in no
way be construed to be a limitation upon the general transfer of powers herein contained.
(k) Establish county, regional, or statewide schedules of maximum fees and charges
which may be paid by county agencies for medical, dental, surgical, hospital, nursing and
nursing home care and medicine and medical supplies under all programs of medical
care provided by the state and for congregate living care under the income maintenance
programs.
(l) Have the authority to conduct and administer experimental projects to test
methods and procedures of administering assistance and services to recipients or potential
recipients of public welfare. To carry out such experimental projects, it is further provided
that the commissioner of human services is authorized to waive the enforcement of
existing specific statutory program requirements, rules, and standards in one or more
counties. The order establishing the waiver shall provide alternative methods and
procedures of administration, shall not be in conflict with the basic purposes, coverage, or
benefits provided by law, and in no event shall the duration of a project exceed four years.
It is further provided that no order establishing an experimental project as authorized by
the provisions of this section shall become effective until the following conditions have
been met:
(1) the secretary of health and human services of the United States has agreed, for
the same project, to waive state plan requirements relative to statewide uniformity; and
(2) a comprehensive plan, including estimated project costs, shall be approved by
the Legislative Advisory Commission and filed with the commissioner of administration.
(m) According to federal requirements, establish procedures to be followed by
local welfare boards in creating citizen advisory committees, including procedures for
selection of committee members.
(n) Allocate federal fiscal disallowances or sanctions which are based on quality
control error rates for the aid to families with dependent children program formerly
codified in sections 256.72 to 256.87, medical assistance, or food stamp program in the
following manner:
(1) one-half of the total amount of the disallowance shall be borne by the county
boards responsible for administering the programs. For the medical assistance and the
AFDC program formerly codified in sections 256.72 to 256.87, disallowances shall be
shared by each county board in the same proportion as that county's expenditures for the
sanctioned program are to the total of all counties' expenditures for the AFDC program
formerly codified in sections 256.72 to 256.87, and medical assistance programs. For the
food stamp program, sanctions shall be shared by each county board, with 50 percent of
the sanction being distributed to each county in the same proportion as that county's
administrative costs for food stamps are to the total of all food stamp administrative costs
for all counties, and 50 percent of the sanctions being distributed to each county in the
same proportion as that county's value of food stamp benefits issued are to the total of
all benefits issued for all counties. Each county shall pay its share of the disallowance
to the state of Minnesota. When a county fails to pay the amount due hereunder, the
commissioner may deduct the amount from reimbursement otherwise due the county, or
the attorney general, upon the request of the commissioner, may institute civil action
to recover the amount due; and
(2) notwithstanding the provisions of clause (1), if the disallowance results from
knowing noncompliance by one or more counties with a specific program instruction, and
that knowing noncompliance is a matter of official county board record, the commissioner
may require payment or recover from the county or counties, in the manner prescribed in
clause (1), an amount equal to the portion of the total disallowance which resulted from the
noncompliance, and may distribute the balance of the disallowance according to clause (1).
(o) Develop and implement special projects that maximize reimbursements and
result in the recovery of money to the state. For the purpose of recovering state money,
the commissioner may enter into contracts with third parties. Any recoveries that result
from projects or contracts entered into under this paragraph shall be deposited in the
state treasury and credited to a special account until the balance in the account reaches
$1,000,000. When the balance in the account exceeds $1,000,000, the excess shall be
transferred and credited to the general fund. All money in the account is appropriated to
the commissioner for the purposes of this paragraph.
(p) Have the authority to make direct payments to facilities providing shelter
to women and their children according to section 256D.05, subdivision 3. Upon
the written request of a shelter facility that has been denied payments under section
256D.05, subdivision 3, the commissioner shall review all relevant evidence and make
a determination within 30 days of the request for review regarding issuance of direct
payments to the shelter facility. Failure to act within 30 days shall be considered a
determination not to issue direct payments.
(q) Have the authority to establish and enforce the following county reporting
requirements:
(1) the commissioner shall establish fiscal and statistical reporting requirements
necessary to account for the expenditure of funds allocated to counties for human
services programs. When establishing financial and statistical reporting requirements, the
commissioner shall evaluate all reports, in consultation with the counties, to determine if
the reports can be simplified or the number of reports can be reduced;
(2) the county board shall submit monthly or quarterly reports to the department
as required by the commissioner. Monthly reports are due no later than 15 working days
after the end of the month. Quarterly reports are due no later than 30 calendar days after
the end of the quarter, unless the commissioner determines that the deadline must be
shortened to 20 calendar days to avoid jeopardizing compliance with federal deadlines
or risking a loss of federal funding. Only reports that are complete, legible, and in the
required format shall be accepted by the commissioner;
(3) if the required reports are not received by the deadlines established in clause (2),
the commissioner may delay payments and withhold funds from the county board until
the next reporting period. When the report is needed to account for the use of federal
funds and the late report results in a reduction in federal funding, the commissioner shall
withhold from the county boards with late reports an amount equal to the reduction in
federal funding until full federal funding is received;
(4) a county board that submits reports that are late, illegible, incomplete, or not
in the required format for two out of three consecutive reporting periods is considered
noncompliant. When a county board is found to be noncompliant, the commissioner
shall notify the county board of the reason the county board is considered noncompliant
and request that the county board develop a corrective action plan stating how the
county board plans to correct the problem. The corrective action plan must be submitted
to the commissioner within 45 days after the date the county board received notice
of noncompliance;
(5) the final deadline for fiscal reports or amendments to fiscal reports is one year
after the date the report was originally due. If the commissioner does not receive a report
by the final deadline, the county board forfeits the funding associated with the report for
that reporting period and the county board must repay any funds associated with the
report received for that reporting period;
(6) the commissioner may not delay payments, withhold funds, or require repayment
under clause (3) or (5) if the county demonstrates that the commissioner failed to
provide appropriate forms, guidelines, and technical assistance to enable the county to
comply with the requirements. If the county board disagrees with an action taken by the
commissioner under clause (3) or (5), the county board may appeal the action according
to sections 14.57 to 14.69; and
(7) counties subject to withholding of funds under clause (3) or forfeiture or
repayment of funds under clause (5) shall not reduce or withhold benefits or services to
clients to cover costs incurred due to actions taken by the commissioner under clause
(3) or (5).
(r) Allocate federal fiscal disallowances or sanctions for audit exceptions when
federal fiscal disallowances or sanctions are based on a statewide random sample for
the foster care program under title IV-E of the Social Security Act, United States Code,
title 42, in direct proportion to each county's title IV-E foster care maintenance claim
for that period.
(s) Be responsible for ensuring the detection, prevention, investigation, and
resolution of fraudulent activities or behavior by applicants, recipients, and other
participants in the human services programs administered by the department.
(t) Require county agencies to identify overpayments, establish claims, and utilize
all available and cost-beneficial methodologies to collect and recover these overpayments
in the human services programs administered by the department.
(u) Have the authority to administer a drug rebate program for drugs purchased
pursuant to the prescription drug program established under section 256.955 after the
beneficiary's satisfaction of any deductible established in the program. The commissioner
shall require a rebate agreement from all manufacturers of covered drugs as defined in
section 256B.0625, subdivision 13. Rebate agreements for prescription drugs delivered on
or after July 1, 2002, must include rebates for individuals covered under the prescription
drug program who are under 65 years of age. For each drug, the amount of the rebate shall
be equal to the rebate as defined for purposes of the federal rebate program in United
States Code, title 42, section 1396r-8. The manufacturers must provide full payment
within 30 days of receipt of the state invoice for the rebate within the terms and conditions
used for the federal rebate program established pursuant to section 1927 of title XIX of
the Social Security Act. The manufacturers must provide the commissioner with any
information necessary to verify the rebate determined per drug. The rebate program shall
utilize the terms and conditions used for the federal rebate program established pursuant to
section 1927 of title XIX of the Social Security Act.
(v) Have the authority to administer the federal drug rebate program for drugs
purchased under the medical assistance program as allowed by section 1927 of title XIX
of the Social Security Act and according to the terms and conditions of section 1927.
Rebates shall be collected for all drugs that have been dispensed or administered in an
outpatient setting and that are from manufacturers who have signed a rebate agreement
with the United States Department of Health and Human Services.
(w) Have the authority to administer a supplemental drug rebate program for drugs
purchased under the medical assistance program. The commissioner may enter into
supplemental rebate contracts with pharmaceutical manufacturers and may require prior
authorization for drugs that are from manufacturers that have not signed a supplemental
rebate contract. Prior authorization of drugs shall be subject to the provisions of section
256B.0625, subdivision 13.
(x) Operate the department's communication systems account established in Laws
1993, First Special Session chapter 1, article 1, section 2, subdivision 2, to manage shared
communication costs necessary for the operation of the programs the commissioner
supervises. A communications account may also be established for each regional
treatment center which operates communications systems. Each account must be used
to manage shared communication costs necessary for the operations of the programs the
commissioner supervises. The commissioner may distribute the costs of operating and
maintaining communication systems to participants in a manner that reflects actual usage.
Costs may include acquisition, licensing, insurance, maintenance, repair, staff time and
other costs as determined by the commissioner. Nonprofit organizations and state, county,
and local government agencies involved in the operation of programs the commissioner
supervises may participate in the use of the department's communications technology and
share in the cost of operation. The commissioner may accept on behalf of the state any
gift, bequest, devise or personal property of any kind, or money tendered to the state for
any lawful purpose pertaining to the communication activities of the department. Any
money received for this purpose must be deposited in the department's communication
systems accounts. Money collected by the commissioner for the use of communication
systems must be deposited in the state communication systems account and is appropriated
to the commissioner for purposes of this section.
(y) Receive any federal matching money that is made available through the medical
assistance program for the consumer satisfaction survey. Any federal money received for
the survey is appropriated to the commissioner for this purpose. The commissioner may
expend the federal money received for the consumer satisfaction survey in either year of
the biennium.
(z) Designate community information and referral call centers and incorporate
cost reimbursement claims from the designated community information and referral
call centers into the federal cost reimbursement claiming processes of the department
according to federal law, rule, and regulations. Existing information and referral centers
provided by Greater Twin Cities United Way or existing call centers for which Greater
Twin Cities United Way has legal authority to represent, shall be included in these
designations upon review by the commissioner and assurance that these services are
accredited and in compliance with national standards. Any reimbursement is appropriated
to the commissioner and all designated information and referral centers shall receive
payments according to normal department schedules established by the commissioner
upon final approval of allocation methodologies from the United States Department of
Health and Human Services Division of Cost Allocation or other appropriate authorities.
(aa) Develop recommended standards for foster care homes that address the
components of specialized therapeutic services to be provided by foster care homes with
those services.
(bb) Authorize the method of payment to or from the department as part of the
human services programs administered by the department. This authorization includes the
receipt or disbursement of funds held by the department in a fiduciary capacity as part of
the human services programs administered by the department.
(cc) Have the authority to administer a drug rebate program for drugs purchased for
persons eligible for general assistance medical care under section 256D.03, subdivision 3.
For manufacturers that agree to participate in the general assistance medical care rebate
program, the commissioner shall enter into a rebate agreement for covered drugs as
defined in section 256B.0625, subdivisions 13 and 13d. For each drug, the amount of the
rebate shall be equal to the rebate as defined for purposes of the federal rebate program in
United States Code, title 42, section 1396r-8. The manufacturers must provide payment
within the terms and conditions used for the federal rebate program established under
section 1927 of title XIX of the Social Security Act. The rebate program shall utilize
the terms and conditions used for the federal rebate program established under section
1927 of title XIX of the Social Security Act.
Effective January 1, 2006, drug coverage under general assistance medical care shall
be limited to those prescription drugs that:
(1) are covered under the medical assistance program as described in section
256B.0625, subdivisions 13 and 13d; and
(2) are provided by manufacturers that have fully executed general assistance
medical care rebate agreements with the commissioner and comply with such agreements.
Prescription drug coverage under general assistance medical care shall conform to
coverage under the medical assistance program according to section 256B.0625,
subdivisions 13 to 13g.
The rebate revenues collected under the drug rebate program are deposited in the
general fund.
Sec. 2.
Minnesota Statutes 2006, section 259.24, subdivision 3, is amended to read:
Subd. 3.
Child.
When the child to be adopted is over 14 years of age, the child's
written consent new text begin to adoption by a particular person is new text end also deleted text begin shall bedeleted text end necessary.new text begin A child
of any age who is under the guardianship of the commissioner and is legally available
for adoption may not refuse or waive the commissioner's agent's exhaustive efforts to
recruit, identify, and place the child in an adoptive home required under section 260C.317,
subdivision 3, paragraph (b), or sign a document relieving county social services agencies
of all recruitment efforts on the child's behalf.
new text end
Sec. 3.
Minnesota Statutes 2006, section 259.53, subdivision 1, is amended to read:
Subdivision 1.
Notice to commissioner; referral for postplacement assessment.
(a) Upon the filing of a petition for adoption of a child new text begin who is:
new text end
new text begin
(1) under the guardianship of the commissioner or a licensed child-placing agency
according to section 260C.201, subdivision 11, or 260C.317;
new text end
new text begin
(2) placed by the commissioner, commissioner's agent, or licensed child-placing
agency after a consent to adopt according to section 259.24 or under an agreement
conferring authority to place for adoption according to section 259.25; or
new text end
new text begin
(3) placed by preadoptive custody order for a direct adoptive placement ordered
by the district court under section 259.47,
new text end
the court administrator shall immediately transmit a copy of the petition to the
commissioner of human services.
(b) The court shall immediately refer the petition to the agency specified below for
completion of a postplacement assessment and report as required by subdivision 2.
(1) If the child to be adopted has been committed to the guardianship of the
commissioner or an agency under section 260C.317 or an agency has been given authority
to place the child under section 259.25, the court shall refer the petition to that agency,
unless another agency is supervising the placement, in which case the court shall refer the
petition to the supervising agency.
(2) If the child to be adopted has been placed in the petitioner's home by a direct
adoptive placement, the court shall refer the petition to the agency supervising the
placement under section 259.47, subdivision 3, paragraph (a), clause (6).
(3) If the child is to be adopted by an individual who is related to the child as defined
by section 245A.02, subdivision 13, and in all other instances not described in clause (1)
or (2), the court shall refer the petition to the local social services agency of the county in
which the prospective adoptive parent lives.
Sec. 4.
Minnesota Statutes 2006, section 259.57, subdivision 1, is amended to read:
Subdivision 1.
Findings; orders.
Upon the hearing,
(a) if the court finds that it is in the best interests of the child that the petition
be granted, a decree of adoption shall be made and recorded in the office of the court
administrator, ordering that henceforth the child shall be the child of the petitioner. In the
decree the court may change the name of the child if desired. After the decree is grantednew text begin
for a child who is:new text end
new text begin
(1) under the guardianship of the commissioner or a licensed child-placing agency
according to section 260C.201, subdivision 11, or 260C.317;
new text end
new text begin
(2) placed by the commissioner, commissioner's agent, or licensed child-placing
agency after a consent to adopt according to section 259.24 or under an agreement
conferring authority to place for adoption according to section 259.25; or
new text end
new text begin
(3) adopted after a direct adoptive placement ordered by the district court under
section 259.47,
new text end
the court administrator shall immediately mail a copy of the recorded decree to the
commissioner of human services;
(b) if the court is not satisfied that the proposed adoption is in the best interests
of the child, the court shall deny the petition, and shall order the child returned to the
custody of the person or agency legally vested with permanent custody or certify the
case for appropriate action and disposition to the court having jurisdiction to determine
the custody and guardianship of the child.
Sec. 5.
Minnesota Statutes 2006, section 259.67, subdivision 7, is amended to read:
Subd. 7.
Reimbursement of costs.
(a) Subject to rules of the commissioner, and
the provisions of this subdivision a child-placing agency licensed in Minnesota or any
other state, or local or tribal social services agency shall receive a reimbursement from the
commissioner equal to 100 percent of the reasonable and appropriate cost of providing
adoption services deleted text begin for a child certified as eligible for adoption assistance under subdivision
4. Such assistancedeleted text end new text begin . Adoption services under this subdivisionnew text end may include adoptive family
recruitment, counseling, and special training when needed.
new text begin
(b) An eligible child must have a goal of adoption, which may include an adoption
in accordance with tribal law, and meet one of the following criteria:
new text end
new text begin
(1) is a ward of the commissioner of human services or a ward of tribal court
pursuant to section 260.755, subdivision 20, who meets one of the criteria in subdivision
4, paragraph (b), clause (1), (2), or (3); or
new text end
new text begin
(2) is under the guardianship of a Minnesota-licensed child-placing agency who
meets one of the criteria in subdivision 4, paragraph (b), clause (1) or (2).
new text end
new text begin (c) new text end A child-placing agency licensed in Minnesota or any other state shall receive
reimbursement for adoption services it purchases for or directly provides to an eligible
child. new text begin Tribal social services shall receive reimbursement for adoption services it purchases
for or directly provides to an eligible child. new text end A local deleted text begin or tribaldeleted text end social services agency shall
receive deleted text begin suchdeleted text end reimbursement only for adoption services it purchases for an eligible child.
deleted text begin (b) A child-placing agency licensed in Minnesota or any other state or local or tribal
social services agency seeking reimbursement under this subdivision shall enter intodeleted text end new text begin
Before providing adoption services for which reimbursement will be sought under this
subdivision, new text end a reimbursement agreementnew text begin , on the designated format, must be entered intonew text end
with the commissioner deleted text begin before providing adoption services for which reimbursement
is soughtdeleted text end . No reimbursement under this subdivision shall be made to an agency for
services provided prior to entering a reimbursement agreement. Separate reimbursement
agreements shall be made for each child and separate records shall be kept on each child
for whom a reimbursement agreement is made. new text begin The commissioner of human services shall
agree that the reimbursement costs are reasonable and appropriate. The commissioner
may spend up to $16,000 for each purchase of service agreement. Only one agreement per
child is allowed, unless an exception is granted by the commissioner. new text end Funds encumbered
and obligated under such an agreement for the child remain available until the terms of
the agreement are fulfilled or the agreement is terminated.
deleted text begin (c) When a local or tribal social services agency uses a purchase of service agreement
to provide services reimbursable under a reimbursement agreement,deleted text end The commissioner
deleted text begin maydeleted text end new text begin shallnew text end make reimbursement payments directly to the agency providing the service if
direct reimbursement is specified by the purchase of service agreement, and if the request
for reimbursement is submitted by the local or tribal social services agency along with a
verification that the service was provided.
Sec. 6.
Minnesota Statutes 2006, section 259.75, subdivision 8, is amended to read:
Subd. 8.
Reasons for deferral.
Deferral of the listing of a child with the state
adoption exchange shall be only for one or more of the following reasons:
(a) the child is in an adoptive placement but is not legally adopted;
(b) the child's foster parents or other individuals are now considering adoption;
(c) diagnostic study or testing is required to clarify the child's problem and provide
an adequate description;new text begin or
new text end
(d) the child is currently in a hospital and continuing need for daily professional care
will not permit placement in a family settingdeleted text begin ; ordeleted text end new text begin .
new text end
deleted text begin
(e) the child is 14 years of age or older and will not consent to an adoption plan.
deleted text end
Approval of a request to defer listing for any of the reasons specified in paragraph (b) or
(c) shall be valid for a period not to exceed 90 days, with no subsequent deferrals for
those reasons.
Sec. 7.
Minnesota Statutes 2006, section 260.012, is amended to read:
260.012 DUTY TO ENSURE PLACEMENT PREVENTION AND FAMILY
REUNIFICATION; REASONABLE EFFORTS.
(a) Once a child alleged to be in need of protection or services is under the court's
jurisdiction, the court shall ensure that reasonable efforts, including culturally appropriate
services, by the social services agency are made to prevent placement or to eliminate the
need for removal and to reunite the child with the child's family at the earliest possible
time, and deleted text begin when a child cannot be reunified with the parent or guardian from whom thedeleted text end
deleted text begin child was removed,deleted text end the court must ensure that the responsible social services agency
makes reasonable efforts to finalize an alternative permanent plan for the child as provided
in paragraph (e). In determining reasonable efforts to be made with respect to a child and
in making those reasonable efforts, the child's best interests, health, and safety must be of
paramount concern. Reasonable efforts to prevent placement and for rehabilitation and
reunification are always required except upon a determination by the court that a petition
has been filed stating a prima facie case that:
(1) the parent has subjected a child to egregious harm as defined in section
260C.007, subdivision 14;
(2) the parental rights of the parent to another child have been terminated
involuntarily;
(3) the child is an abandoned infant under section 260C.301, subdivision 2,
paragraph (a), clause (2);
(4) the parent's custodial rights to another child have been involuntarily transferred
to a relative under section 260C.201, subdivision 11, paragraph (e), clause (1), or a similar
law of another jurisdiction; or
(5) the provision of services or further services for the purpose of reunification is
futile and therefore unreasonable under the circumstances.
(b) When the court makes one of the prima facie determinations under paragraph (a),
either permanency pleadings under section 260C.201, subdivision 11, or a termination
of parental rights petition under sections 260C.141 and 260C.301 must be filed. A
permanency hearing under section 260C.201, subdivision 11, must be held within 30
days of this determination.
(c) In the case of an Indian child, in proceedings under sections 260B.178 or
260C.178, 260C.201, and 260C.301 the juvenile court must make findings and conclusions
consistent with the Indian Child Welfare Act of 1978, United States Code, title 25, section
1901 et seq., as to the provision of active efforts. In cases governed by the Indian Child
Welfare Act of 1978, United States Code, title 25, section 1901, the responsible social
services agency must provide active efforts as required under United States Code, title
25, section 1911(d).
(d) "Reasonable efforts to prevent placement" means:
(1) the agency has made reasonable efforts to prevent the placement of the child in
foster care; or
(2) given the particular circumstances of the child and family at the time of the
child's removal, there are no services or efforts available which could allow the child to
safely remain in the home.
(e) "Reasonable efforts to finalize a permanent plan for the child" means due
diligence by the responsible social services agency to:
(1) reunify the child with the parent or guardian from whom the child was removed;
(2) assess a noncustodial parent's ability to provide day-to-day care for the child and,
where appropriate, provide services necessary to enable the noncustodial parent to safely
provide the care, as required by section 260C.212, subdivision 4;
(3) conduct a relative search as required under section 260C.212, subdivision 5; and
(4) when the child cannot return to the parent or guardian from whom the child was
removed, to plan for and finalize a safe and legally permanent alternative home for the
child, new text begin and considers permanent alternative homes for the child inside or outside of the
state, new text end preferably through adoption or transfer of permanent legal and physical custody of
the child.
(f) Reasonable efforts are made upon the exercise of due diligence by the responsible
social services agency to use culturally appropriate and available services to meet the
needs of the child and the child's family. Services may include those provided by the
responsible social services agency and other culturally appropriate services available in
the community. At each stage of the proceedings where the court is required to review
the appropriateness of the responsible social services agency's reasonable efforts as
described in paragraphs (a), (d), and (e), the social services agency has the burden of
demonstrating that:
(1) it has made reasonable efforts to prevent placement of the child in foster care;
(2) it has made reasonable efforts to eliminate the need for removal of the child from
the child's home and to reunify the child with the child's family at the earliest possible time;
(3) it has made reasonable efforts to finalize an alternative permanent home for
the childnew text begin , and considers permanent alternative homes for the child inside or outside of
the statenew text end ; or
(4) reasonable efforts to prevent placement and to reunify the child with the parent
or guardian are not required. The agency may meet this burden by stating facts in a sworn
petition filed under section 260C.141, by filing an affidavit summarizing the agency's
reasonable efforts or facts the agency believes demonstrate there is no need for reasonable
efforts to reunify the parent and child, or through testimony or a certified report required
under juvenile court rules.
(g) Once the court determines that reasonable efforts for reunification are not
required because the court has made one of the prima facie determinations under paragraph
(a), the court may only require reasonable efforts for reunification after a hearing according
to section 260C.163, where the court finds there is not clear and convincing evidence of
the facts upon which the court based its prima facie determination. In this case when there
is clear and convincing evidence that the child is in need of protection or services, the
court may find the child in need of protection or services and order any of the dispositions
available under section 260C.201, subdivision 1. Reunification of a surviving child with a
parent is not required if the parent has been convicted of:
(1) a violation of, or an attempt or conspiracy to commit a violation of, sections
609.185 to 609.20; 609.222, subdivision 2; or 609.223 in regard to another child of the
parent;
(2) a violation of section 609.222, subdivision 2; or 609.223, in regard to the
surviving child; or
(3) a violation of, or an attempt or conspiracy to commit a violation of, United States
Code, title 18, section 1111(a) or 1112(a), in regard to another child of the parent.
(h) The juvenile court, in proceedings under sections 260B.178 or 260C.178,
260C.201, and 260C.301 shall make findings and conclusions as to the provision of
reasonable efforts. When determining whether reasonable efforts have been made, the
court shall consider whether services to the child and family were:
(1) relevant to the safety and protection of the child;
(2) adequate to meet the needs of the child and family;
(3) culturally appropriate;
(4) available and accessible;
(5) consistent and timely; and
(6) realistic under the circumstances.
In the alternative, the court may determine that provision of services or further
services for the purpose of rehabilitation is futile and therefore unreasonable under the
circumstances or that reasonable efforts are not required as provided in paragraph (a).
(i) This section does not prevent out-of-home placement for treatment of a child with
a mental disability when the child's diagnostic assessment or individual treatment plan
indicates that appropriate and necessary treatment cannot be effectively provided outside
of a residential or inpatient treatment program.
(j) If continuation of reasonable efforts to prevent placement or reunify the child
with the parent or guardian from whom the child was removed is determined by the court
to be inconsistent with the permanent plan for the child or upon the court making one of
the prima facie determinations under paragraph (a), reasonable efforts must be made to
place the child in a timely manner in a safe and permanent home and to complete whatever
steps are necessary to legally finalize the permanent placement of the child.
(k) Reasonable efforts to place a child for adoption or in another permanent
placement may be made concurrently with reasonable efforts to prevent placement or to
reunify the child with the parent or guardian from whom the child was removed. When
the responsible social services agency decides to concurrently make reasonable efforts for
both reunification and permanent placement away from the parent under paragraph (a), the
agency shall disclose its decision and both plans for concurrent reasonable efforts to all
parties and the court. When the agency discloses its decision to proceed on both plans for
reunification and permanent placement away from the parent, the court's review of the
agency's reasonable efforts shall include the agency's efforts under both plans.
Sec. 8.
Minnesota Statutes 2006, section 260.755, subdivision 12, is amended to read:
Subd. 12.
Indian tribe.
"Indian tribe" means an Indian tribe, band, nation, or
other organized group or community of Indians recognized as eligible for the services
provided to Indians by the secretary because of their status as Indians, including any deleted text begin banddeleted text end new text begin
Native groupnew text end under the Alaska Native Claims Settlement Act, United States Code, title 43,
section 1602deleted text begin , and exercising tribal governmental powersdeleted text end .
Sec. 9.
Minnesota Statutes 2006, section 260.755, subdivision 20, is amended to read:
Subd. 20.
Tribal court.
"Tribal court" means a court with deleted text begin federally recognizeddeleted text end
jurisdiction over child custody proceedings new text begin and new text end which is either a court of Indian offenses,
or a court established and operated under the code or custom of an Indian tribe, or deleted text begin thedeleted text end new text begin
any othernew text end administrative body of a tribe which is vested with authority over child custody
proceedings. Except as provided in section 260.771, subdivision 5, nothing in this chapter
shall be construed as conferring jurisdiction on an Indian tribe.
Sec. 10.
Minnesota Statutes 2006, section 260.761, subdivision 7, is amended to read:
Subd. 7.
Identification of extended family members.
Any agency considering
placement of an Indian child shall make deleted text begin reasonabledeleted text end new text begin activenew text end efforts to identify and locate
extended family members.
Sec. 11.
Minnesota Statutes 2006, section 260.765, subdivision 5, is amended to read:
Subd. 5.
Identification of extended family members.
Any agency considering
placement of an Indian child shall make deleted text begin reasonabledeleted text end new text begin activenew text end efforts to identify and locate
extended family members.
Sec. 12.
Minnesota Statutes 2006, section 260.771, subdivision 1, is amended to read:
Subdivision 1.
Indian tribe jurisdiction.
An Indian tribe deleted text begin with a tribal courtdeleted text end has
exclusive jurisdiction over a child placement proceeding involving an Indian child who
resides new text begin or is domiciled new text end within the reservation of deleted text begin suchdeleted text end new text begin thenew text end tribe deleted text begin at the commencement of
the proceedingsdeleted text end new text begin , except where jurisdiction is otherwise vested in the state by existing
federal lawnew text end . When an Indian child is deleted text begin in the legal custody of a person or agency pursuant
to an order ofdeleted text end a new text begin ward of the new text end tribal court, the Indian tribe retains exclusive jurisdiction,
notwithstanding the residence or domicile of the child.
Sec. 13.
Minnesota Statutes 2006, section 260.771, subdivision 2, is amended to read:
Subd. 2.
Court determination of tribal affiliation of child.
In any child placement
proceeding, the court shall establish whether an Indian child is involved and the identity
of the Indian child's tribe.new text begin This chapter and the federal Indian Child Welfare Act are
applicable without exception in any child custody proceeding, as defined in the federal act,
involving an Indian child. This chapter applies to child custody proceedings involving
an Indian child whether the child is in the physical or legal custody of an Indian parent,
Indian custodian, Indian extended family member, or other person at the commencement
of the proceedings. A court shall not determine the applicability of this chapter or the
federal Indian Child Welfare Act to a child custody proceeding based upon whether an
Indian child is part of an existing Indian family or based upon the level of contact a child
has with the child's Indian tribe, reservation, society, or off-reservation community.
new text end
Sec. 14.
new text begin
[260.852] PLACEMENT PROCEDURES.
new text end
new text begin Subdivision 1. new text end
new text begin Home study. new text end
new text begin
The state must have procedures for the orderly and
timely interstate placement of children that are implemented in accordance with an
interstate compact and that, within 60 days after the state receives from another state a
request to conduct a study of a home environment for purposes of assessing the safety
and suitability of placing a child in the home, the state shall, directly or by contract,
conduct and complete a home study and return to the other state a report on the results of
the study, which shall address the extent to which placement in the home would meet the
needs of the child; except in the case of a home study begun before October 1, 2008, if the
state fails to comply with conducting and completing the home study within the 60-day
period and this is as a result of circumstances beyond the control of the state, the state has
75 days to comply if the state documents the circumstances involved and certifies that
completing the home study is in the best interests of the child.
new text end
new text begin
This subdivision does not require the completion within the applicable period of
the parts of the home study involving the education and training of the prospective foster
or adoptive parents.
new text end
new text begin Subd. 2. new text end
new text begin Effect of received report. new text end
new text begin
The state shall treat any report described in
subdivision 1 that is received from another state, an Indian tribe, or a private agency
under contract with another state or Indian tribe as meeting any requirements imposed by
the state for the completion of a home study before placing a child in the home, unless,
within 14 days after receipt of the report, the state determines, based on grounds that
are specific to the content of the report, that making a decision in reliance on the report
would be contrary to the welfare of the child.
new text end
new text begin Subd. 3. new text end
new text begin Resources. new text end
new text begin
The state shall make effective use of cross-jurisdictional
resources, including through contract for the purchase of services, and shall eliminate
legal barriers to facilitate timely adoptive or permanent placements for waiting children.
The state shall not impose any restriction on the use of private agencies for the purpose of
conducting a home study to meet the 60-day requirement.
new text end
new text begin Subd. 4. new text end
new text begin Incentive eligibility. new text end
new text begin
Minnesota is an incentive-eligible state and must:
new text end
new text begin
(1) have an approved plan as required by the United States Secretary of Health
and Human Services;
new text end
new text begin
(2) be in compliance with the data requirements of the United States Department of
Health and Human Services; and
new text end
new text begin
(3) have data that verify that a home study is completed within 30 days.
new text end
new text begin Subd. 5. new text end
new text begin Data requirements. new text end
new text begin
The state shall provide to the United States Secretary
of Health and Human Services a written report, covering the preceding fiscal year, that
specifies:
new text end
new text begin
(1) the total number of interstate home studies requested by the state with respect
to children in foster care under the responsibility of the state, and with respect to each
study, the identity of the other state involved;
new text end
new text begin
(2) the total number of timely interstate home studies completed by the state with
respect to children in foster care under the responsibility of other states and, with respect
to each study, the identity of the other state involved; and
new text end
new text begin
(3) other information the United States Secretary of Health and Human Services
requires in order to determine whether Minnesota is a home study incentive-eligible state.
new text end
new text begin Subd. 6. new text end
new text begin Definitions. new text end
new text begin
(a) The definitions in this subdivision apply to this section.
new text end
new text begin
(b) "Home study" means an evaluation of a home environment conducted in
accordance with applicable requirements of the state in which the home is located, to
determine whether a proposed placement of a child would meet the individual needs of the
child, including the child's safety; permanency; health; well-being; and mental, emotional,
and physical development.
new text end
new text begin
(c) "Interstate home study" means a home study conducted by a state at the request
of another state to facilitate an adoptive or foster placement in the state of a child in foster
care under the responsibility of the state.
new text end
new text begin
(d) "Timely interstate home study" means an interstate home study completed by a
state if the state provides to the state that requested the study, within 30 days after receipt
of the request, a report on the results of the study, except that there is no requirement
for completion within the 30-day period of the parts of the home study involving the
education and training of the prospective foster or adoptive parents.
new text end
new text begin Subd. 7. new text end
new text begin Background study requirements for adoption and foster care. new text end
new text begin
(a)
Background study requirements for an adoption home study must be completed consistent
with section 259.41, subdivisions 1, 2, and 3.
new text end
new text begin
(b) Background study requirements for a foster care license must be completed
consistent with section 245C.08.
new text end
new text begin Subd. 8. new text end
new text begin Home visits. new text end
new text begin
If a child has been placed in foster care outside the state in
which the home of the parents of the child is located, periodically, but at least every six
months, a caseworker on the staff of the agency of the state in which the home of the
parents of the child is located or the state in which the child has been placed, or a private
agency under contract with either state, must visit the child in the home or institution and
submit a report on each visit to the agency of the state in which the home of the parents of
the child is located.
new text end
Sec. 15.
Minnesota Statutes 2006, section 260B.157, subdivision 1, is amended to read:
Subdivision 1.
Investigation.
Upon request of the court the local social services
agency or probation officer shall investigate the personal and family history and
environment of any minor coming within the jurisdiction of the court under section
260B.101 and shall report its findings to the court. The court may order any minor coming
within its jurisdiction to be examined by a duly qualified physician, psychiatrist, or
psychologist appointed by the court.
The court shall deleted text begin havedeleted text end new text begin ordernew text end a chemical use assessment conducted when a child is
(1) found to be delinquent for violating a provision of chapter 152, or for committing a
felony-level violation of a provision of chapter 609 if the probation officer determines
that alcohol or drug use was a contributing factor in the commission of the offense, or
(2) alleged to be delinquent for violating a provision of chapter 152, if the child is being
held in custody under a detention order. The assessor's qualifications and the assessment
criteria shall comply with Minnesota Rules, parts 9530.6600 to 9530.6655. If funds under
chapter 254B are to be used to pay for the recommended treatment, the assessment and
placement must comply with all provisions of Minnesota Rules, parts 9530.6600 to
9530.6655 and 9530.7000 to 9530.7030. The commissioner of human services shall
reimburse the court for the cost of the chemical use assessment, up to a maximum of $100.
The court shall deleted text begin havedeleted text end new text begin ordernew text end a children's mental health screening conducted when
a child is found to be delinquent. The screening shall be conducted with a screening
instrument approved by the commissioner of human services and shall be conducted by a
mental health practitioner as defined in section 245.4871, subdivision 26, or a probation
officer who is trained in the use of the screening instrument. If the screening indicates
a need for assessment, the local social services agency, in consultation with the child's
family, shall have a diagnostic assessment conducted, including a functional assessment,
as defined in section 245.4871.
With the consent of the commissioner of corrections and agreement of the county to
pay the costs thereof, the court may, by order, place a minor coming within its jurisdiction
in an institution maintained by the commissioner for the detention, diagnosis, custody and
treatment of persons adjudicated to be delinquent, in order that the condition of the minor
be given due consideration in the disposition of the case. Any funds received under the
provisions of this subdivision shall not cancel until the end of the fiscal year immediately
following the fiscal year in which the funds were received. The funds are available for
use by the commissioner of corrections during that period and are hereby appropriated
annually to the commissioner of corrections as reimbursement of the costs of providing
these services to the juvenile courts.
Sec. 16.
Minnesota Statutes 2006, section 260C.152, subdivision 5, is amended to read:
Subd. 5.
Notice to foster parents and preadoptive parents and relatives.
The
foster parents, if any, of a child and any preadoptive parent or relative providing care
for the child must be provided notice of and deleted text begin an opportunitydeleted text end new text begin a rightnew text end to be heard in any
review or hearing to be held with respect to the child. Any other relative may also request,
and must be granted, a notice and the opportunity to be heard under this section. This
subdivision does not require that a foster parent, preadoptive parent, or relative providing
care for the child be made a party to a review or hearing solely on the basis of the notice
and deleted text begin opportunitydeleted text end new text begin rightnew text end to be heard.
Sec. 17.
Minnesota Statutes 2006, section 260C.163, subdivision 1, is amended to read:
Subdivision 1.
General.
(a) Except for hearings arising under section 260C.425,
hearings on any matter shall be without a jury and may be conducted in an informal
manner. In all adjudicatory proceedings involving a child alleged to be in need of
protection or services, the court shall admit only evidence that would be admissible in a
civil trial. To be proved at trial, allegations of a petition alleging a child to be in need of
protection or services must be proved by clear and convincing evidence.
(b) Except for proceedings involving a child alleged to be in need of protection or
services and petitions for the termination of parental rights, hearings may be continued or
adjourned from time to time. In proceedings involving a child alleged to be in need of
protection or services and petitions for the termination of parental rights, hearings may not
be continued or adjourned for more than one week unless the court makes specific findings
that the continuance or adjournment is in the best interests of the child. If a hearing is held
on a petition involving physical or sexual abuse of a child who is alleged to be in need of
protection or services or neglected and in foster care, the court shall file the decision with
the court administrator as soon as possible but no later than 15 days after the matter is
submitted to the court. When a continuance or adjournment is ordered in any proceeding,
the court may make any interim orders as it deems in the best interests of the minor in
accordance with the provisions of sections 260C.001 to 260C.421.
(c) Except as otherwise provided in this paragraph, the court shall exclude the
general public from hearings under this chapter and shall admit only those persons who, in
the discretion of the court, have a direct interest in the case or in the work of the court.
(d) Adoption hearings shall be conducted in accordance with the provisions of
laws relating to adoptions.
new text begin
(e) In any permanency hearing, including the transition of a child from foster care
to independent living, the court shall ensure that any consult with the child is in an
age-appropriate manner.
new text end
Sec. 18.
Minnesota Statutes 2006, section 260C.201, subdivision 11, is amended to
read:
Subd. 11.
Review of court-ordered placements; permanent placement
determination.
(a) This subdivision and subdivision 11a do not apply in cases where
the child is in placement due solely to the child's developmental disability or emotional
disturbance, where legal custody has not been transferred to the responsible social services
agency, and where the court finds compelling reasons under section 260C.007, subdivision
8, to continue the child in foster care past the time periods specified in this subdivision.
Foster care placements of children due solely to their disability are governed by section
260C.141, subdivision 2a. In all other cases where the child is in foster care or in the care
of a noncustodial parent under subdivision 1, the court shall commence proceedings
to determine the permanent status of a child not later than 12 months after the child is
placed in foster care or in the care of a noncustodial parent. At the admit-deny hearing
commencing such proceedings, the court shall determine whether there is a prima facie
basis for finding that the agency made reasonable efforts, or in the case of an Indian
child active efforts, required under section 260.012 and proceed according to the rules of
juvenile court.
For purposes of this subdivision, the date of the child's placement in foster care is
the earlier of the first court-ordered placement or 60 days after the date on which the
child has been voluntarily placed in foster care by the child's parent or guardian. For
purposes of this subdivision, time spent by a child under the protective supervision of
the responsible social services agency in the home of a noncustodial parent pursuant to
an order under subdivision 1 counts towards the requirement of a permanency hearing
under this subdivision or subdivision 11a. Time spent on a trial home visit deleted text begin does not countdeleted text end
new text begin counts new text end towards the requirement of a permanency hearing under this subdivision deleted text begin ordeleted text end new text begin and a
permanency review for a child under eight years of age under new text end subdivision 11a.
For purposes of this subdivision, 12 months is calculated as follows:
(1) during the pendency of a petition alleging that a child is in need of protection
or services, all time periods when a child is placed in foster care or in the home of a
noncustodial parent are cumulated;
(2) if a child has been placed in foster care within the previous five years under one
or more previous petitions, the lengths of all prior time periods when the child was placed
in foster care within the previous five years are cumulated. If a child under this clause
has been in foster care for 12 months or more, the court, if it is in the best interests of the
child and for compelling reasons, may extend the total time the child may continue out
of the home under the current petition up to an additional six months before making a
permanency determination.
(b) Unless the responsible social services agency recommends return of the child
to the custodial parent or parents, not later than 30 days prior to the admit-deny hearing
required under paragraph (a) and the rules of juvenile court, the responsible social services
agency shall file pleadings in juvenile court to establish the basis for the juvenile court to
order permanent placement of the child, including a termination of parental rights petition,
according to paragraph (d). Notice of the hearing and copies of the pleadings must be
provided pursuant to section 260C.152.
(c) The permanency proceedings shall be conducted in a timely fashion including
that any trial required under section 260C.163 shall be commenced within 60 days of the
admit-deny hearing required under paragraph (a). At the conclusion of the permanency
proceedings, the court shall:
(1) order the child returned to the care of the parent or guardian from whom the
child was removed; or
(2) order a permanent placement or termination of parental rights if permanent
placement or termination of parental rights is in the child's best interests. The "best
interests of the child" means all relevant factors to be considered and evaluated. Transfer
of permanent legal and physical custody, termination of parental rights, or guardianship
and legal custody to the commissioner through a consent to adopt are preferred
permanency options for a child who cannot return home.
(d) If the child is not returned to the home, the court must order one of the following
dispositions:
(1) permanent legal and physical custody to a relative in the best interests of the
child according to the following conditions:
(i) an order for transfer of permanent legal and physical custody to a relative shall
only be made after the court has reviewed the suitability of the prospective legal and
physical custodian;
(ii) in transferring permanent legal and physical custody to a relative, the juvenile
court shall follow the standards applicable under this chapter and chapter 260, and the
procedures set out in the juvenile court rules;
(iii) an order establishing permanent legal and physical custody under this
subdivision must be filed with the family court;
(iv) a transfer of legal and physical custody includes responsibility for the protection,
education, care, and control of the child and decision making on behalf of the child;
(v) the social services agency may bring a petition or motion naming a fit and
willing relative as a proposed permanent legal and physical custodian. The commissioner
of human services shall annually prepare for counties information that must be given to
proposed custodians about their legal rights and obligations as custodians together with
information on financial and medical benefits for which the child is eligible; and
(vi) the juvenile court may maintain jurisdiction over the responsible social services
agency, the parents or guardian of the child, the child, and the permanent legal and
physical custodian for purposes of ensuring appropriate services are delivered to the child
and permanent legal custodian or for the purpose of ensuring conditions ordered by the
court related to the care and custody of the child are met;
(2) termination of parental rights when the requirements of sections 260C.301 to
260C.328 are met or according to the following conditions:
(i) order the social services agency to file a petition for termination of parental
rights in which case all the requirements of sections 260C.301 to 260C.328 remain
applicable; and
(ii) an adoption completed subsequent to a determination under this subdivision may
include an agreement for communication or contact under section 259.58;
(3) long-term foster care according to the following conditions:
(i) the court may order a child into long-term foster care only if it approves the
responsible social service agency's compelling reasons that neither an award of permanent
legal and physical custody to a relative, nor termination of parental rights is in the child's
best interests;
(ii) further, the court may only order long-term foster care for the child under this
section if it finds the following:
(A) the child has reached age 12 and the responsible social services agency has made
reasonable efforts to locate and place the child with an adoptive family or with a fit and
willing relative who will agree to a transfer of permanent legal and physical custody of
the child, but such efforts have not proven successful; or
(B) the child is a sibling of a child described in subitem (A) and the siblings have
a significant positive relationship and are ordered into the same long-term foster care
home; and
(iii) at least annually, the responsible social services agency reconsiders its provision
of services to the child and the child's placement in long-term foster care to ensure that:
(A) long-term foster care continues to be the most appropriate legal arrangement
for meeting the child's need for permanency and stability, including whether there is
another permanent placement option under this chapter that would better serve the child's
needs and best interests;
(B) whenever possible, there is an identified long-term foster care family that is
committed to being the foster family for the child as long as the child is a minor or under
the jurisdiction of the court;
(C) the child is receiving appropriate services or assistance to maintain or build
connections with the child's family and community;
(D) the child's physical and mental health needs are being appropriately provided
for; and
(E) the child's educational needs are being met;
(4) foster care for a specified period of time according to the following conditions:
(i) foster care for a specified period of time may be ordered only if:
(A) the sole basis for an adjudication that the child is in need of protection or
services is the child's behavior;
(B) the court finds that foster care for a specified period of time is in the best
interests of the child; and
(C) the court approves the responsible social services agency's compelling reasons
that neither an award of permanent legal and physical custody to a relative, nor termination
of parental rights is in the child's best interests;
(ii) the order does not specify that the child continue in foster care for any period
exceeding one year; or
(5) guardianship and legal custody to the commissioner of human services under
the following procedures and conditions:
(i) there is an identified prospective adoptive home agreed to by the responsible
social services agency having legal custody of the child pursuant to court order under this
section that has agreed to adopt the child and the court accepts the parent's voluntary
consent to adopt under section 259.24, except that such consent executed by a parent under
this item, following proper notice that consent given under this provision is irrevocable
upon acceptance by the court, shall be irrevocable unless fraud is established and an order
issues permitting revocation as stated in item (vii);
(ii) if the court accepts a consent to adopt in lieu of ordering one of the other
enumerated permanency dispositions, the court must review the matter at least every 90
days. The review will address the reasonable efforts of the agency to achieve a finalized
adoption;
(iii) a consent to adopt under this clause vests all legal authority regarding the child,
including guardianship and legal custody of the child, with the commissioner of human
services as if the child were a state ward after termination of parental rights;
(iv) the court must forward a copy of the consent to adopt, together with a certified
copy of the order transferring guardianship and legal custody to the commissioner, to
the commissioner;
(v) if an adoption is not finalized by the identified prospective adoptive parent within
12 months of the execution of the consent to adopt under this clause, the commissioner of
human services or the commissioner's delegate shall pursue adoptive placement in another
home unless the commissioner certifies that the failure to finalize is not due to either an
action or a failure to act by the prospective adoptive parent;
(vi) notwithstanding item (v), the commissioner of human services or the
commissioner's designee must pursue adoptive placement in another home as soon as the
commissioner or commissioner's designee determines that finalization of the adoption with
the identified prospective adoptive parent is not possible, that the identified prospective
adoptive parent is not willing to adopt the child, that the identified prospective adoptive
parent is not cooperative in completing the steps necessary to finalize the adoption, or
upon the commissioner's determination to withhold consent to the adoption.
(vii) unless otherwise required by the Indian Child Welfare Act, United States Code,
title 25, section 1913, a consent to adopt executed under this section, following proper
notice that consent given under this provision is irrevocable upon acceptance by the court,
shall be irrevocable upon acceptance by the court except upon order permitting revocation
issued by the same court after written findings that consent was obtained by fraud.
(e) In ordering a permanent placement of a child, the court must be governed by the
best interests of the child, including a review of the relationship between the child and
relatives and the child and other important persons with whom the child has resided or
had significant contact.new text begin When the court has determined that permanent placement of the
child away from the parent is necessary, the court shall consider permanent alternative
homes that are available both inside and outside the state.
new text end
(f) Once a permanent placement determination has been made and permanent
placement has been established, further court reviews are necessary if:
(1) the placement is long-term foster care or foster care for a specified period of time;
(2) the court orders further hearings because it has retained jurisdiction of a transfer
of permanent legal and physical custody matter;
(3) an adoption has not yet been finalized; or
(4) there is a disruption of the permanent or long-term placement.
(g) Court reviews of an order for long-term foster care, whether under this section
or section 260C.317, subdivision 3, paragraph (d), must be conducted at least yearly and
must review the child's out-of-home placement plan and the reasonable efforts of the
agency to finalize the permanent plan for the child including the agency's efforts to:
(1) ensure that long-term foster care continues to be the most appropriate legal
arrangement for meeting the child's need for permanency and stability or, if not, to identify
and attempt to finalize another permanent placement option under this chapter that would
better serve the child's needs and best interests;
(2) identify a specific long-term foster home for the child, if one has not already
been identified;
(3) support continued placement of the child in the identified home, if one has been
identified;
(4) ensure appropriate services are provided to address the physical health, mental
health, and educational needs of the child during the period of long-term foster care and
also ensure appropriate services or assistance to maintain relationships with appropriate
family members and the child's community; and
(5) plan for the child's independence upon the child's leaving long-term foster care
living as required under section 260C.212, subdivision 1.
(h) In the event it is necessary for a child that has been ordered into foster care for a
specified period of time to be in foster care longer than one year after the permanency
hearing held under this section, not later than 12 months after the time the child was
ordered into foster care for a specified period of time, the matter must be returned to
court for a review of the appropriateness of continuing the child in foster care and of the
responsible social services agency's reasonable efforts to finalize a permanent plan for
the child; if it is in the child's best interests to continue the order for foster care for a
specified period of time past a total of 12 months, the court shall set objectives for the
child's continuation in foster care, specify any further amount of time the child may be in
foster care, and review the plan for the safe return of the child to the parent.
(i) An order permanently placing a child out of the home of the parent or guardian
must include the following detailed findings:
(1) how the child's best interests are served by the order;
(2) the nature and extent of the responsible social service agency's reasonable efforts,
or, in the case of an Indian child, active efforts to reunify the child with the parent or
guardian where reasonable efforts are required;
(3) the parent's or parents' efforts and ability to use services to correct the conditions
which led to the out-of-home placement; and
(4) that the conditions which led to the out-of-home placement have not been
corrected so that the child can safely return home.
(j) An order for permanent legal and physical custody of a child may be modified
under sections 518.18 and 518.185. The social services agency is a party to the proceeding
and must receive notice. A parent may only seek modification of an order for long-term
foster care upon motion and a showing by the parent of a substantial change in the parent's
circumstances such that the parent could provide appropriate care for the child and that
removal of the child from the child's permanent placement and the return to the parent's
care would be in the best interest of the child. The responsible social services agency may
ask the court to vacate an order for long-term foster care upon a prima facie showing
that there is a factual basis for the court to order another permanency option under this
chapter and that such an option is in the child's best interests. Upon a hearing where
the court determines that there is a factual basis for vacating the order for long-term
foster care and that another permanent order regarding the placement of the child is in
the child's best interests, the court may vacate the order for long-term foster care and
enter a different order for permanent placement that is in the child's best interests. The
court shall not require further reasonable efforts to reunify the child with the parent or
guardian as a basis for vacating the order for long-term foster care and ordering a different
permanent placement in the child's best interests. The county attorney must file pleadings
and give notice as required under the rules of juvenile court in order to modify an order for
long-term foster care under this paragraph.
(k) The court shall issue an order required under this section within 15 days of the
close of the proceedings. The court may extend issuing the order an additional 15 days
when necessary in the interests of justice and the best interests of the child.
new text begin
(l) This paragraph applies to proceedings required under this subdivision when
the child is on a trial home visit:
new text end
new text begin
(1) if the child is on a trial home visit 12 months after the child was placed in
foster care or in the care of a noncustodial parent as calculated in this subdivision, the
responsible social services agency may file a report with the court regarding the child's and
parent's progress on the trial home visit and its reasonable efforts to finalize the child's safe
and permanent return to the care of the parent in lieu of filing the pleadings required under
paragraph (b). The court shall make findings regarding reasonableness of the responsible
social services efforts to finalize the child's return home as the permanent order in the best
interests of the child. The court may continue the trial home visit to a total time not to
exceed six months as provided in subdivision 1. If the court finds the responsible social
services agency has not made reasonable efforts to finalize the child's return home as the
permanent order in the best interests of the child, the court may order other or additional
efforts to support the child remaining in the care of the parent; and
new text end
new text begin
(2) if a trial home visit ordered or continued at proceedings under this subdivision
terminates, the court shall re-commence proceedings under this subdivision to determine
the permanent status of the child not later than 30 days after the child is returned to foster
care.
new text end
Sec. 19.
Minnesota Statutes 2006, section 260C.212, subdivision 1, is amended to read:
Subdivision 1.
Out-of-home placement; plan.
(a) An out-of-home placement plan
shall be prepared within 30 days after any child is placed in a residential facility by court
order or by the voluntary release of the child by the parent or parents.
For purposes of this section, a residential facility means any group home, family
foster home or other publicly supported out-of-home residential facility, including any
out-of-home residential facility under contract with the state, county or other political
subdivision, or any agency thereof, to provide those services or foster care as defined in
section 260C.007, subdivision 18.
(b) An out-of-home placement plan means a written document which is prepared by
the responsible social services agency jointly with the parent or parents or guardian of the
child and in consultation with the child's guardian ad litem, the child's tribe, if the child is
an Indian child, the child's foster parent or representative of the residential facility, and,
where appropriate, the child. For a child in placement due solely or in part to the child's
emotional disturbance, preparation of the out-of-home placement plan shall additionally
include the child's mental health treatment provider. As appropriate, the plan shall be:
(1) submitted to the court for approval under section 260C.178, subdivision 7;
(2) ordered by the court, either as presented or modified after hearing, under section
260C.178, subdivision 7, or 260C.201, subdivision 6; and
(3) signed by the parent or parents or guardian of the child, the child's guardian ad
litem, a representative of the child's tribe, the responsible social services agency, and, if
possible, the child.
(c) The out-of-home placement plan shall be explained to all persons involved in its
implementation, including the child who has signed the plan, and shall set forth:
(1) a description of the residential facility including how the out-of-home placement
plan is designed to achieve a safe placement for the child in the least restrictive, most
family-like, setting available which is in close proximity to the home of the parent or
parents or guardian of the child when the case plan goal is reunification, and how the
placement is consistent with the best interests and special needs of the child according to
the factors under subdivision 2, paragraph (b);
(2) the specific reasons for the placement of the child in a residential facility, and
when reunification is the plan, a description of the problems or conditions in the home of
the parent or parents which necessitated removal of the child from home and the changes
the parent or parents must make in order for the child to safely return home;
(3) a description of the services offered and provided to prevent removal of the child
from the home and to reunify the family including:
(i) the specific actions to be taken by the parent or parents of the child to eliminate
or correct the problems or conditions identified in clause (2), and the time period during
which the actions are to be taken; and
(ii) the reasonable efforts, or in the case of an Indian child, active efforts to be made
to achieve a safe and stable home for the child including social and other supportive
services to be provided or offered to the parent or parents or guardian of the child, the
child, and the residential facility during the period the child is in the residential facility;
(4) a description of any services or resources that were requested by the child or the
child's parent, guardian, foster parent, or custodian since the date of the child's placement
in the residential facility, and whether those services or resources were provided and if
not, the basis for the denial of the services or resources;
(5) the visitation plan for the parent or parents or guardian, other relatives as defined
in section 260C.007, subdivision 27, and siblings of the child if the siblings are not placed
together in the residential facility, and whether visitation is consistent with the best interest
of the child, during the period the child is in the residential facility;
(6) documentation of steps to finalize the adoption or legal guardianship of the child
if the court has issued an order terminating the rights of both parents of the child or of
the only known, living parent of the childdeleted text begin , anddeleted text end new text begin . At a minimum, the documentation must
include child-specific recruitment efforts such as relative search and the use of state,
regional, and national adoption exchanges to facilitate orderly and timely placements in
and outside of the state.new text end A copy of this documentation shall be provided to the court in the
review required under section 260C.317, subdivision 3, paragraph (b);
(7) deleted text begin to the extent available and accessible,deleted text end the health and educational records of the
child includingnew text begin the most recent information available regardingnew text end :
(i) the names and addresses of the child's health and educational providers;
(ii) the child's grade level performance;
(iii) the child's school record;
(iv) assurances that the child's placement in foster care takes into account proximity
to the school in which the child is enrolled at the time of placement;
(v) a record of the child's immunizations;
(vi) the child's known medical problems, including any known communicable
diseases, as defined in section 144.4172, subdivision 2;
(vii) the child's medications; and
(viii) any other relevant health and education information;
(8) an independent living plan for a child age 16 or older who is in placement as
a result of a permanency disposition. The plan should include, but not be limited to,
the following objectives:
(i) educational, vocational, or employment planning;
(ii) health care planning and medical coverage;
(iii) transportation including, where appropriate, assisting the child in obtaining a
driver's license;
(iv) money management;
(v) planning for housing;
(vi) social and recreational skills; and
(vii) establishing and maintaining connections with the child's family and
community; and
(9) for a child in placement due solely or in part to the child's emotional disturbance,
diagnostic and assessment information, specific services relating to meeting the mental
health care needs of the child, and treatment outcomes.
(d) The parent or parents or guardian and the child each shall have the right to legal
counsel in the preparation of the case plan and shall be informed of the right at the time
of placement of the child. The child shall also have the right to a guardian ad litem.
If unable to employ counsel from their own resources, the court shall appoint counsel
upon the request of the parent or parents or the child or the child's legal guardian. The
parent or parents may also receive assistance from any person or social services agency
in preparation of the case plan.
After the plan has been agreed upon by the parties involved or approved or ordered
by the court, the foster parents shall be fully informed of the provisions of the case plan
and shall be provided a copy of the plan.
new text begin
Upon discharge from foster care, the parent, adoptive parent, or permanent legal and
physical custodian, as appropriate, and the child, if appropriate, must be provided with
a current copy of the child's health and education record.
new text end
Sec. 20.
Minnesota Statutes 2006, section 260C.212, subdivision 4, is amended to read:
Subd. 4.
Responsible social service agency's duties for children in placement.
(a)
When a child is in placement, the responsible social services agency shall make diligent
efforts to identify, locate, and, where appropriate, offer services to both parents of the child.
(1) The responsible social services agency shall assess whether a noncustodial or
nonadjudicated parent is willing and capable of providing for the day-to-day care of the
child temporarily or permanently. An assessment under this clause may include, but
is not limited to, obtaining information under section 260C.209. If after assessment,
the responsible social services agency determines that a noncustodial or nonadjudicated
parent is willing and capable of providing day-to-day care of the child, the responsible
social services agency may seek authority from the custodial parent or the court to have
that parent assume day-to-day care of the child. If a parent is not an adjudicated parent,
the responsible social services agency shall require the nonadjudicated parent to cooperate
with paternity establishment procedures as part of the case plan.
(2) If, after assessment, the responsible social services agency determines that the
child cannot be in the day-to-day care of either parent, the agency shall:
(i) prepare an out-of-home placement plan addressing the conditions that each parent
must meet before the child can be in that parent's day-to-day care; and
(ii) provide a parent who is the subject of a background study under section
260C.209 15 days' notice that it intends to use the study to recommend against putting the
child with that parent, as well as the notice provided in section 260C.209, subdivision 4,
and the court shall afford the parent an opportunity to be heard concerning the study.
The results of a background study of a noncustodial parent shall not be used by the
agency to determine that the parent is incapable of providing day-to-day care of the child
unless the agency reasonably believes that placement of the child into the home of that
parent would endanger the child's health, safety, or welfare.
(3) If, after the provision of services following an out-of-home placement plan under
this section, the child cannot return to the care of the parent from whom the child was
removed or who had legal custody at the time the child was placed in foster care, the
agency may petition on behalf of a noncustodial parent to establish legal custody with
that parent under section 260C.201, subdivision 11. If paternity has not already been
established, it may be established in the same proceeding in the manner provided for
under chapter 257.
(4) The responsible social services agency may be relieved of the requirement to
locate and offer services to both parents by the juvenile court upon a finding of good cause
after the filing of a petition under section 260C.141.
(b) The responsible social services agency shall give notice to the parent or parents
or guardian of each child in a residential facility, other than a child in placement due
solely to that child's developmental disability or emotional disturbance, of the following
information:
(1) that residential care of the child may result in termination of parental rights or an
order permanently placing the child out of the custody of the parent, but only after notice
and a hearing as required under chapter 260C and the juvenile court rules;
(2) time limits on the length of placement and of reunification services, including
the date on which the child is expected to be returned to and safely maintained in the
home of the parent or parents or placed for adoption or otherwise permanently removed
from the care of the parent by court order;
(3) the nature of the services available to the parent;
(4) the consequences to the parent and the child if the parent fails or is unable to use
services to correct the circumstances that led to the child's placement;
(5) the first consideration for placement with relatives;
(6) the benefit to the child in getting the child out of residential care as soon as
possible, preferably by returning the child home, but if that is not possible, through a
permanent legal placement of the child away from the parent;
(7) when safe for the child, the benefits to the child and the parent of maintaining
visitation with the child as soon as possible in the course of the case and, in any event,
according to the visitation plan under this section; and
(8) the financial responsibilities and obligations, if any, of the parent or parents for
the support of the child during the period the child is in the residential facility.
(c) The responsible social services agency shall inform a parent considering
voluntary placement of a child who is not developmentally disabled or emotionally
disturbed of the following information:
(1) the parent and the child each has a right to separate legal counsel before signing a
voluntary placement agreement, but not to counsel appointed at public expense;
(2) the parent is not required to agree to the voluntary placement, and a parent
who enters a voluntary placement agreement may at any time request that the agency
return the child. If the parent so requests, the child must be returned within 24 hours of
the receipt of the request;
(3) evidence gathered during the time the child is voluntarily placed may be used
at a later time as the basis for a petition alleging that the child is in need of protection
or services or as the basis for a petition seeking termination of parental rights or other
permanent placement of the child away from the parent;
(4) if the responsible social services agency files a petition alleging that the child is
in need of protection or services or a petition seeking the termination of parental rights
or other permanent placement of the child away from the parent, the parent would have
the right to appointment of separate legal counsel and the child would have a right to the
appointment of counsel and a guardian ad litem as provided by law, and that counsel will
be appointed at public expense if they are unable to afford counsel; and
(5) the timelines and procedures for review of voluntary placements under
subdivision 3, and the effect the time spent in voluntary placement on the scheduling of a
permanent placement determination hearing under section 260C.201, subdivision 11.
(d) When an agency accepts a child for placement, the agency shall determine
whether the child has had a physical examination by or under the direction of a licensed
physician within the 12 months immediately preceding the date when the child came into
the agency's care. If there is documentation that the child has had an examination within
the last 12 months, the agency is responsible for seeing that the child has another physical
examination within one year of the documented examination and annually in subsequent
years. If the agency determines that the child has not had a physical examination within
the 12 months immediately preceding placement, the agency shall ensure that the child
has an examination within 30 days of coming into the agency's care and once a year
in subsequent years.
new text begin
(e) If a child leaves foster care by reason of having attained the age of majority
under state law, the child must be given at no cost a copy of the child's health and
education report.
new text end
Sec. 21.
Minnesota Statutes 2006, section 260C.212, subdivision 9, is amended to read:
Subd. 9.
Review of certain child placements.
(a) new text begin When a developmentally
disabled child or emotionally disturbed child needs placement in a residential facility for
the sole reason of accessing services or a level of skilled care that cannot be provided in
the parent's home, the child must be placed pursuant to a voluntary placement agreement
between the responsible social services agency and the child's parent. The voluntary
placement agreement must give the responsible social services agency legal responsibility
for the child's physical care, custody, and control, but must not transfer legal custody of
the child to the agency. The voluntary placement agreement must be executed in a form
developed and promulgated by the commissioner of human services. The responsible
social services agency shall report to the commissioner the number of children who are the
subject of a voluntary placement agreement under this subdivision and other information
regarding these children as the commissioner may require.
new text end
new text begin (b)new text end If a developmentally disabled child or a child diagnosed as emotionally disturbed
has been placed in a residential facility pursuant to a voluntary release by the child's parent
or parents because of the child's disabling conditions or need for long-term residential
treatment or supervision, the social services agency responsible for the placement shall
report to the court and bring a petition for review of the child's foster care status as
required in section 260C.141, subdivision 2a.
deleted text begin (b)deleted text end new text begin (c) new text end If a child is in placement due solely to the child's developmental disability or
emotional disturbance, deleted text begin anddeleted text end the court finds compelling reasons not to proceed under section
260C.201, subdivision 11, new text begin and new text end custody of the child is not transferred to the responsible
social services agency under section 260C.201, subdivision 1, paragraph (a), clause (2),
deleted text begin anddeleted text end no petition is required by section 260C.201, subdivision 11.
deleted text begin (c)deleted text end new text begin (d) new text end Whenever a petition for review is brought pursuant to this subdivision, a
guardian ad litem shall be appointed for the child.
Sec. 22.
Minnesota Statutes 2006, section 260C.317, subdivision 3, is amended to read:
Subd. 3.
Order; retention of jurisdiction.
(a) A certified copy of the findings and
the order terminating parental rights, and a summary of the court's information concerning
the child shall be furnished by the court to the commissioner or the agency to which
guardianship is transferred. The orders shall be on a document separate from the findings.
The court shall furnish the individual to whom guardianship is transferred a copy of the
order terminating parental rights.
(b) The court shall retain jurisdiction in a case where adoption is the intended
permanent placement disposition until the child's adoption is finalized, the child is 18 years
of age, or the child is otherwise ordered discharged from the jurisdiction of the court. The
guardian ad litem and counsel for the child shall continue on the case until an adoption
decree is entered. A hearing must be held every 90 days following termination of parental
rights for the court to review progress toward an adoptive placement and the specific
recruitment efforts the agency has taken to find an adoptive family or other placement
living arrangement for the child and to finalize the adoption or other permanency plan.
(c) The responsible social services agency may make a determination of compelling
reasons for a child to be in long-term foster care when the agency has made exhaustive
efforts to recruit, identify, and place the child in an adoptive home, and the child continues
in foster care for at least 24 months after the court has issued the order terminating
parental rights. new text begin A child of any age who is under the guardianship of the commissioner of
the Department of Human Services and is legally available for adoption may not refuse
or waive the commissioner's agent's exhaustive efforts to recruit, identify, and place the
child in an adoptive home required under paragraph (b) or sign a document relieving
county social services agencies of all recruitment efforts on the child's behalf. new text end Upon
approving the agency's determination of compelling reasons, the court may order the
child placed in long-term foster care. At least every 12 months thereafter as long as the
child continues in out-of-home placement, the court shall conduct a permanency review
hearing to determine the future status of the child using the review requirements of section
260C.201, subdivision 11, paragraph (g).
(d) The court shall retain jurisdiction through the child's minority in a case where
long-term foster care is the permanent disposition whether under paragraph (c) or section
260C.201, subdivision 11.
Sec. 23.
Minnesota Statutes 2006, section 260C.331, subdivision 1, is amended to read:
Subdivision 1.
Care, examination, or treatment.
(a) Except where parental rights
are terminated,
(1) whenever legal custody of a child is transferred by the court to a responsible
social services agency,
(2) whenever legal custody is transferred to a person other than the responsible social
services agency, but under the supervision of the responsible social services agency, or
(3) whenever a child is given physical or mental examinations or treatment under
order of the court, and no provision is otherwise made by law for payment for the care,
examination, or treatment of the child, these costs are a charge upon the welfare funds of
the county in which proceedings are held upon certification of the judge of juvenile court.
(b) The court shall order, and the responsible social services agency shall require,
the parents or custodian of a child, while the child is under the age of 18, to use the
total income and resources attributable to the child for the period of care, examination,
or treatment, except for clothing and personal needs allowance as provided in section
256B.35, to reimburse the county for the cost of care, examination, or treatment. Income
and resources attributable to the child include, but are not limited to, Social Security
benefits, supplemental security income (SSI), veterans benefits, railroad retirement
benefits and child support. When the child is over the age of 18, and continues to receive
care, examination, or treatment, the court shall order, and the responsible social services
agency shall require, reimbursement from the child for the cost of care, examination, or
treatment from the income and resources attributable to the child less the clothing and
personal needs allowance.new text begin Income does not include earnings from a child over the age of
18 who is working as part of a plan under section 260C.212, subdivision 1, paragraph (c),
clause (8), to transition from foster care.new text end
(c) If the income and resources attributable to the child are not enough to reimburse
the county for the full cost of the care, examination, or treatment, the court shall inquire
into the ability of the parents to support the child and, after giving the parents a reasonable
opportunity to be heard, the court shall order, and the responsible social services agency
shall require, the parents to contribute to the cost of care, examination, or treatment of
the child. When determining the amount to be contributed by the parents, the court shall
use a fee schedule based upon ability to pay that is established by the responsible social
services agency and approved by the commissioner of human services. The income of
a stepparent who has not adopted a child shall be excluded in calculating the parental
contribution under this section.
(d) The court shall order the amount of reimbursement attributable to the parents
or custodian, or attributable to the child, or attributable to both sources, withheld under
chapter 518A from the income of the parents or the custodian of the child. A parent or
custodian who fails to pay without good reason may be proceeded against for contempt, or
the court may inform the county attorney, who shall proceed to collect the unpaid sums,
or both procedures may be used.
(e) If the court orders a physical or mental examination for a child, the examination
is a medically necessary service for purposes of determining whether the service is
covered by a health insurance policy, health maintenance contract, or other health
coverage plan. Court-ordered treatment shall be subject to policy, contract, or plan
requirements for medical necessity. Nothing in this paragraph changes or eliminates
benefit limits, conditions of coverage, co-payments or deductibles, provider restrictions,
or other requirements in the policy, contract, or plan that relate to coverage of other
medically necessary services.
Sec. 24.
Minnesota Statutes 2006, section 626.556, subdivision 2, is amended to read:
Subd. 2.
Definitions.
As used in this section, the following terms have the meanings
given them unless the specific content indicates otherwise:
(a) "Family assessment" means a comprehensive assessment of child safety, risk
of subsequent child maltreatment, and family strengths and needs that is applied to a
child maltreatment report that does not allege substantial child endangerment. Family
assessment does not include a determination as to whether child maltreatment occurred
but does determine the need for services to address the safety of family members and the
risk of subsequent maltreatment.
(b) "Investigation" means fact gathering related to the current safety of a child
and the risk of subsequent maltreatment that determines whether child maltreatment
occurred and whether child protective services are needed. An investigation must be used
when reports involve substantial child endangerment, and for reports of maltreatment in
facilities required to be licensed under chapter 245A or 245B; under sections 144.50 to
144.58 and 241.021; in a school as defined in sections 120A.05, subdivisions 9, 11, and
13, and 124D.10; or in a nonlicensed personal care provider association as defined in
sections 256B.04, subdivision 16, and 256B.0625, subdivision 19a.
(c) "Substantial child endangerment" means a person responsible for a child's care,
new text begin and in the case of sexual abuse includes new text end a person who has a significant relationship to the
child as defined in section 609.341, or a person in a position of authority as defined in
section 609.341, who by act or omission commits or attempts to commit an act against a
child under their care that constitutes any of the following:
(1) egregious harm as defined in section 260C.007, subdivision 14;
(2) sexual abuse as defined in paragraph (d);
(3) abandonment under section 260C.301, subdivision 2;
(4) neglect as defined in paragraph (f), clause (2), that substantially endangers the
child's physical or mental health, including a growth delay, which may be referred to as
failure to thrive, that has been diagnosed by a physician and is due to parental neglect;
(5) murder in the first, second, or third degree under section 609.185, 609.19, or
609.195;
(6) manslaughter in the first or second degree under section 609.20 or 609.205;
(7) assault in the first, second, or third degree under section 609.221, 609.222, or
609.223;
(8) solicitation, inducement, and promotion of prostitution under section 609.322;
(9) criminal sexual conduct under sections 609.342 to 609.3451;
(10) solicitation of children to engage in sexual conduct under section 609.352;
(11) malicious punishment or neglect or endangerment of a child under section
609.377 or 609.378;
(12) use of a minor in sexual performance under section 617.246; or
(13) parental behavior, status, or condition which mandates that the county attorney
file a termination of parental rights petition under section 260C.301, subdivision 3,
paragraph (a).
(d) "Sexual abuse" means the subjection of a child by a person responsible for the
child's care, by a person who has a significant relationship to the child, as defined in
section 609.341, or by a person in a position of authority, as defined in section 609.341,
subdivision 10, to any act which constitutes a violation of section 609.342 (criminal sexual
conduct in the first degree), 609.343 (criminal sexual conduct in the second degree),
609.344 (criminal sexual conduct in the third degree), 609.345 (criminal sexual conduct
in the fourth degree), or 609.3451 (criminal sexual conduct in the fifth degree). Sexual
abuse also includes any act which involves a minor which constitutes a violation of
prostitution offenses under sections 609.321 to 609.324 or 617.246. Sexual abuse includes
threatened sexual abuse.
(e) "Person responsible for the child's care" means (1) an individual functioning
within the family unit and having responsibilities for the care of the child such as a
parent, guardian, or other person having similar care responsibilities, or (2) an individual
functioning outside the family unit and having responsibilities for the care of the child
such as a teacher, school administrator, other school employees or agents, or other lawful
custodian of a child having either full-time or short-term care responsibilities including,
but not limited to, day care, babysitting whether paid or unpaid, counseling, teaching,
and coaching.
(f) "Neglect" means:
(1) failure by a person responsible for a child's care to supply a child with necessary
food, clothing, shelter, health, medical, or other care required for the child's physical or
mental health when reasonably able to do so;
(2) failure to protect a child from conditions or actions that seriously endanger the
child's physical or mental health when reasonably able to do so, including a growth delay,
which may be referred to as a failure to thrive, that has been diagnosed by a physician and
is due to parental neglect;
(3) failure to provide for necessary supervision or child care arrangements
appropriate for a child after considering factors as the child's age, mental ability, physical
condition, length of absence, or environment, when the child is unable to care for the
child's own basic needs or safety, or the basic needs or safety of another child in their care;
(4) failure to ensure that the child is educated as defined in sections 120A.22 and
260C.163, subdivision 11, which does not include a parent's refusal to provide the parent's
child with sympathomimetic medications, consistent with section 125A.091, subdivision 5;
(5) nothing in this section shall be construed to mean that a child is neglected solely
because the child's parent, guardian, or other person responsible for the child's care in
good faith selects and depends upon spiritual means or prayer for treatment or care of
disease or remedial care of the child in lieu of medical care; except that a parent, guardian,
or caretaker, or a person mandated to report pursuant to subdivision 3, has a duty to report
if a lack of medical care may cause serious danger to the child's health. This section does
not impose upon persons, not otherwise legally responsible for providing a child with
necessary food, clothing, shelter, education, or medical care, a duty to provide that care;
(6) prenatal exposure to a controlled substance, as defined in section 253B.02,
subdivision 2, used by the mother for a nonmedical purpose, as evidenced by withdrawal
symptoms in the child at birth, results of a toxicology test performed on the mother at
delivery or the child at birth, or medical effects or developmental delays during the child's
first year of life that medically indicate prenatal exposure to a controlled substance;
(7) "medical neglect" as defined in section 260C.007, subdivision 6, clause (5);
(8) chronic and severe use of alcohol or a controlled substance by a parent or
person responsible for the care of the child that adversely affects the child's basic needs
and safety; or
(9) emotional harm from a pattern of behavior which contributes to impaired
emotional functioning of the child which may be demonstrated by a substantial and
observable effect in the child's behavior, emotional response, or cognition that is not
within the normal range for the child's age and stage of development, with due regard to
the child's culture.
(g) "Physical abuse" means any physical injury, mental injury, or threatened injury,
inflicted by a person responsible for the child's care on a child other than by accidental
means, or any physical or mental injury that cannot reasonably be explained by the child's
history of injuries, or any aversive or deprivation procedures, or regulated interventions,
that have not been authorized under section 121A.67 or 245.825. Abuse does not include
reasonable and moderate physical discipline of a child administered by a parent or legal
guardian which does not result in an injury. Abuse does not include the use of reasonable
force by a teacher, principal, or school employee as allowed by section 121A.582. Actions
which are not reasonable and moderate include, but are not limited to, any of the following
that are done in anger or without regard to the safety of the child:
(1) throwing, kicking, burning, biting, or cutting a child;
(2) striking a child with a closed fist;
(3) shaking a child under age three;
(4) striking or other actions which result in any nonaccidental injury to a child
under 18 months of age;
(5) unreasonable interference with a child's breathing;
(6) threatening a child with a weapon, as defined in section 609.02, subdivision 6;
(7) striking a child under age one on the face or head;
(8) purposely giving a child poison, alcohol, or dangerous, harmful, or controlled
substances which were not prescribed for the child by a practitioner, in order to control or
punish the child; or other substances that substantially affect the child's behavior, motor
coordination, or judgment or that results in sickness or internal injury, or subjects the
child to medical procedures that would be unnecessary if the child were not exposed
to the substances;
(9) unreasonable physical confinement or restraint not permitted under section
609.379, including but not limited to tying, caging, or chaining; or
(10) in a school facility or school zone, an act by a person responsible for the child's
care that is a violation under section 121A.58.
(h) "Report" means any report received by the local welfare agency, police
department, county sheriff, or agency responsible for assessing or investigating
maltreatment pursuant to this section.
(i) "Facility" means:
(1) a licensed or unlicensed day care facility, residential facility, agency, hospital,
sanitarium, or other facility or institution required to be licensed under sections 144.50 to
144.58, 241.021, or 245A.01 to 245A.16, or chapter 245B;
(2) a school as defined in sections 120A.05, subdivisions 9, 11, and 13; and
124D.10; or
(3) a nonlicensed personal care provider organization as defined in sections 256B.04,
subdivision 16, and 256B.0625, subdivision 19a.
(j) "Operator" means an operator or agency as defined in section 245A.02.
(k) "Commissioner" means the commissioner of human services.
(l) "Practice of social services," for the purposes of subdivision 3, includes but is
not limited to employee assistance counseling and the provision of guardian ad litem and
parenting time expeditor services.
(m) "Mental injury" means an injury to the psychological capacity or emotional
stability of a child as evidenced by an observable or substantial impairment in the child's
ability to function within a normal range of performance and behavior with due regard to
the child's culture.
(n) "Threatened injury" means a statement, overt act, condition, or status that
represents a substantial risk of physical or sexual abuse or mental injury. Threatened
injury includes, but is not limited to, exposing a child to a person responsible for the
child's care, as defined in paragraph (e), clause (1), who has:
(1) subjected a child to, or failed to protect a child from, an overt act or condition
that constitutes egregious harm, as defined in section 260C.007, subdivision 14, or a
similar law of another jurisdiction;
(2) been found to be palpably unfit under section 260C.301, paragraph (b), clause
(4), or a similar law of another jurisdiction;
(3) committed an act that has resulted in an involuntary termination of parental rights
under section 260C.301, or a similar law of another jurisdiction; or
(4) committed an act that has resulted in the involuntary transfer of permanent legal
and physical custody of a child to a relative under section 260C.201, subdivision 11,
paragraph (d), clause (1), or a similar law of another jurisdiction.
(o) Persons who conduct assessments or investigations under this section shall take
into account accepted child-rearing practices of the culture in which a child participates
and accepted teacher discipline practices, which are not injurious to the child's health,
welfare, and safety.
Sec. 25.
Minnesota Statutes 2006, section 626.556, subdivision 3, is amended to read:
Subd. 3.
Persons mandated to report.
(a) A person who knows or has reason
to believe a child is being neglected or physically or sexually abused, as defined in
subdivision 2, or has been neglected or physically or sexually abused within the preceding
three years, shall immediately report the information to the local welfare agency, agency
responsible for assessing or investigating the report, police department, or the county
sheriff if the person is:
(1) a professional or professional's delegate who is engaged in the practice of
the healing arts, social services, hospital administration, psychological or psychiatric
treatment, child care, education, correctional supervision, probation and correctional
services, or law enforcement; or
(2) employed as a member of the clergy and received the information while
engaged in ministerial duties, provided that a member of the clergy is not required by
this subdivision to report information that is otherwise privileged under section 595.02,
subdivision 1, paragraph (c).
The police department or the county sheriff, upon receiving a report, shall
immediately notify the local welfare agency or agency responsible for assessing or
investigating the report, orally and in writing. The local welfare agency, or agency
responsible for assessing or investigating the report, upon receiving a report, shall
immediately notify the local police department or the county sheriff orally and in writing.
The county sheriff and the head of every local welfare agency, agency responsible
for assessing or investigating reports, and police department shall each designate a
person within their agency, department, or office who is responsible for ensuring that
the notification duties of this paragraph and paragraph (b) are carried out. Nothing in
this subdivision shall be construed to require more than one report from any institution,
facility, school, or agency.
(b) Any person may voluntarily report to the local welfare agency, agency
responsible for assessing or investigating the report, police department, or the county
sheriff if the person knows, has reason to believe, or suspects a child is being or has been
neglected or subjected to physical or sexual abuse. The police department or the county
sheriff, upon receiving a report, shall immediately notify the local welfare agency or
agency responsible for assessing or investigating the report, orally and in writing. The
local welfare agency or agency responsible for assessing or investigating the report, upon
receiving a report, shall immediately notify the local police department or the county
sheriff orally and in writing.
(c) A person mandated to report physical or sexual child abuse or neglect occurring
within a licensed facility shall report the information to the agency responsible for
licensing the facility under sections 144.50 to 144.58; 241.021; 245A.01 to 245A.16; or
chapter 245B; or a nonlicensed personal care provider organization as defined in sections
256B.04, subdivision 16; and 256B.0625, subdivision 19. A health or corrections agency
receiving a report may request the local welfare agency to provide assistance pursuant
to subdivisions 10, 10a, and 10b. A board or other entity whose licensees perform work
within a school facility, upon receiving a complaint of alleged maltreatment, shall provide
information about the circumstances of the alleged maltreatment to the commissioner of
education. Section 13.03, subdivision 4, applies to data received by the commissioner of
education from a licensing entity.
(d) Any person mandated to report shall receive a summary of the disposition of
any report made by that reporter, including whether the case has been opened for child
protection or other services, or if a referral has been made to a community organization,
unless release would be detrimental to the best interests of the child. Any person who is
not mandated to report shall, upon request to the local welfare agency, receive a concise
summary of the disposition of any report made by that reporter, unless release would be
detrimental to the best interests of the child.
(e) For purposes of this deleted text begin subdivisiondeleted text end new text begin sectionnew text end , "immediately" means as soon as
possible but in no event longer than 24 hours.
Sec. 26.
Minnesota Statutes 2006, section 626.556, is amended by adding a subdivision
to read:
new text begin Subd. 3e. new text end
new text begin
Agency responsibility for assessing or investigating reports of sexual
abuse.
new text end
new text begin
The local welfare agency is the agency responsible for investigating allegations
of sexual abuse if the alleged offender is the parent, guardian, sibling, or an individual
functioning within the family unit as a person responsible for the child's care, or a person
with a significant relationship to the child if that person resides in the child's household.
new text end
Sec. 27.
Minnesota Statutes 2006, section 626.556, is amended by adding a subdivision
to read:
new text begin Subd. 3f. new text end
new text begin
Law enforcement agency responsibility for investigating
maltreatment.
new text end
new text begin
The local law enforcement agency has responsibility for investigating any
report of child maltreatment if a violation of a criminal statute is alleged. Law enforcement
and the responsible agency must coordinate their investigations or assessments as required
under subdivision 10.
new text end
Sec. 28.
Minnesota Statutes 2006, section 626.556, subdivision 10, is amended to read:
Subd. 10.
Duties of local welfare agency and local law enforcement agency upon
receipt of a report.
(a) Upon receipt of a report, the local welfare agency shall determine
whether to conduct a family assessment or an investigation as appropriate to prevent or
provide a remedy for child maltreatment. The local welfare agency:
(1) shall conduct an investigation on reports involving substantial child
endangerment;
(2) shall begin an immediate investigation if, at any time when it is using a family
assessment response, it determines that there is reason to believe that substantial child
endangerment or a serious threat to the child's safety exists;
(3) may conduct a family assessment for reports that do not allege substantial child
endangerment. In determining that a family assessment is appropriate, the local welfare
agency may consider issues of child safety, parental cooperation, and the need for an
immediate response; and
(4) may conduct a family assessment on a report that was initially screened and
assigned for an investigation. In determining that a complete investigation is not required,
the local welfare agency must document the reason for terminating the investigation and
notify the local law enforcement agency if the local law enforcement agency is conducting
a joint investigation.
If the report alleges neglect, physical abuse, or sexual abuse by a parent, guardian,
or individual functioning within the family unit as a person responsible for the child's
care, new text begin or sexual abuse by a person with a significant relationship to the child when that
person resides in the child's household or by a sibling, new text end the local welfare agency shall
immediately conduct a family assessment or investigation as identified in clauses (1) to
(4). In conducting a family assessment or investigation, the local welfare agency shall
gather information on the existence of substance abuse and domestic violence and offer
services for purposes of preventing future child maltreatment, safeguarding and enhancing
the welfare of the abused or neglected minor, and supporting and preserving family
life whenever possible. If the report alleges a violation of a criminal statute involving
sexual abuse, physical abuse, or neglect or endangerment, under section 609.378, the
local law enforcement agency and local welfare agency shall coordinate the planning and
execution of their respective investigation and assessment efforts to avoid a duplication of
fact-finding efforts and multiple interviews. Each agency shall prepare a separate report of
the results of its investigation. In cases of alleged child maltreatment resulting in death,
the local agency may rely on the fact-finding efforts of a law enforcement investigation
to make a determination of whether or not maltreatment occurred. When necessary the
local welfare agency shall seek authority to remove the child from the custody of a parent,
guardian, or adult with whom the child is living. In performing any of these duties, the
local welfare agency shall maintain appropriate records.
If the family assessment or investigation indicates there is a potential for abuse of
alcohol or other drugs by the parent, guardian, or person responsible for the child's care,
the local welfare agency shall conduct a chemical use assessment pursuant to Minnesota
Rules, part 9530.6615. The local welfare agency shall report the determination of the
chemical use assessment, and the recommendations and referrals for alcohol and other
drug treatment services to the state authority on alcohol and drug abuse.
(b) When a local agency receives a report or otherwise has information indicating
that a child who is a client, as defined in section 245.91, has been the subject of physical
abuse, sexual abuse, or neglect at an agency, facility, or program as defined in section
245.91, it shall, in addition to its other duties under this section, immediately inform the
ombudsman established under sections 245.91 to 245.97. The commissioner of education
shall inform the ombudsman established under sections 245.91 to 245.97 of reports
regarding a child defined as a client in section 245.91 that maltreatment occurred at a
school as defined in sections 120A.05, subdivisions 9, 11, and 13, and 124D.10.
(c) Authority of the local welfare agency responsible for assessing or investigating
the child abuse or neglect report, the agency responsible for assessing or investigating
the report, and of the local law enforcement agency for investigating the alleged abuse or
neglect includes, but is not limited to, authority to interview, without parental consent,
the alleged victim and any other minors who currently reside with or who have resided
with the alleged offender. The interview may take place at school or at any facility or
other place where the alleged victim or other minors might be found or the child may be
transported to, and the interview conducted at, a place appropriate for the interview of a
child designated by the local welfare agency or law enforcement agency. The interview
may take place outside the presence of the alleged offender or parent, legal custodian,
guardian, or school official. For family assessments, it is the preferred practice to request
a parent or guardian's permission to interview the child prior to conducting the child
interview, unless doing so would compromise the safety assessment. Except as provided in
this paragraph, the parent, legal custodian, or guardian shall be notified by the responsible
local welfare or law enforcement agency no later than the conclusion of the investigation
or assessment that this interview has occurred. Notwithstanding rule deleted text begin 49.02deleted text end new text begin 32new text end of the
Minnesota Rules of Procedure for Juvenile Courts, the juvenile court may, after hearing on
an ex parte motion by the local welfare agency, order that, where reasonable cause exists,
the agency withhold notification of this interview from the parent, legal custodian, or
guardian. If the interview took place or is to take place on school property, the order shall
specify that school officials may not disclose to the parent, legal custodian, or guardian the
contents of the notification of intent to interview the child on school property, as provided
under this paragraph, and any other related information regarding the interview that may
be a part of the child's school record. A copy of the order shall be sent by the local welfare
or law enforcement agency to the appropriate school official.
(d) When the local welfare, local law enforcement agency, or the agency responsible
for assessing or investigating a report of maltreatment determines that an interview should
take place on school property, written notification of intent to interview the child on school
property must be received by school officials prior to the interview. The notification
shall include the name of the child to be interviewed, the purpose of the interview, and
a reference to the statutory authority to conduct an interview on school property. For
interviews conducted by the local welfare agency, the notification shall be signed by the
chair of the local social services agency or the chair's designee. The notification shall be
private data on individuals subject to the provisions of this paragraph. School officials
may not disclose to the parent, legal custodian, or guardian the contents of the notification
or any other related information regarding the interview until notified in writing by the
local welfare or law enforcement agency that the investigation or assessment has been
concluded, unless a school employee or agent is alleged to have maltreated the child.
Until that time, the local welfare or law enforcement agency or the agency responsible
for assessing or investigating a report of maltreatment shall be solely responsible for any
disclosures regarding the nature of the assessment or investigation.
Except where the alleged offender is believed to be a school official or employee,
the time and place, and manner of the interview on school premises shall be within the
discretion of school officials, but the local welfare or law enforcement agency shall have
the exclusive authority to determine who may attend the interview. The conditions as to
time, place, and manner of the interview set by the school officials shall be reasonable and
the interview shall be conducted not more than 24 hours after the receipt of the notification
unless another time is considered necessary by agreement between the school officials and
the local welfare or law enforcement agency. Where the school fails to comply with the
provisions of this paragraph, the juvenile court may order the school to comply. Every
effort must be made to reduce the disruption of the educational program of the child, other
students, or school staff when an interview is conducted on school premises.
(e) Where the alleged offender or a person responsible for the care of the alleged
victim or other minor prevents access to the victim or other minor by the local welfare
agency, the juvenile court may order the parents, legal custodian, or guardian to produce
the alleged victim or other minor for questioning by the local welfare agency or the local
law enforcement agency outside the presence of the alleged offender or any person
responsible for the child's care at reasonable places and times as specified by court order.
(f) Before making an order under paragraph (e), the court shall issue an order to
show cause, either upon its own motion or upon a verified petition, specifying the basis for
the requested interviews and fixing the time and place of the hearing. The order to show
cause shall be served personally and shall be heard in the same manner as provided in
other cases in the juvenile court. The court shall consider the need for appointment of a
guardian ad litem to protect the best interests of the child. If appointed, the guardian ad
litem shall be present at the hearing on the order to show cause.
(g) The commissioner of human services, the ombudsman for mental health and
developmental disabilities, the local welfare agencies responsible for investigating reports,
the commissioner of education, and the local law enforcement agencies have the right to
enter facilities as defined in subdivision 2 and to inspect and copy the facility's records,
including medical records, as part of the investigation. Notwithstanding the provisions of
chapter 13, they also have the right to inform the facility under investigation that they are
conducting an investigation, to disclose to the facility the names of the individuals under
investigation for abusing or neglecting a child, and to provide the facility with a copy of
the report and the investigative findings.
(h) The local welfare agency responsible for conducting a family assessmentnew text begin or
investigationnew text end shall collect available and relevant information to determine child safety,
risk of subsequent child maltreatment, and family strengths and needs new text begin and share not public
information with an Indian's tribal social services agency without violating any law of the
state that may otherwise impose duties of confidentiality on the local welfare agency in
order to implement the tribal state agreementnew text end . The local welfare agency or the agency
responsible for investigating the report shall collect available and relevant information
to ascertain whether maltreatment occurred and whether protective services are needed.
Information collected includes, when relevant, information with regard to the person
reporting the alleged maltreatment, including the nature of the reporter's relationship to the
child and to the alleged offender, and the basis of the reporter's knowledge for the report;
the child allegedly being maltreated; the alleged offender; the child's caretaker; and other
collateral sources having relevant information related to the alleged maltreatment. The
local welfare agency or the agency responsible for assessing or investigating the report
may make a determination of no maltreatment early in an assessment, and close the case
and retain immunity, if the collected information shows no basis for a full assessment or
investigation.
Information relevant to the assessment or investigation must be asked for, and
may include:
(1) the child's sex and age, prior reports of maltreatment, information relating
to developmental functioning, credibility of the child's statement, and whether the
information provided under this clause is consistent with other information collected
during the course of the assessment or investigation;
(2) the alleged offender's age, a record check for prior reports of maltreatment, and
criminal charges and convictions. The local welfare agency or the agency responsible for
assessing or investigating the report must provide the alleged offender with an opportunity
to make a statement. The alleged offender may submit supporting documentation relevant
to the assessment or investigation;
(3) collateral source information regarding the alleged maltreatment and care of the
child. Collateral information includes, when relevant: (i) a medical examination of the
child; (ii) prior medical records relating to the alleged maltreatment or the care of the
child maintained by any facility, clinic, or health care professional and an interview with
the treating professionals; and (iii) interviews with the child's caretakers, including the
child's parent, guardian, foster parent, child care provider, teachers, counselors, family
members, relatives, and other persons who may have knowledge regarding the alleged
maltreatment and the care of the child; and
(4) information on the existence of domestic abuse and violence in the home of
the child, and substance abuse.
Nothing in this paragraph precludes the local welfare agency, the local law
enforcement agency, or the agency responsible for assessing or investigating the report
from collecting other relevant information necessary to conduct the assessment or
investigation. Notwithstanding section 13.384 or 144.335, the local welfare agency has
access to medical data and records for purposes of clause (3). Notwithstanding the data's
classification in the possession of any other agency, data acquired by the local welfare
agency or the agency responsible for assessing or investigating the report during the course
of the assessment or investigation are private data on individuals and must be maintained
in accordance with subdivision 11. Data of the commissioner of education collected
or maintained during and for the purpose of an investigation of alleged maltreatment
in a school are governed by this section, notwithstanding the data's classification as
educational, licensing, or personnel data under chapter 13.
In conducting an assessment or investigation involving a school facility as defined
in subdivision 2, paragraph (i), the commissioner of education shall collect investigative
reports and data that are relevant to a report of maltreatment and are from local law
enforcement and the school facility.
(i) Upon receipt of a report, the local welfare agency shall conduct a face-to-face
contact with the child reported to be maltreated and with the child's primary caregiver
sufficient to complete a safety assessment and ensure the immediate safety of the child.
The face-to-face contact with the child and primary caregiver shall occur immediately
if substantial child endangerment is alleged and within five calendar days for all other
reports. If the alleged offender was not already interviewed as the primary caregiver, the
local welfare agency shall also conduct a face-to-face interview with the alleged offender
in the early stages of the assessment or investigation. At the initial contact, the local child
welfare agency or the agency responsible for assessing or investigating the report must
inform the alleged offender of the complaints or allegations made against the individual in
a manner consistent with laws protecting the rights of the person who made the report.
The interview with the alleged offender may be postponed if it would jeopardize an active
law enforcement investigation.
(j) When conducting an investigation, the local welfare agency shall use a question
and answer interviewing format with questioning as nondirective as possible to elicit
spontaneous responses. For investigations only, the following interviewing methods and
procedures must be used whenever possible when collecting information:
(1) audio recordings of all interviews with witnesses and collateral sources; and
(2) in cases of alleged sexual abuse, audio-video recordings of each interview with
the alleged victim and child witnesses.
(k) In conducting an assessment or investigation involving a school facility as
defined in subdivision 2, paragraph (i), the commissioner of education shall collect
available and relevant information and use the procedures in paragraphs (i), (k), and
subdivision 3d, except that the requirement for face-to-face observation of the child
and face-to-face interview of the alleged offender is to occur in the initial stages of the
assessment or investigation provided that the commissioner may also base the assessment
or investigation on investigative reports and data received from the school facility and
local law enforcement, to the extent those investigations satisfy the requirements of
paragraphs (i) and (k), and subdivision 3d.
Sec. 29.
Minnesota Statutes 2006, section 626.556, subdivision 10a, is amended to
read:
Subd. 10a.
deleted text begin Abuse outside family unitdeleted text end new text begin Law enforcement agency responsibility
for investigation; welfare agency reliance on law enforcement fact-finding; welfare
agency offer of servicesnew text end .
new text begin (a) new text end If the report alleges neglect, physical abuse, or sexual abuse
by a person new text begin who is not a parent, guardian, sibling, person new text end responsible for the child's care
functioning deleted text begin outsidedeleted text end new text begin withinnew text end the family unitnew text begin , or a person who lives in the child's household
and who has a significant relationship to the child, new text end in a setting other than a facility as
defined in subdivision 2, the local welfare agency shall immediately notify the appropriate
law enforcement agency, which shall conduct an investigation of the alleged abuse or
neglectnew text begin if a violation of a criminal statute is allegednew text end .
new text begin
(b) The local agency may rely on the fact-finding efforts of the law enforcement
investigation conducted under this subdivision to make a determination whether or not
threatened harm or other maltreatment has occurred under subdivision 2 if an alleged
offender has minor children or lives with minors.
new text end
new text begin (c) new text end The local welfare agency shall offer appropriate social services for the purpose of
safeguarding and enhancing the welfare of the abused or neglected minor.
Sec. 30.
Minnesota Statutes 2006, section 626.556, subdivision 10c, is amended to
read:
Subd. 10c.
Duties of local social service agency upon receipt of a report of
medical neglect.
If the report alleges medical neglect as defined in section 260C.007,
subdivision deleted text begin 4deleted text end new text begin 6new text end , clause (5), the local welfare agency shall, in addition to its other duties
under this section, immediately consult with designated hospital staff and with the parents
of the infant to verify that appropriate nutrition, hydration, and medication are being
provided; and shall immediately secure an independent medical review of the infant's
medical charts and records and, if necessary, seek a court order for an independent medical
examination of the infant. If the review or examination leads to a conclusion of medical
neglect, the agency shall intervene on behalf of the infant by initiating legal proceedings
under section 260C.141 and by filing an expedited motion to prevent the withholding
of medically indicated treatment.
Sec. 31.
Minnesota Statutes 2006, section 626.556, subdivision 10f, is amended to read:
Subd. 10f.
Notice of determinations.
Within ten working days of the conclusion
of a family assessment, the local welfare agency shall notify the parent or guardian of
the child of the need for services to address child safety concerns or significant risk of
subsequent child maltreatment. The local welfare agency and the family may also jointly
agree that family support and family preservation services are needed. Within ten working
days of the conclusion of an investigation, the local welfare agency or agency responsible
for assessing or investigating the report shall notify the parent or guardian of the child, the
person determined to be maltreating the child, and if applicable, the director of the facility,
of the determination and a summary of the specific reasons for the determination. The
notice must also include a certification that the information collection procedures under
subdivision 10, paragraphs (h), (i), and (j), were followed and a notice of the right of a
data subject to obtain access to other private data on the subject collected, created, or
maintained under this section. In addition, the notice shall include the length of time that
the records will be kept under subdivision 11c. The investigating agency shall notify the
parent or guardian of the child who is the subject of the report, and any person or facility
determined to have maltreated a child, of their appeal or review rights under this section
or section 256.022.new text begin The notice must also state that a finding of maltreatment may result
in denial of a license application or background study disqualification under chapter
245C related to employment or services that are licensed by the Department of Human
Services under chapter 245A, the Department of Health under chapter 144 or 144A, the
Department of Corrections under section 241.021, and from providing services related to
an unlicensed personal care provider organization under chapter 256B.
new text end
Sec. 32. new text begin REVISOR'S INSTRUCTION.
new text end
new text begin
(a) The revisor shall renumber Minnesota Statutes, section 626.556, subdivision 3d,
as Minnesota Statutes, section 626.556, subdivision 3g.
new text end
new text begin
(b) The revisor shall change references to Minnesota Statutes, section 260.851,
to section 260.853 and references to Minnesota Statutes, section 260.851, article 5, to
section 260.853, article 4, wherever those references appear in Minnesota Statutes and
Minnesota Rules.
new text end
ARTICLE 2
CHILDREN AND FAMILY
Section 1.
Minnesota Statutes 2006, section 13.46, subdivision 2, is amended to read:
Subd. 2.
General.
(a) Unless the data is summary data or a statute specifically
provides a different classification, data on individuals collected, maintained, used, or
disseminated by the welfare system is private data on individuals, and shall not be
disclosed except:
(1) according to section 13.05;
(2) according to court order;
(3) according to a statute specifically authorizing access to the private data;
(4) to an agent of the welfare system, including a law enforcement person, attorney,
or investigator acting for it in the investigation or prosecution of a criminal or civil
proceeding relating to the administration of a program;
(5) to personnel of the welfare system who require the data to verify an individual's
identity; determine eligibility, amount of assistance, and the need to provide services to
an individual or family across programs; evaluate the effectiveness of programs; and
investigate suspected fraud;
(6) to administer federal funds or programs;
(7) between personnel of the welfare system working in the same program;
(8) to the Department of Revenue to administer and evaluate tax refund or tax credit
programs and to identify individuals who may benefit from these programs. The following
information may be disclosed under this paragraph: an individual's and their dependent's
names, dates of birth, Social Security numbers, income, addresses, and other data as
required, upon request by the Department of Revenue. Disclosures by the commissioner
of revenue to the commissioner of human services for the purposes described in this clause
are governed by section 270B.14, subdivision 1. Tax refund or tax credit programs include,
but are not limited to, the dependent care credit under section 290.067, the Minnesota
working family credit under section 290.0671, the property tax refund and rental credit
under section 290A.04, and the Minnesota education credit under section 290.0674;
(9) between the Department of Human Services, the Department of Education, and
the Department of Employment and Economic Development for the purpose of monitoring
the eligibility of the data subject for unemployment benefits, for any employment or
training program administered, supervised, or certified by that agency, for the purpose of
administering any rehabilitation program or child care assistance program, whether alone
or in conjunction with the welfare system, or to monitor and evaluate the Minnesota
family investment program new text begin or the child care assistance program new text end by exchanging data on
recipients and former recipients of food support, cash assistance under chapter 256, 256D,
256J, or 256K, child care assistance under chapter 119B, or medical programs under
chapter 256B, 256D, or 256L;
(10) to appropriate parties in connection with an emergency if knowledge of
the information is necessary to protect the health or safety of the individual or other
individuals or persons;
(11) data maintained by residential programs as defined in section 245A.02 may
be disclosed to the protection and advocacy system established in this state according
to Part C of Public Law 98-527 to protect the legal and human rights of persons with
developmental disabilities or other related conditions who live in residential facilities for
these persons if the protection and advocacy system receives a complaint by or on behalf
of that person and the person does not have a legal guardian or the state or a designee of
the state is the legal guardian of the person;
(12) to the county medical examiner or the county coroner for identifying or locating
relatives or friends of a deceased person;
(13) data on a child support obligor who makes payments to the public agency
may be disclosed to the Minnesota Office of Higher Education to the extent necessary to
determine eligibility under section 136A.121, subdivision 2, clause (5);
(14) participant Social Security numbers and names collected by the telephone
assistance program may be disclosed to the Department of Revenue to conduct an
electronic data match with the property tax refund database to determine eligibility under
section 237.70, subdivision 4a;
(15) the current address of a Minnesota family investment program participant
may be disclosed to law enforcement officers who provide the name of the participant
and notify the agency that:
(i) the participant:
(A) is a fugitive felon fleeing to avoid prosecution, or custody or confinement after
conviction, for a crime or attempt to commit a crime that is a felony under the laws of the
jurisdiction from which the individual is fleeing; or
(B) is violating a condition of probation or parole imposed under state or federal law;
(ii) the location or apprehension of the felon is within the law enforcement officer's
official duties; and
(iii) the request is made in writing and in the proper exercise of those duties;
(16) the current address of a recipient of general assistance or general assistance
medical care may be disclosed to probation officers and corrections agents who are
supervising the recipient and to law enforcement officers who are investigating the
recipient in connection with a felony level offense;
(17) information obtained from food support applicant or recipient households may
be disclosed to local, state, or federal law enforcement officials, upon their written request,
for the purpose of investigating an alleged violation of the Food Stamp Act, according
to Code of Federal Regulations, title 7, section 272.1(c);
(18) the address, Social Security number, and, if available, photograph of any
member of a household receiving food support shall be made available, on request, to a
local, state, or federal law enforcement officer if the officer furnishes the agency with the
name of the member and notifies the agency that:
(i) the member:
(A) is fleeing to avoid prosecution, or custody or confinement after conviction, for a
crime or attempt to commit a crime that is a felony in the jurisdiction the member is fleeing;
(B) is violating a condition of probation or parole imposed under state or federal
law; or
(C) has information that is necessary for the officer to conduct an official duty related
to conduct described in subitem (A) or (B);
(ii) locating or apprehending the member is within the officer's official duties; and
(iii) the request is made in writing and in the proper exercise of the officer's official
duty;
(19) the current address of a recipient of Minnesota family investment program,
general assistance, general assistance medical care, or food support may be disclosed to
law enforcement officers who, in writing, provide the name of the recipient and notify the
agency that the recipient is a person required to register under section 243.166, but is not
residing at the address at which the recipient is registered under section 243.166;
(20) certain information regarding child support obligors who are in arrears may be
made public according to section 518A.74;
(21) data on child support payments made by a child support obligor and data on
the distribution of those payments excluding identifying information on obligees may be
disclosed to all obligees to whom the obligor owes support, and data on the enforcement
actions undertaken by the public authority, the status of those actions, and data on the
income of the obligor or obligee may be disclosed to the other party;
(22) data in the work reporting system may be disclosed under section 256.998,
subdivision 7;
(23) to the Department of Education for the purpose of matching Department of
Education student data with public assistance data to determine students eligible for free
and reduced price meals, meal supplements, and free milk according to United States
Code, title 42, sections 1758, 1761, 1766, 1766a, 1772, and 1773; to allocate federal and
state funds that are distributed based on income of the student's family; and to verify
receipt of energy assistance for the telephone assistance plan;
(24) the current address and telephone number of program recipients and emergency
contacts may be released to the commissioner of health or a local board of health as
defined in section 145A.02, subdivision 2, when the commissioner or local board of health
has reason to believe that a program recipient is a disease case, carrier, suspect case, or at
risk of illness, and the data are necessary to locate the person;
(25) to other state agencies, statewide systems, and political subdivisions of this
state, including the attorney general, and agencies of other states, interstate information
networks, federal agencies, and other entities as required by federal regulation or law for
the administration of the child support enforcement program;
(26) to personnel of public assistance programs as defined in section 256.741, for
access to the child support system database for the purpose of administration, including
monitoring and evaluation of those public assistance programs;
(27) to monitor and evaluate the Minnesota family investment program by
exchanging data between the Departments of Human Services and Education, on
recipients and former recipients of food support, cash assistance under chapter 256, 256D,
256J, or 256K, child care assistance under chapter 119B, or medical programs under
chapter 256B, 256D, or 256L;
(28) to evaluate child support program performance and to identify and prevent
fraud in the child support program by exchanging data between the Department of Human
Services, Department of Revenue under section 270B.14, subdivision 1, paragraphs (a)
and (b), without regard to the limitation of use in paragraph (c), Department of Health,
Department of Employment and Economic Development, and other state agencies as is
reasonably necessary to perform these functions; or
(29) counties operating child care assistance programs under chapter 119B may
disseminate data on program participants, applicants, and providers to the commissioner
of education.
(b) Information on persons who have been treated for drug or alcohol abuse may
only be disclosed according to the requirements of Code of Federal Regulations, title
42, sections 2.1 to 2.67.
(c) Data provided to law enforcement agencies under paragraph (a), clause (15),
(16), (17), or (18), or paragraph (b), are investigative data and are confidential or protected
nonpublic while the investigation is active. The data are private after the investigation
becomes inactive under section 13.82, subdivision 5, paragraph (a) or (b).
(d) Mental health data shall be treated as provided in subdivisions 7, 8, and 9, but is
not subject to the access provisions of subdivision 10, paragraph (b).
For the purposes of this subdivision, a request will be deemed to be made in writing
if made through a computer interface system.
Sec. 2.
Minnesota Statutes 2006, section 16D.13, subdivision 3, is amended to read:
Subd. 3.
Exclusion.
A state agency may not charge interest under this section on
overpayments of assistance benefits under the programs formerly codified in sections
256.031 to 256.0361, 256.72 to 256.87, and under chapters new text begin 119B, new text end 256Dnew text begin ,new text end and 256I, or the
federal food stamp program. Notwithstanding this prohibition, any debts that have been
reduced to judgment under these programs are subject to the interest charges provided
under section 549.09.
Sec. 3.
Minnesota Statutes 2006, section 119B.011, is amended by adding a subdivision
to read:
new text begin Subd. 13a. new text end
new text begin Family stabilization services. new text end
new text begin
"Family stabilization services" means the
services under section 256J.575.
new text end
Sec. 4.
Minnesota Statutes 2006, section 119B.035, subdivision 1, is amended to read:
Subdivision 1.
Establishment.
A family in which a parent provides care for the
family's infant child may receive a subsidy in lieu of assistance if the family is eligible for
or is receiving assistance under the basic sliding fee program. An eligible family must
meet the eligibility factors under section 119B.09, except as provided in subdivision 4,
and the requirements of this section. Subject to federal match and maintenance of effort
requirements for the child care and development fund, new text begin and up to available appropriations,
new text end the commissioner shall deleted text begin establish a pool of up to three percent of the annual state
appropriation for the basic sliding fee program todeleted text end provide assistance under the at-home
infant child care program and for administrative costs associated with the program. At
the end of a fiscal year, the commissioner may carry forward any unspent funds under
this section to the next fiscal year within the same biennium for assistance under the
basic sliding fee program.
Sec. 5.
Minnesota Statutes 2006, section 119B.05, subdivision 1, is amended to read:
Subdivision 1.
Eligible participants.
Families eligible for child care assistance
under the MFIP child care program are:
(1) MFIP participants who are employed or in job search and meet the requirements
of section 119B.10;
(2) persons who are members of transition year families under section 119B.011,
subdivision 20, and meet the requirements of section 119B.10;
(3) families who are participating in employment orientation or job search, or
other employment or training activities that are included in an approved employability
development plan under section 256J.95;
(4) MFIP families who are participating in work job search, job support,
employment, or training activities as required in their employment plan, or in appeals,
hearings, assessments, or orientations according to chapter 256J;
(5) MFIP families who are participating in social services activities under chapter
256J as required in their employment plan approved according to chapter 256J;
(6) new text begin families who are participating in services or activities that are included in an
approved family stabilization plan under section 256J.575;new text end
new text begin (7) new text end families who are participating in programs as required in tribal contracts under
section 119B.02, subdivision 2, or 256.01, subdivision 2; and
deleted text begin (7)deleted text end new text begin (8) new text end families who are participating in the transition year extension under section
119B.011, subdivision 20a.
Sec. 6.
Minnesota Statutes 2006, section 119B.09, subdivision 7, is amended to read:
Subd. 7.
Date of eligibility for assistance.
(a) The date of eligibility for child
care assistance under this chapter is the later of the date the application was signed; the
beginning date of employment, education, or training; the date the infant is born for
applicants to the at-home infant care program; or the date a determination has been made
that the applicant is a participant in employment and training services under Minnesota
Rules, part 3400.0080, deleted text begin subpart 2a,deleted text end or chapter 256J.
(b) Payment ceases for a family under the at-home infant child care program when a
family has used a total of 12 months of assistance as specified under section 119B.035.
Payment of child care assistance for employed persons on MFIP is effective the date of
employment or the date of MFIP eligibility, whichever is later. Payment of child care
assistance for MFIP or DWP participants in employment and training services is effective
the date of commencement of the services or the date of MFIP or DWP eligibility,
whichever is later. Payment of child care assistance for transition year child care must be
made retroactive to the date of eligibility for transition year child care.
Sec. 7.
Minnesota Statutes 2006, section 119B.09, is amended by adding a subdivision
to read:
new text begin Subd. 11. new text end
new text begin Payment of other child care expenses. new text end
new text begin
Payment by a source other
than the family, of part or all of a family's child care expenses not payable under this
chapter, does not affect the family's eligibility for child care assistance, and the amount
paid is excluded from the family's income, if the funds are paid directly to the family's
child care provider on behalf of the family. Child care providers who accept third-party
payments must maintain family-specific documentation of payment source, amount, type
of expenses, and time period covered by the payment.
new text end
Sec. 8.
Minnesota Statutes 2006, section 119B.09, is amended by adding a subdivision
to read:
new text begin Subd. 12. new text end
new text begin Sliding fee. new text end
new text begin
Child care services to families must be made available on a
sliding fee basis. The commissioner shall convert eligibility requirements in section
119B.09 and parent fee schedules in 119B.12 to state median income, based on a family
size of three, adjusted for family size, by July 1, 2008. The commissioner shall report
to the 2008 legislature with the necessary statutory changes to codify this conversion
to state median income.
new text end
Sec. 9.
Minnesota Statutes 2006, section 119B.12, is amended to read:
119B.12 SLIDING FEE SCALE.
Subdivision 1.
Fee schedule.
In setting the sliding fee schedule, the commissioner
shall exclude from the amount of income used to determine eligibility an amount for
federal and state income and Social Security taxes attributable to that income level
according to federal and state standardized tax tables. The commissioner shall base the
parent fee on the ability of the family to pay for child care. The fee schedule must be
designed to use any available tax credits.
new text begin
PARENT FEE SCHEDULE. The parent fee schedule is as follows:
new text end
|
new text begin
Income Range (as a percent of the federal poverty guidelines) new text end |
new text begin
Co-payment (as a percentage of adjusted gross income) new text end |
|
new text begin
0-74.99% new text end |
new text begin
$0/month new text end |
|
new text begin
75.00-99.99% new text end |
new text begin
$5/month new text end |
|
new text begin
100.00-104.99% new text end |
new text begin
2.61% new text end |
|
new text begin
105.00-109.99% new text end |
new text begin
2.61% new text end |
|
new text begin
110.00-114.99% new text end |
new text begin
2.61% new text end |
|
new text begin
115.00-119.99% new text end |
new text begin
2.61% new text end |
|
new text begin
120.00-124.99% new text end |
new text begin
2.91% new text end |
|
new text begin
125.00-129.99% new text end |
new text begin
2.91% new text end |
|
new text begin
130.00-134.99% new text end |
new text begin
2.91% new text end |
|
new text begin
135.00-139.99% new text end |
new text begin
2.91% new text end |
|
new text begin
140.00-144.99% new text end |
new text begin
3.21% new text end |
|
new text begin
145.00-149.99% new text end |
new text begin
3.21% new text end |
|
new text begin
150.00-154.99% new text end |
new text begin
3.21% new text end |
|
new text begin
155.00-159.99% new text end |
new text begin
3.84% new text end |
|
new text begin
160.00-164.99% new text end |
new text begin
3.84% new text end |
|
new text begin
165.00-169.99% new text end |
new text begin
4.46% new text end |
|
new text begin
170.00-174.99% new text end |
new text begin
4.76% new text end |
|
new text begin
175.00-179.99% new text end |
new text begin
5.05% new text end |
|
new text begin
180.00-184.99% new text end |
new text begin
5.65% new text end |
|
new text begin
185.00-189.99% new text end |
new text begin
5.95% new text end |
|
new text begin
190.00-194.99% new text end |
new text begin
6.24% new text end |
|
new text begin
195.00-199.99% new text end |
new text begin
6.84% new text end |
|
new text begin
200.00-204.99% new text end |
new text begin
7.58% new text end |
|
new text begin
205.00-209.99% new text end |
new text begin
8.33% new text end |
|
new text begin
210.00-214.99% new text end |
new text begin
9.20% new text end |
|
new text begin
215.00-219.99% new text end |
new text begin
10.07% new text end |
|
new text begin
220.00-224.99% new text end |
new text begin
10.94% new text end |
|
new text begin
225.00-229.99% new text end |
new text begin
11.55% new text end |
|
new text begin
230.00-234.99% new text end |
new text begin
12.16% new text end |
|
new text begin
235.00-239.99% new text end |
new text begin
12.77% new text end |
|
new text begin
240.00-244.99% new text end |
new text begin
13.38% new text end |
|
new text begin
245.00-249.99% new text end |
new text begin
14.00% new text end |
|
new text begin
250% new text end |
new text begin
ineligible new text end |
new text begin
A family's monthly co-payment fee is the fixed percentage established for the
income range multiplied by the highest possible income within that income range.
new text end
Subd. 2.
Parent fee.
A family must be assessed a parent fee for each service period.
A family's parent fee must be a fixed percentage of its annual gross income. Parent fees
must apply to families eligible for child care assistance under sections 119B.03 and
119B.05. Income must be as defined in section 119B.011, subdivision 15. The fixed
percent is based on the relationship of the family's annual gross income to 100 percent
of the annual federal poverty guidelines. Parent fees must begin at 75 percent of the
poverty level. The minimum parent fees for families between 75 percent and 100 percent
of poverty level must be deleted text begin $10deleted text end new text begin $5new text end per month. Parent fees must provide for graduated
movement to full payment. Payment of part or all of a family's parent fee directly to the
family's child care provider on behalf of the family by a source other than the family shall
not affect the family's eligibility for child care assistance, and the amount paid shall be
excluded from the family's income. Child care providers who accept third-party payments
must maintain family specific documentation of payment source, amount, and time period
covered by the payment.
new text begin EFFECTIVE DATE. new text end
new text begin
(a) This section is effective July 1, 2007.
new text end
new text begin
(b) Effective July 1, 2008, the parent fee scale for families with incomes greater than
or equal to 100 percent of FPG shall be converted to state median income for a family size
of three, adjusted for family size, as directed in section 119B.09, subdivision 12.
new text end
Sec. 10.
Minnesota Statutes 2006, section 119B.125, subdivision 2, is amended to read:
Subd. 2.
Persons who cannot be authorized.
(a) A person who meets any of the
conditions under paragraphs (b) to (n) must not be authorized as a legal nonlicensed
family child care provider. To determine whether any of the listed conditions exist,
the county must request information about the provider from the Bureau of Criminal
Apprehension, the juvenile courts, and social service agencies. When one of the listed
entities does not maintain information on a statewide basis, the county must contact the
entity in the county where the provider resides and any other county in which the provider
previously resided in the past year. For purposes of this subdivision, a finding that a
delinquency petition is proven in juvenile court must be considered a conviction in state
district court. If a county has determined that a provider is able to be authorized in that
county, and a family in another county later selects that provider, the provider is able to
be authorized in the second county without undergoing a new background investigation
unless one of the following conditions exists:
(1) two years have passed since the first authorization;
(2) another person age 13 or older has joined the provider's household since the
last authorization;
(3) a current household member has turned 13 since the last authorization; or
(4) there is reason to believe that a household member has a factor that prevents
authorization.
(b) The person has been convicted of one of the following offenses or has admitted to
committing or a preponderance of the evidence indicates that the person has committed an
act that meets the definition of one of the following offenses: sections 609.185 to 609.195,
murder in the first, second, or third degree; 609.2661 to 609.2663, murder of an unborn
child in the first, second, or third degree; 609.322, solicitation, inducement, promotion
of prostitution, or receiving profit from prostitution; 609.342 to 609.345, criminal sexual
conduct in the first, second, third, or fourth degree; 609.352, solicitation of children to
engage in sexual conduct; 609.365, incest; 609.377, felony malicious punishment of a
child; 617.246, use of minors in sexual performance; 617.247, possession of pictorial
representation of a minor; 609.2242 to 609.2243, felony domestic assault; a felony offense
of spousal abuse; a felony offense of child abuse or neglect; a felony offense of a crime
against children; or an attempt or conspiracy to commit any of these offenses as defined in
Minnesota Statutes; or an offense in any other state or country where the elements are
substantially similar to any of the offenses listed in this paragraph.
(c) Less than 15 years have passed since the discharge of the sentence imposed for
the offense and the person has received a felony conviction for one of the following
offenses, or the person has admitted to committing or a preponderance of the evidence
indicates that the person has committed an act that meets the definition of a felony
conviction for one of the following offenses: sections 609.20 to 609.205, manslaughter in
the first or second degree; 609.21, criminal vehicular homicide; 609.215, aiding suicide
or aiding attempted suicide; 609.221 to 609.2231, assault in the first, second, third, or
fourth degree; 609.224, repeat offenses of fifth degree assault; 609.228, great bodily
harm caused by distribution of drugs; 609.2325, criminal abuse of a vulnerable adult;
609.2335, financial exploitation of a vulnerable adult; 609.235, use of drugs to injure or
facilitate a crime; 609.24, simple robbery; 617.241, repeat offenses of obscene materials
and performances; 609.245, aggravated robbery; 609.25, kidnapping; 609.255, false
imprisonment; 609.2664 to 609.2665, manslaughter of an unborn child in the first or
second degree; 609.267 to 609.2672, assault of an unborn child in the first, second, or third
degree; 609.268, injury or death of an unborn child in the commission of a crime; 609.27,
coercion; 609.275, attempt to coerce; 609.324, subdivision 1, other prohibited acts, minor
engaged in prostitution; 609.3451, repeat offenses of criminal sexual conduct in the fifth
degree; 609.378, neglect or endangerment of a child; 609.52, theft; 609.521, possession of
shoplifting gear; 609.561 to 609.563, arson in the first, second, or third degree; 609.582,
burglary in the first, second, third, or fourth degree; 609.625, aggravated forgery; 609.63,
forgery; 609.631, check forgery, offering a forged check; 609.635, obtaining signature
by false pretenses; 609.66, dangerous weapon; 609.665, setting a spring gun; 609.67,
unlawfully owning, possessing, or operating a machine gun; 609.687, adulteration; 609.71,
riot; 609.713, terrorist threats; 609.749, harassment, stalking; 260C.301, termination of
parental rights; 152.021 to 152.022 and 152.0262, controlled substance crime in the first
or second degree; 152.023, subdivision 1, clause (3) or (4), or 152.023, subdivision 2,
clause (4), controlled substance crime in third degree; 152.024, subdivision 1, clause
(2), (3), or (4), controlled substance crime in fourth degree; 617.23, repeat offenses of
indecent exposure; an attempt or conspiracy to commit any of these offenses as defined in
Minnesota Statutes; or an offense in any other state or country where the elements are
substantially similar to any of the offenses listed in this paragraph.
(d) Less than ten years have passed since the discharge of the sentence imposed for
the offense and the person has received a gross misdemeanor conviction for one of the
following offenses or the person has admitted to committing or a preponderance of the
evidence indicates that the person has committed an act that meets the definition of a gross
misdemeanor conviction for one of the following offenses: sections 609.224, fifth degree
assault; 609.2242 to 609.2243, domestic assault; 518B.01, subdivision 14, violation of
an order for protection; 609.3451, fifth degree criminal sexual conduct; 609.746, repeat
offenses of interference with privacy; 617.23, repeat offenses of indecent exposure;
617.241, obscene materials and performances; 617.243, indecent literature, distribution;
617.293, disseminating or displaying harmful material to minors; 609.71, riot; 609.66,
dangerous weapons; 609.749, harassment, stalking; 609.224, subdivision 2, paragraph
(c), fifth degree assault against a vulnerable adult by a caregiver; 609.23, mistreatment
of persons confined; 609.231, mistreatment of residents or patients; 609.2325, criminal
abuse of a vulnerable adult; 609.2335, financial exploitation of a vulnerable adult;
609.233, criminal neglect of a vulnerable adult; 609.234, failure to report maltreatment of
a vulnerable adult; 609.72, subdivision 3, disorderly conduct against a vulnerable adult;
609.265, abduction; 609.378, neglect or endangerment of a child; 609.377, malicious
punishment of a child; 609.324, subdivision 1a, other prohibited acts, minor engaged
in prostitution; 609.33, disorderly house; 609.52, theft; 609.582, burglary in the first,
second, third, or fourth degree; 609.631, check forgery, offering a forged check; 609.275,
attempt to coerce; an attempt or conspiracy to commit any of these offenses as defined in
Minnesota Statutes; or an offense in any other state or country where the elements are
substantially similar to any of the offenses listed in this paragraph.
(e) Less than seven years have passed since the discharge of the sentence imposed
for the offense and the person has received a misdemeanor conviction for one of the
following offenses or the person has admitted to committing or a preponderance of
the evidence indicates that the person has committed an act that meets the definition
of a misdemeanor conviction for one of the following offenses: sections 609.224, fifth
degree assault; 609.2242, domestic assault; 518B.01, violation of an order for protection;
609.3232, violation of an order for protection; 609.746, interference with privacy; 609.79,
obscene or harassing telephone calls; 609.795, letter, telegram, or package opening,
harassment; 617.23, indecent exposure; 609.2672, assault of an unborn child, third degree;
617.293, dissemination and display of harmful materials to minors; 609.66, dangerous
weapons; 609.665, spring guns; an attempt or conspiracy to commit any of these offenses
as defined in Minnesota Statutes; or an offense in any other state or country where the
elements are substantially similar to any of the offenses listed in this paragraph.
(f) The person has been identified by the child protection agency in the county where
the provider resides or a county where the provider has resided or by the statewide child
protection database as a person found by a preponderance of evidence under section
626.556 to be responsible for physical or sexual abuse of a child within the last seven years.
(g) The person has been identified by the adult protection agency in the county
where the provider resides or a county where the provider has resided or by the statewide
adult protection database as the person responsible for abuse or neglect of a vulnerable
adult within the last seven years.
(h) The person has refused to give written consent for disclosure of criminal history
records.
(i) The person has been denied a family child care license or has received a fine or a
sanction as a licensed child care provider that has not been reversed on appeal.
(j) The person has a family child care licensing disqualification that has not been
set aside.
(k) The person has admitted or a county has found that there is a preponderance of
evidence that fraudulent information was given to the county for child care assistance
application purposes or was used in submitting child care assistance bills for payment.
(l) The person has been convicted of the crime of theft by wrongfully obtaining
public assistancenew text begin or has been found guilty of wrongfully obtaining public assistance by a
federal court, state court, or an administrative hearing determination or waiver, through a
disqualification consent agreement, as part of an approved diversion plan under section
401.065, or a court-ordered stay with probationary or other conditionsnew text end .
(m) The person has a household member age 13 or older who has access to children
during the hours that care is provided and who meets one of the conditions listed in
paragraphs (b) to (l).
(n) The person has a household member ages ten to 12 who has access to children
during the hours that care is provided; information or circumstances exist which provide
the county with articulable suspicion that further pertinent information may exist showing
the household member meets one of the conditions listed in paragraphs (b) to (l); and the
household member actually meets one of the conditions listed in paragraphs (b) to (l).
Sec. 11.
Minnesota Statutes 2006, section 119B.13, subdivision 1, is amended to read:
Subdivision 1.
Subsidy restrictions.
(a) Beginning July 1, 2006, the maximum rate
paid for child care assistance in any county or multicounty region under the child care
fund shall be the rate for like-care arrangements in the county effective January 1, 2006,
increased by six percent.
(b) Rate changes shall be implemented for services provided in September 2006
unless a participant eligibility redetermination or a new provider agreement is completed
between July 1, 2006, and August 31, 2006.
As necessary, appropriate notice of adverse action must be made according to
Minnesota Rules, part 3400.0185, subparts 3 and 4.
New cases approved on or after July 1, 2006, shall have the maximum rates under
paragraph (a), implemented immediately.
(c) deleted text begin Not less than once every two yearsdeleted text end new text begin Every yearnew text end , the commissioner shall survey
rates charged by child care providers in Minnesota to determine the 75th percentile for
like-care arrangements in counties. When the commissioner determines that, using the
commissioner's established protocol, the number of providers responding to the survey is
too small to determine the 75th percentile rate for like-care arrangements in a county or
multicounty region, the commissioner may establish the 75th percentile maximum rate
based on like-care arrangements in a county, region, or category that the commissioner
deems to be similar.
(d) A rate which includes a special needs rate paid under subdivision 3 new text begin or under
a school readiness service agreement paid under section 61new text end may be in excess of the
maximum rate allowed under this subdivision.
(e) The department shall monitor the effect of this paragraph on provider rates. The
county shall pay the provider's full charges for every child in care up to the maximum
established. The commissioner shall determine the maximum rate for each type of care on
an hourly, full-day, and weekly basis, including special needs and disability care.
(f) When the provider charge is greater than the maximum provider rate allowed,
the parent is responsible for payment of the difference in the rates in addition to any
family co-payment fee.
Sec. 12.
Minnesota Statutes 2006, section 119B.13, subdivision 3a, is amended to read:
Subd. 3a.
Provider rate differential for accreditation.
A family child care
provider or child care center shall be paid a 15 percent differential above the maximum
rate established in subdivision 1, up to the actual provider rate, if the provider or center
holds a current early childhood development credential or is accredited. For a family
child care provider, early childhood development credential and accreditation includes
an individual who has earned a child development associate degree, new text begin a child development
associate credential, new text end a diploma in child development from a Minnesota state technical
college, or a bachelor's new text begin or post baccalaureate new text end degree in early childhood education from
an accredited college or university, or who is accredited by the National Association for
Family Child Care or the Competency Based Training and Assessment Program. For a
child care center, accreditation includes accreditation by the National Association for the
Education of Young Children, the Council on Accreditation, the National Early Childhood
Program Accreditation, the National School-Age Care Association, or the National Head
Start Association Program of Excellence. For Montessori programs, accreditation includes
the American Montessori Society, Association of Montessori International-USA, or the
National Center for Montessori Education.
Sec. 13.
Minnesota Statutes 2006, section 119B.13, subdivision 7, is amended to read:
Subd. 7.
Absent days.
(a) Child care providers may not be reimbursed for more
than 25 full-day absent days per child, excluding holidays, in a fiscal year, or for more
than ten consecutive full-day absent days, unless the child has a documented medical
condition that causes more frequent absences. new text begin Absences due to a documented medical
condition of a parent or sibling who lives in the same residence as the child receiving
child care assistance do not count against the 25-day absent day limit in a fiscal year.
new text end Documentation of medical conditions must be on the forms and submitted according to
the timelines established by the commissioner. new text begin A public health nurse or school nurse
may verify the illness in lieu of a medical practitioner. If a provider sends a child home
early due to a medical reason, including, but not limited to, fever or contagious illness,
the child care center director or lead teacher may verify the illness in lieu of a medical
practitioner. new text end If a child attends for part of the time authorized to be in care in a day, but is
absent for part of the time authorized to be in care in that same day, the absent time will be
reimbursed but the time will not count toward the ten consecutive or 25 cumulative absent
day limits. new text begin Children in families where at least one parent is under the age of 21, does not
have a high school or general equivalency diploma, and is a student in a school district
or another similar program that provides or arranges for child care, as well as parenting,
social services, career and employment supports, and academic support to achieve high
school graduation, may be exempt from the absent day limits upon request of the program
and approval of the county. new text end If a child attends part of an authorized day, payment to the
provider must be for the full amount of care authorized for that day. Child care providers
may only be reimbursed for absent days if the provider has a written policy for child
absences and charges all other families in care for similar absences.
(b) Child care providers must be reimbursed for up to ten federal or state holidays
or designated holidays per year when the provider charges all families for these days
and the holiday or designated holiday falls on a day when the child is authorized to be
in attendance. Parents may substitute other cultural or religious holidays for the ten
recognized state and federal holidays. Holidays do not count toward the ten consecutive or
25 cumulative absent day limits.
(c) A family or child care provider may not be assessed an overpayment for an
absent day payment unless (1) there was an error in the amount of care authorized for the
family, (2) all of the allowed full-day absent payments for the child have been paid, or (3)
the family or provider did not timely report a change as required under law.
(d) The provider and family must receive notification of the number of absent days
used upon initial provider authorization for a family and when the family has used 15
cumulative absent days. Upon statewide implementation of the Minnesota Electronic
Child Care System, the provider and family authorization for a family and ongoing
notification of the number of absent days used as of the date of the notification.
new text begin
(e) A county may pay for more absent days than the statewide absent day policy
established under this subdivision if current market practice in the county justifies payment
for those additional days. County policies for payment of absent days in excess of the
statewide absent day policy and justification for these county policies must be included in
the county's child care fund plan under section 119B.08, subdivision 3.
new text end
Sec. 14.
Minnesota Statutes 2006, section 119B.21, subdivision 5, is amended to read:
Subd. 5.
Child care services grants.
(a) A child care resource and referral program
designated under section 119B.19, subdivision 1a, may award child care services grants
for:
(1) creating new licensed child care facilities and expanding existing facilities,
including, but not limited to, supplies, equipment, facility renovation, and remodeling;
(2) improving licensed child care facility programs;
(3) staff training and development services including, but not limited to, in-service
training, curriculum development, accreditation, certification, consulting, resource centers,
deleted text begin anddeleted text end program and resource materialsnew text begin , supporting effective teacher-child interactions,
child-focused teaching, and content-driven classroom instructionnew text end ;
(4) interim financing;
(5) capacity building through the purchase of appropriate technology to create,
enhance, and maintain business management systems;
(6) emergency assistance for child care programs;
(7) new programs or projects for the creation, expansion, or improvement of
programs that serve ethnic immigrant and refugee communities; and
(8) targeted recruitment initiatives to expand and build the capacity of the child
care system and to improve the quality of care provided by legal nonlicensed child care
providers.
(b) A child care resource and referral program designated under section 119B.19,
subdivision 1a, may award child care services grants to:
(1) licensed providers;
(2) providers in the process of being licensed;
(3) corporations or public agencies that develop or provide child care services;
(4) school-age care programs; or
(5) any combination of clauses (1) to (4).
Unlicensed providers are only eligible for grants under paragraph (a), clause (7).
(c) A recipient of a child care services grant for facility improvements, interim
financing, or staff training and development must provide a 25 percent local match.
Sec. 15.
Minnesota Statutes 2006, section 256.01, subdivision 4, is amended to read:
Subd. 4.
Duties as state agency.
new text begin (a) new text end The state agency shall:
(1) supervise the administration of assistance to dependent children under Laws
1937, chapter 438, by the county agencies in an integrated program with other service for
dependent children maintained under the direction of the state agency;
deleted text begin
(2) may subpoena witnesses and administer oaths, make rules, and take such action
as may be necessary, or desirable for carrying out the provisions of Laws 1937, chapter
438. All rules made by the state agency shall be binding on the counties and shall be
complied with by the respective county agencies;
deleted text end
deleted text begin (3)deleted text end new text begin (2) new text end establish adequate standards for personnel employed by the counties and the
state agency in the administration of Laws 1937, chapter 438, and make the necessary
rules to maintain such standards;
deleted text begin (4)deleted text end new text begin (3) new text end prescribe the form of and print and supply to the county agencies blanks
for applications, reports, affidavits, and such other forms as it may deem necessary and
advisable;
deleted text begin (5)deleted text end new text begin (4) new text end cooperate with the federal government and its public welfare agencies
in any reasonable manner as may be necessary to qualify for federal aid for temporary
assistance for needy families and in conformity with title I of Public Law 104-193, the
Personal Responsibility and Work Opportunity Reconciliation Act of 1996 and successor
amendments, including the making of such reports and such forms and containing such
information as the Federal Social Security Board may from time to time require, and
comply with such provisions as such board may from time to time find necessary to assure
the correctness and verification of such reports;
deleted text begin
(6) may cooperate with other state agencies in establishing reciprocal agreements in
instances where a child receiving Minnesota family investment program assistance moves
or contemplates moving into or out of the state, in order that such child may continue to
receive supervised aid from the state moved from until the child shall have resided for
one year in the state moved to;
deleted text end
deleted text begin (7)deleted text end new text begin (5) new text end on or before October 1 in each even-numbered year make a biennial report
to the governor concerning the activities of the agency;
deleted text begin (8)deleted text end new text begin (6) new text end enter into agreements with other departments of the state as necessary to meet
all requirements of the federal government; and
deleted text begin (9)deleted text end new text begin (7) new text end cooperate with the commissioner of education to enforce the requirements
for program integrity and fraud prevention for investigation for child care assistance
under chapter 119B.
new text begin
(b) The state agency may:
new text end
new text begin
(1) subpoena witnesses and administer oaths, make rules, and take such action as
may be necessary or desirable for carrying out the provisions of Laws 1937, chapter 438.
All rules made by the state agency shall be binding on the counties and shall be complied
with by the respective county agencies;
new text end
new text begin
(2) cooperate with other state agencies in establishing reciprocal agreements in
instances where a child receiving Minnesota family investment program assistance moves
or contemplates moving into or out of the state, in order that the child may continue
to receive supervised aid from the state moved from until the child has resided for one
year in the state moved to; and
new text end
new text begin
(3) administer oaths and affirmations, take depositions, certify to official acts, and
issue subpoenas to compel the attendance of individuals and the production of documents
and other personal property necessary in connection with the administration of programs
administered by the Department of Human Services.
new text end
new text begin
(c) The fees for service of a subpoena in paragraph (b), clause (3), must be paid in
the same manner as prescribed by law for a service of process issued by a district court.
Witnesses must receive the same fees and mileage as in civil actions.
new text end
new text begin
(d) The subpoena in paragraph (b), clause (3), shall be enforceable through the
district court in the district where the subpoena is issued.
new text end
Sec. 16.
Minnesota Statutes 2006, section 256.01, is amended by adding a subdivision
to read:
new text begin Subd. 23. new text end
new text begin Administrative simplification; county cost study. new text end
new text begin
(a) The commissioner
shall establish and convene the first meeting of an advisory committee to identify ways
to simplify and streamline human services laws and administrative requirements. The
advisory committee shall select its chair from its membership at the first meeting.
new text end
new text begin
(b) The committee shall consist of three senators appointed by the senate
Subcommittee on Committees of the Committee on Rules and Administration, three
state representatives appointed by the speaker of the house of representatives, and
nine department staff and county representatives appointed by the commissioner. The
appointments required under this paragraph must be completed by September 1, 2007.
new text end
new text begin
(c) The committee shall discuss methods of reducing inconsistency between
programs and complexity within programs in order to improve administrative efficiency
and reduce the risk of recipient noncompliance. Topics for discussion may include child
support enforcement, adoption services, child care licensing, child care assistance, and
other programs. The state senators and state representatives on the advisory committee,
in consultation with the advisory committee, shall report annually to the chairs of the
legislative committees and divisions with jurisdiction over the Department of Human
Services, beginning January 15, 2008, with recommendations developed by the advisory
group.
new text end
new text begin
(d) The commissioner, in consultation with the advisory committee, shall study
and report to the legislature by January 15, 2009, on the transfer of any responsibilities
between the department and counties that would result in more efficient and effective
administration of human services programs.
new text end
new text begin
(e) This section expires on June 30, 2012.
new text end
Sec. 17.
Minnesota Statutes 2006, section 256.015, subdivision 7, is amended to read:
Subd. 7.
Cooperation required.
Upon the request of the Department of Human
Services, any state agency or third party payer shall cooperate with the department in
furnishing information to help establish a third party liability. Upon the request of the
Department of Human Services or county child support or human service agencies, any
employer or third party payer shall cooperate in furnishing information about group health
insurance plans or medical benefit plans available to its employees. new text begin For purposes of
section 176.191, subdivision 4, the Department of Labor and Industry may allow the
Department of Human Services and county agencies direct access and data matching on
information relating to workers' compensation claims in order to determine whether the
claimant has reported the fact of a pending claim and the amount paid to or on behalf of
the claimant to the Department of Human Services. new text end The Department of Human Services
and county agencies shall limit its use of information gained from agencies, third party
payers, and employers to purposes directly connected with the administration of its public
assistance and child support programs. The provision of information by agencies, third
party payers, and employers to the department under this subdivision is not a violation of
any right of confidentiality or data privacy.
Sec. 18.
Minnesota Statutes 2006, section 256.017, subdivision 1, is amended to read:
Subdivision 1.
Authority and purpose.
The commissioner shall administer a
compliance system for the Minnesota family investment program, the food stamp or food
support program, emergency assistance, general assistance, medical assistance, general
assistance medical care, emergency general assistance, Minnesota supplemental assistance,
preadmission screening, deleted text begin anddeleted text end alternative care grantsnew text begin , and the child care assistance programnew text end
under the powers and authorities named in section 256.01, subdivision 2. The purpose of
the compliance system is to permit the commissioner to supervise the administration of
public assistance programs and to enforce timely and accurate distribution of benefits,
completeness of service and efficient and effective program management and operations,
to increase uniformity and consistency in the administration and delivery of public
assistance programs throughout the state, and to reduce the possibility of sanctions and
fiscal disallowances for noncompliance with federal regulations and state statutes.
The commissioner shall utilize training, technical assistance, and monitoring
activities, as specified in section 256.01, subdivision 2, to encourage county agency
compliance with written policies and procedures.
Sec. 19.
Minnesota Statutes 2006, section 256.017, subdivision 9, is amended to read:
Subd. 9.
Timing and disposition of penalty and case disallowance funds.
Quality
control case penalty and administrative penalty amounts shall be disallowed or withheld
from the next regular reimbursement made to the county agency for state and federal
benefit reimbursements and federal administrative reimbursements for all programs
covered in this section, according to procedures established in statute, but shall not be
imposed sooner than 30 calendar days from the date of written notice of such penalties.
new text begin Except for penalties withheld under the child care assistance program, new text end all penalties
must be deposited in the county incentive fund provided in section 256.018. new text begin Penalties
withheld under the child care assistance program shall be reallocated to counties using the
allocation formula under section 119B.03, subdivision 5. new text end All penalties must be imposed
according to this provision until a decision is made regarding the status of a written
exception. Penalties must be returned to county agencies when a review of a written
exception results in a decision in their favor.
Sec. 20.
Minnesota Statutes 2006, section 256.984, subdivision 1, is amended to read:
Subdivision 1.
Declaration.
Every application for public assistance under this
chapter or chapters 256B, 256D, 256J, new text begin and 256L; child care programs under chapter 119B;
new text end and food stamps or food support under chapter 393 shall be in writing or reduced to
writing as prescribed by the state agency and shall contain the following declaration which
shall be signed by the applicant:
"I declare under the penalties of perjury that this application has been examined
by me and to the best of my knowledge is a true and correct statement of every
material point. I understand that a person convicted of perjury may be sentenced
to imprisonment of not more than five years or to payment of a fine of not more
than $10,000, or both."
Sec. 21.
new text begin
[256D.0516] EXPIRATION OF FOOD SUPPORT BENEFITS AND
REPORTING REQUIREMENTS.
new text end
new text begin Subdivision 1. new text end
new text begin Expiration of food support benefits. new text end
new text begin
Food support benefits shall
not be stored off line or expunged from a recipient's account unless the benefits have not
been accessed for 12 months after the month they were issued.
new text end
new text begin Subd. 2. new text end
new text begin Food support reporting requirements. new text end
new text begin
The commissioner of human
services shall implement simplified reporting as permitted under the Food Stamp Act of
1977, as amended, and the food stamp regulations in Code of Federal Regulations, title
7, part 273. Food support recipient households required to report periodically shall not
be required to report more often than one time every six months. This provision shall
not apply to households receiving food benefits under the Minnesota family investment
program waiver.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
Subdivision 1 is effective February 1, 2008, and subdivision
2 is effective May 1, 2008.
new text end
Sec. 22.
Minnesota Statutes 2006, section 256J.01, is amended by adding a subdivision
to read:
new text begin Subd. 6. new text end
new text begin Legislative approval to move programs or activities. new text end
new text begin
The commissioner
shall not move programs or activities funded with MFIP or TANF maintenance of effort
funds to other funding sources without legislative approval.
new text end
Sec. 23.
Minnesota Statutes 2006, section 256J.02, subdivision 1, is amended to read:
Subdivision 1.
Commissioner's authority to administer block grant funds.
The
commissioner of human services is authorized to receive, administer, and expend funds
available under the TANF block grant authorized under title I of Public Law 104-193, the
Personal Responsibility and Work Opportunity Reconciliation Act of 1996new text begin , and under
Public Law 109-171, the Deficit Reduction Act of 2005new text end .
Sec. 24.
Minnesota Statutes 2006, section 256J.02, subdivision 4, is amended to read:
Subd. 4.
Authority to transfer.
Subject to limitations of title I of Public Law
104-193, the Personal Responsibility and Work Opportunity Reconciliation Act of 1996,
as amended, new text begin and under Public Law 109-171, the Deficit Reduction Act of 2005, new text end the
legislature may transfer money from the TANF block grant to the child care fund under
chapter 119B, or the Title XX block grant.
Sec. 25.
Minnesota Statutes 2006, section 256J.021, is amended to read:
256J.021 SEPARATE STATE PROGRAM FOR USE OF STATE MONEY.
(a) deleted text begin Until October 1, 2006, the commissioner of human services must treat MFIP
expenditures made to or on behalf of any minor child under section 256J.02, subdivision
2, clause (1), who is a resident of this state under section 256J.12, and who is part of a
two-parent eligible household as expenditures under a separately funded state program
and report those expenditures to the federal Department of Health and Human Services as
separate state program expenditures under Code of Federal Regulations, title 45, section
263.5.deleted text end new text begin Families receiving assistance under this section shall comply with all applicable
requirements in this chapter.new text end
(b) Beginning October 1, 2006, the commissioner of human services must treat
MFIP expenditures made to or on behalf of any minor child under section 256J.02,
subdivision 2, clause (1), deleted text begin who is a resident of this state under section 256J.12, anddeleted text end who is
part of a two-parent deleted text begin eligibledeleted text end household, as expenditures under a separately funded state
program. These expenditures shall not count toward the state's maintenance of effort
(MOE) requirements under the federal Temporary Assistance to Needy Families (TANF)
program deleted text begin except if counting certain families would allow the commissioner to avoid a
deleted text end deleted text begin federal penalty. Families receiving assistance under this section must comply with all
deleted text end deleted text begin applicable requirements in this chapterdeleted text end .
new text begin
(c) Beginning February 1, 2008, the commissioner of human services shall treat
MFIP expenditures made to or on behalf of any minor child who is part of a household
that meets criteria in section 256J.575, subdivision 3, as expenditures under a separately
funded state program under section 256J.575, subdivision 8.
new text end
Sec. 26.
Minnesota Statutes 2006, section 256J.08, subdivision 65, is amended to read:
Subd. 65.
Participant.
new text begin (a) new text end "Participant" deleted text begin meansdeleted text end new text begin includes any of the following:
new text end
new text begin (1)new text end a person who is currently receiving cash assistance or the food portion available
through MFIPdeleted text begin . A person who fails to withdraw or access electronically any portion of the
person's cash and food assistance payment by the end of the payment month, who makes a
written request for closure before the first of a payment month and repays cash and food
assistance electronically issued for that payment month within that payment month, or
who returns any uncashed assistance check and food coupons and withdraws from the
program is not a participant.deleted text end new text begin ;
new text end
new text begin (2)new text end a person who withdraws a cash or food assistance payment by electronic transfer
or receives and cashes an MFIP assistance check or food coupons and is subsequently
determined to be ineligible for assistance for that period of time is a participant, regardless
whether that assistance is repaiddeleted text begin . The term "participant" includesdeleted text end new text begin ;
new text end
new text begin (3)new text end the caregiver relative and the minor child whose needs are included in the
assistance paymentdeleted text begin .deleted text end new text begin ;
new text end
new text begin (4)new text end a person in an assistance unit who does not receive a cash and food assistance
payment because the case has been suspended from MFIP deleted text begin is a participant.deleted text end new text begin ;
new text end
new text begin (5)new text end a person who receives cash payments under the diversionary work program
under section 256J.95 is a participantdeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(6) a person who receives cash payments under family stabilization services under
section 256J.575.
new text end
new text begin
(b) "Participant" does not include a person who fails to withdraw or access
electronically any portion of the person's cash and food assistance payment by the end of
the payment month, who makes a written request for closure before the first of a payment
month and repays cash and food assistance electronically issued for that payment month
within that payment month, or who returns any uncashed assistance check and food
coupons and withdraws from the program.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 27.
Minnesota Statutes 2006, section 256J.20, subdivision 3, is amended to read:
Subd. 3.
Other property limitations.
To be eligible for MFIP, the equity value of
all nonexcluded real and personal property of the assistance unit must not exceed $2,000
for applicants and $5,000 for ongoing participants. The value of assets in clauses (1) to
(19) must be excluded when determining the equity value of real and personal property:
(1) a licensed vehicle up to a loan value of less than or equal to deleted text begin $7,500. The county
deleted text end deleted text begin agency shall apply any excess loan value as if it were equity value to the asset limit
deleted text end deleted text begin described in this sectiondeleted text end new text begin $15,000new text end . If the assistance unit owns more than one licensed
vehicle, deleted text begin the county agency shalldeleted text end determine deleted text begin the vehicle with the highest loan value and
count only the loan value over $7,500,deleted text end new text begin the loan value of all additional vehicles and
exclude the combined loan value of less than or equal to $7,500. The county agency shall
apply any excess loan value as if it were equity value to the asset limit described in this
section,new text end excluding: (i) the value of one vehicle per physically disabled person when the
vehicle is needed to transport the disabled unit member; this exclusion does not apply to
mentally disabled people; (ii) the value of special equipment for a disabled member of
the assistance unit; and (iii) any vehicle used for long-distance travel, other than daily
commuting, for the employment of a unit member.
deleted text begin The county agency shall count the deleted text end deleted text begin loandeleted text end deleted text begin value of all other vehicles and apply this
deleted text end deleted text begin amount deleted text end deleted text begin as if it were equity valuedeleted text end deleted text begin to the asset limit described in this section. deleted text end To establish the
loan value of vehicles, a county agency must use the N.A.D.A. Official Used Car Guide,
Midwest Edition, for newer model cars. When a vehicle is not listed in the guidebook,
or when the applicant or participant disputes the loan value listed in the guidebook as
unreasonable given the condition of the particular vehicle, the county agency may require
the applicant or participant document the loan value by securing a written statement from
a motor vehicle dealer licensed under section 168.27, stating the amount that the dealer
would pay to purchase the vehicle. The county agency shall reimburse the applicant or
participant for the cost of a written statement that documents a lower loan value;
(2) the value of life insurance policies for members of the assistance unit;
(3) one burial plot per member of an assistance unit;
(4) the value of personal property needed to produce earned income, including
tools, implements, farm animals, inventory, business loans, business checking and
savings accounts used at least annually and used exclusively for the operation of a
self-employment business, and any motor vehicles if at least 50 percent of the vehicle's use
is to produce income and if the vehicles are essential for the self-employment business;
(5) the value of personal property not otherwise specified which is commonly
used by household members in day-to-day living such as clothing, necessary household
furniture, equipment, and other basic maintenance items essential for daily living;
(6) the value of real and personal property owned by a recipient of Supplemental
Security Income or Minnesota supplemental aid;
(7) the value of corrective payments, but only for the month in which the payment
is received and for the following month;
(8) a mobile home or other vehicle used by an applicant or participant as the
applicant's or participant's home;
(9) money in a separate escrow account that is needed to pay real estate taxes or
insurance and that is used for this purpose;
(10) money held in escrow to cover employee FICA, employee tax withholding,
sales tax withholding, employee worker compensation, business insurance, property rental,
property taxes, and other costs that are paid at least annually, but less often than monthly;
(11) monthly assistance payments for the current month's or short-term emergency
needs under section 256J.626, subdivision 2;
(12) the value of school loans, grants, or scholarships for the period they are
intended to cover;
(13) payments listed in section 256J.21, subdivision 2, clause (9), which are held
in escrow for a period not to exceed three months to replace or repair personal or real
property;
(14) income received in a budget month through the end of the payment month;
(15) savings from earned income of a minor child or a minor parent that are set aside
in a separate account designated specifically for future education or employment costs;
(16) the federal earned income credit, Minnesota working family credit, state and
federal income tax refunds, state homeowners and renters credits under chapter 290A,
property tax rebates and other federal or state tax rebates in the month received and the
following month;
(17) payments excluded under federal law as long as those payments are held in a
separate account from any nonexcluded funds;
(18) the assets of children ineligible to receive MFIP benefits because foster care or
adoption assistance payments are made on their behalf; and
(19) the assets of persons whose income is excluded under section 256J.21,
subdivision 2, clause (43).
Sec. 28.
Minnesota Statutes 2006, section 256J.21, subdivision 2, is amended to read:
Subd. 2.
Income exclusions.
The following must be excluded in determining a
family's available income:
(1) payments for basic care, difficulty of care, and clothing allowances received for
providing family foster care to children or adults under Minnesota Rules, parts 9555.5050
to 9555.6265, 9560.0521, and 9560.0650 to 9560.0655, and payments received and used
for care and maintenance of a third-party beneficiary who is not a household member;
(2) reimbursements for employment training received through the Workforce
Investment Act of 1998, United States Code, title 20, chapter 73, section 9201;
(3) reimbursement for out-of-pocket expenses incurred while performing volunteer
services, jury duty, employment, or informal carpooling arrangements directly related to
employment;
(4) all educational assistance, except the county agency must count graduate student
teaching assistantships, fellowships, and other similar paid work as earned income and,
after allowing deductions for any unmet and necessary educational expenses, shall
count scholarships or grants awarded to graduate students that do not require teaching
or research as unearned income;
(5) loans, regardless of purpose, from public or private lending institutions,
governmental lending institutions, or governmental agencies;
(6) loans from private individuals, regardless of purpose, provided an applicant or
participant documents that the lender expects repayment;
(7)(i) state income tax refunds; and
(ii) federal income tax refunds;
(8)(i) federal earned income credits;
(ii) Minnesota working family credits;
(iii) state homeowners and renters credits under chapter 290A; and
(iv) federal or state tax rebates;
(9) funds received for reimbursement, replacement, or rebate of personal or real
property when these payments are made by public agencies, awarded by a court, solicited
through public appeal, or made as a grant by a federal agency, state or local government,
or disaster assistance organizations, subsequent to a presidential declaration of disaster;
(10) the portion of an insurance settlement that is used to pay medical, funeral, and
burial expenses, or to repair or replace insured property;
(11) reimbursements for medical expenses that cannot be paid by medical assistance;
(12) payments by a vocational rehabilitation program administered by the state
under chapter 268A, except those payments that are for current living expenses;
(13) in-kind income, including any payments directly made by a third party to a
provider of goods and services;
(14) assistance payments to correct underpayments, but only for the month in which
the payment is received;
(15) payments for short-term emergency needs under section 256J.626, subdivision
2;
(16) funeral and cemetery payments as provided by section 256.935;
(17) nonrecurring cash gifts of $30 or less, not exceeding $30 per participant in
a calendar month;
(18) any form of energy assistance payment made through Public Law 97-35,
Low-Income Home Energy Assistance Act of 1981, payments made directly to energy
providers by other public and private agencies, and any form of credit or rebate payment
issued by energy providers;
(19) Supplemental Security Income (SSI), including retroactive SSI payments and
other income of an SSI recipient, except as described in section 256J.37, subdivision 3b;
(20) Minnesota supplemental aid, including retroactive payments;
(21) proceeds from the sale of real or personal property;
(22) state adoption assistance payments under section 259.67, and up to an equal
amount of county adoption assistance payments;
(23) state-funded family subsidy program payments made under section 252.32
to help families care for children with developmental disabilities, consumer support
grant funds under section 256.476, and resources and services for a disabled household
member under one of the home and community-based waiver services programs under
chapter 256B;
(24) interest payments and dividends from property that is not excluded from and
that does not exceed the asset limit;
(25) rent rebates;
(26) income earned by a minor caregiver, minor child through age 6, or a minor
child who is at least a half-time student in an approved elementary or secondary education
program;
(27) income earned by a caregiver under age 20 who is at least a half-time student in
an approved elementary or secondary education program;
(28) MFIP child care payments under section 119B.05;
(29) all other payments made through MFIP to support a caregiver's pursuit of
greater economic stability;
(30) income a participant receives related to shared living expenses;
(31) reverse mortgages;
(32) benefits provided by the Child Nutrition Act of 1966, United States Code, title
42, chapter 13A, sections 1771 to 1790;
(33) benefits provided by the women, infants, and children (WIC) nutrition program,
United States Code, title 42, chapter 13A, section 1786;
(34) benefits from the National School Lunch Act, United States Code, title 42,
chapter 13, sections 1751 to 1769e;
(35) relocation assistance for displaced persons under the Uniform Relocation
Assistance and Real Property Acquisition Policies Act of 1970, United States Code, title
42, chapter 61, subchapter II, section 4636, or the National Housing Act, United States
Code, title 12, chapter 13, sections 1701 to 1750jj;
(36) benefits from the Trade Act of 1974, United States Code, title 19, chapter
12, part 2, sections 2271 to 2322;
(37) war reparations payments to Japanese Americans and Aleuts under United
States Code, title 50, sections 1989 to 1989d;
(38) payments to veterans or their dependents as a result of legal settlements
regarding Agent Orange or other chemical exposure under Public Law 101-239, section
10405, paragraph (a)(2)(E);
(39) income that is otherwise specifically excluded from MFIP consideration in
federal law, state law, or federal regulation;
(40) security and utility deposit refunds;
(41) American Indian tribal land settlements excluded under Public Laws 98-123,
98-124, and 99-377 to the Mississippi Band Chippewa Indians of White Earth, Leech
Lake, and Mille Lacs reservations and payments to members of the White Earth Band,
under United States Code, title 25, chapter 9, section 331, and chapter 16, section 1407;
(42) all income of the minor parent's parents and stepparents when determining the
grant for the minor parent in households that include a minor parent living with parents or
stepparents on MFIP with other children;
(43) income of the minor parent's parents and stepparents equal to 200 percent of the
federal poverty guideline for a family size not including the minor parent and the minor
parent's child in households that include a minor parent living with parents or stepparents
not on MFIP when determining the grant for the minor parent. The remainder of income is
deemed as specified in section 256J.37, subdivision 1b;
(44) payments made to children eligible for relative custody assistance under section
257.85;
(45) vendor payments for goods and services made on behalf of a client unless the
client has the option of receiving the payment in cash; deleted text begin and
deleted text end
(46) the principal portion of a contract for deed paymentdeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(47) cash payments to individuals enrolled for full-time service as a volunteer under
AmeriCorps programs including AmeriCorps VISTA, AmeriCorps State, AmeriCorps
National, and AmeriCorps NCCC.
new text end
Sec. 29.
Minnesota Statutes 2006, section 256J.32, subdivision 6, is amended to read:
Subd. 6.
Recertification.
The county agency shall recertify eligibility in an annual
face-to-face interview with the participant and verify the following:
(1) presence of the minor child in the home, if questionable;
(2) income, unless excluded, including self-employment expenses used as a
deduction or deposits or withdrawals from business accounts;
(3) assets when the value is within $200 of the asset limit;
(4) information to establish an exception under section 256J.24, subdivision 9,
if questionable; deleted text begin anddeleted text end
(5) inconsistent information, if related to eligibilitynew text begin ; and
new text end
new text begin (6) whether a single caregiver household meets requirements in section 256J.575,
subdivision 3new text end .
Sec. 30.
Minnesota Statutes 2006, section 256J.42, subdivision 1, is amended to read:
Subdivision 1.
Time limit.
(a) Except as otherwise provided for in this section, an
assistance unit in which any adult caregiver has received 60 months of cash assistance
funded in whole or in part by the TANF block grant in this or any other state or
United States territory, or from a tribal TANF program, MFIP, the AFDC program
formerly codified in sections 256.72 to 256.87, or the family general assistance program
formerly codified in sections 256D.01 to 256D.23, funded in whole or in part by state
appropriations, is ineligible to receive MFIP. Any cash assistance funded with TANF
dollars in this or any other state or United States territory, or from a tribal TANF program,
or MFIP assistance funded in whole or in part by state appropriations, that was received
by the unit on or after the date TANF was implemented, including any assistance received
in states or United States territories of prior residence, counts toward the 60-month
limitation. new text begin Months during which any cash assistance is received by an assistance unit
with a mandatory member who is disqualified for wrongfully obtaining public assistance
under section 256.98, subdivision 8, counts toward the time limit for the disqualified
member. new text end The 60-month limit applies to a minor caregiver except under subdivision 5. The
60-month time period does not need to be consecutive months for this provision to apply.
(b) The months before July 1998 in which individuals received assistance as part of
the field trials as an MFIP, MFIP-R, or MFIP or MFIP-R comparison group family are
not included in the 60-month time limit.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective October 1, 2007.
new text end
Sec. 31.
Minnesota Statutes 2006, section 256J.46, is amended by adding a subdivision
to read:
new text begin Subd. 3. new text end
new text begin Restrictions on sanctions. new text end
new text begin
A participant shall not be sanctioned for
failure to meet the agreed upon hours in a participant's employment plan under section
256J.521, subdivision 2, when the participant fails to meet the agreed upon hours of
participation in paid employment because the participant is not eligible for holiday pay
and the participant's place of employment is closed for a holiday.
new text end
Sec. 32.
Minnesota Statutes 2006, section 256J.49, subdivision 13, is amended to read:
Subd. 13.
Work activity.
"Work activity" means any activity in a participant's
approved employment plan that leads to employment. For purposes of the MFIP program,
this includes activities that meet the definition of work activity under the participation
requirements of TANF. Work activity includes:
(1) unsubsidized employment, including work study and paid apprenticeships or
internships;
(2) subsidized private sector or public sector employment, including grant diversion
as specified in section 256J.69, on-the-job training as specified in section 256J.66,
the self-employment investment demonstration program (SEID) as specified in section
256J.65, paid work experience, and supported work when a wage subsidy is provided;
(3) unpaid work experience, including community service, volunteer work,
the community work experience program as specified in section 256J.67, unpaid
apprenticeships or internships, and supported work when a wage subsidy is not provideddeleted text begin ;deleted text end new text begin .
Unpaid work experience is only an option if the participant has been unable to obtain or
maintain paid employment in the competitive labor market, and no paid work experience
programs are available to the participant. Unless a participant consents to participating
in unpaid work experience, the participant's employment plan may only include unpaid
work experience if including the unpaid work experience in the plan will meet the
following criteria:
new text end
new text begin
(i) the unpaid work experience will provide the participant specific skills or
experience that cannot be obtained through other work activity options where the
participant resides or is willing to reside; and
new text end
new text begin
(ii) the skills or experience gained through the unpaid work experience will result
in higher wages for the participant than the participant could earn without the unpaid
work experience;
new text end
(4) job search including job readiness assistance, job clubs, job placement,
job-related counseling, and job retention services;
(5) job readiness education, including English as a second language (ESL) or
functional work literacy classes as limited by the provisions of section 256J.531,
subdivision 2, general educational development (GED) course work, high school
completion, and adult basic education as limited by the provisions of section 256J.531,
subdivision 1;
(6) job skills training directly related to employment, including education and
training that can reasonably be expected to lead to employment, as limited by the
provisions of section 256J.53;
(7) providing child care services to a participant who is working in a community
service program;
(8) activities included in the employment plan that is developed under section
256J.521, subdivision 3; and
(9) preemployment activities including chemical and mental health assessments,
treatment, and services; learning disabilities services; child protective services; family
stabilization services; or other programs designed to enhance employability.
Sec. 33.
Minnesota Statutes 2006, section 256J.521, subdivision 1, is amended to read:
Subdivision 1.
Assessments.
(a) For purposes of MFIP employment services,
assessment is a continuing process of gathering information related to employability
for the purpose of identifying both participant's strengths and strategies for coping with
issues that interfere with employment. The job counselor must use information from the
assessment process to develop and update the employment plan under subdivision 2 or 3,
as appropriate, deleted text begin anddeleted text end to determine whether the participant qualifies for a family violence
waiver including an employment plan under subdivision 3new text begin , and to determine whether the
participant should be referred to family stabilization services under section 256J.575new text end .
(b) The scope of assessment must cover at least the following areas:
(1) basic information about the participant's ability to obtain and retain employment,
including: a review of the participant's education level; interests, skills, and abilities; prior
employment or work experience; transferable work skills; child care and transportation
needs;
(2) identification of personal and family circumstances that impact the participant's
ability to obtain and retain employment, including: any special needs of the children, the
level of English proficiency, family violence issues, and any involvement with social
services or the legal system;
(3) the results of a mental and chemical health screening tool designed by the
commissioner and results of the brief screening tool for special learning needs. Screening
tools for mental and chemical health and special learning needs must be approved by the
commissioner and may only be administered by job counselors or county staff trained in
using such screening tools. The commissioner shall work with county agencies to develop
protocols for referrals and follow-up actions after screens are administered to participants,
including guidance on how employment plans may be modified based upon outcomes
of certain screens. Participants must be told of the purpose of the screens and how the
information will be used to assist the participant in identifying and overcoming barriers to
employment. Screening for mental and chemical health and special learning needs must
be completed by participants who are unable to find suitable employment after six weeks
of job search under subdivision 2, paragraph (b), and participants who are determined to
have barriers to employment under subdivision 2, paragraph (d). Failure to complete the
screens will result in sanction under section 256J.46; and
(4) a comprehensive review of participation and progress for participants who have
received MFIP assistance and have not worked in unsubsidized employment during the
past 12 months. The purpose of the review is to determine the need for additional services
and supports, including placement in subsidized employment or unpaid work experience
under section 256J.49, subdivision 13new text begin , or referral to family stabilization services under
section 256J.575new text end .
(c) Information gathered during a caregiver's participation in the diversionary work
program under section 256J.95 must be incorporated into the assessment process.
(d) The job counselor may require the participant to complete a professional chemical
use assessment to be performed according to the rules adopted under section 254A.03,
subdivision 3, including provisions in the administrative rules which recognize the cultural
background of the participant, or a professional psychological assessment as a component
of the assessment process, when the job counselor has a reasonable belief, based on
objective evidence, that a participant's ability to obtain and retain suitable employment
is impaired by a medical condition. The job counselor may assist the participant with
arranging services, including child care assistance and transportation, necessary to meet
needs identified by the assessment. Data gathered as part of a professional assessment
must be classified and disclosed according to the provisions in section 13.46.
Sec. 34.
Minnesota Statutes 2006, section 256J.521, subdivision 2, is amended to read:
Subd. 2.
Employment plan; contents.
(a) Based on the assessment under
subdivision 1, the job counselor and the participant must develop an employment plan
that includes participation in activities and hours that meet the requirements of section
256J.55, subdivision 1. The purpose of the employment plan is to identify for each
participant the most direct path to unsubsidized employment and any subsequent steps that
support long-term economic stability. The employment plan should be developed using
the highest level of activity appropriate for the participant. Activities must be chosen from
clauses (1) to (6), which are listed in order of preference. Notwithstanding this order of
preference for activities, priority must be given for activities related to a family violence
waiver when developing the employment plan. The employment plan must also list the
specific steps the participant will take to obtain employment, including steps necessary
for the participant to progress from one level of activity to another, and a timetable for
completion of each step. Levels of activity include:
(1) unsubsidized employment;
(2) job search;
(3) subsidized employment or unpaid work experience;
(4) unsubsidized employment and job readiness education or job skills training;
(5) unsubsidized employment or unpaid work experience and activities related to
a family violence waiver or preemployment needs; and
(6) activities related to a family violence waiver or preemployment needs.
(b) Participants who are determined to possess sufficient skills such that the
participant is likely to succeed in obtaining unsubsidized employment must job search at
least 30 hours per week for up to six weeks and accept any offer of suitable employment.
The remaining hours necessary to meet the requirements of section 256J.55, subdivision
1, may be met through participation in other work activities under section 256J.49,
subdivision 13. The participant's employment plan must specify, at a minimum: (1)
whether the job search is supervised or unsupervised; (2) support services that will
be provided; and (3) how frequently the participant must report to the job counselor.
Participants who are unable to find suitable employment after six weeks must meet
with the job counselor to determine whether other activities in paragraph (a) should be
incorporated into the employment plan. Job search activities which are continued after six
weeks must be structured and supervised.
(c) Beginning July 1, 2004, activities and hourly requirements in the employment
plan may be adjusted as necessary to accommodate the personal and family circumstances
of participants identified under section 256J.561, subdivision 2, paragraph (d). Participants
who no longer meet the provisions of section 256J.561, subdivision 2, paragraph (d),
must meet with the job counselor within ten days of the determination to revise the
employment plan.
(d) Participants who are determined to have barriers to obtaining or retaining
employment that will not be overcome during six weeks of job search under paragraph (b)
must work with the job counselor to develop an employment plan that addresses those
barriers by incorporating appropriate activities from paragraph (a), clauses (1) to (6).
The employment plan must include enough hours to meet the participation requirements
in section 256J.55, subdivision 1, unless a compelling reason to require fewer hours
is noted in the participant's file.
(e) The job counselor and the participant must sign the employment plan to indicate
agreement on the contents.
new text begin (f) Except as provided under paragraph (g),new text end failure to develop or comply with
activities in the plan, or voluntarily quitting suitable employment without good cause, will
result in the imposition of a sanction under section 256J.46.
new text begin
(g) When a participant fails to meet the agreed upon hours of participation in paid
employment because the participant is not eligible for holiday pay and the participant's
place of employment is closed for a holiday, the job counselor shall not impose a sanction
or increase the hours of participation in any other activity, including paid employment, to
offset the hours that were missed due to the holiday.
new text end
deleted text begin (f)deleted text end new text begin (h) new text end Employment plans must be reviewed at least every three months to determine
whether activities and hourly requirements should be revised.new text begin The job counselor is
encouraged to allow participants who are participating in at least 20 hours of work
activities to also participate in education and training activities in order to meet the federal
hourly participations rates.
new text end
Sec. 35.
Minnesota Statutes 2006, section 256J.53, subdivision 2, is amended to read:
Subd. 2.
Approval of postsecondary education or training.
(a) In order for a
postsecondary education or training program to be an approved activity in an employment
plan, the deleted text begin participant must be working in unsubsidized employment at least 20 hours per
week.deleted text end new text begin plan must include additional work activities if the education and training activities
do not meet the minimum hours required to meet the federal work participation rate under
Code of Federal Regulations, title 45, sections 261.31 and 261.35.
new text end
(b) Participants seeking approval of a postsecondary education or training plan
must provide documentation that:
(1) the employment goal can only be met with the additional education or training;
(2) there are suitable employment opportunities that require the specific education or
training in the area in which the participant resides or is willing to reside;
(3) the education or training will result in significantly higher wages for the
participant than the participant could earn without the education or training;
(4) the participant can meet the requirements for admission into the program; and
(5) there is a reasonable expectation that the participant will complete the training
program based on such factors as the participant's MFIP assessment, previous education,
training, and work history; current motivation; and changes in previous circumstances.
deleted text begin
(c) The hourly unsubsidized employment requirement does not apply for intensive
education or training programs lasting 12 weeks or less when full-time attendance is
required.
deleted text end
deleted text begin
(d) Participants with an approved employment plan in place on July 1, 2003, which
includes more than 12 months of postsecondary education or training shall be allowed to
complete that plan provided that hourly requirements in section deleted text begin 256J.55, subdivision 1deleted text end ,
and conditions specified in paragraph (b), and subdivisions 3 and 5 are met. A participant
whose case is subsequently closed for three months or less for reasons other than
noncompliance with program requirements and who returns to MFIP shall be allowed to
complete that plan provided that hourly requirements in section deleted text begin 256J.55, subdivision 1deleted text end ,
and conditions specified in paragraph (b) and subdivisions 3 and 5 are met.
deleted text end
Sec. 36.
Minnesota Statutes 2006, section 256J.55, subdivision 1, is amended to read:
Subdivision 1.
Participation requirements.
(a) All caregivers must participate
in employment services under sections 256J.515 to 256J.57 concurrent with receipt of
MFIP assistance.
(b) Until July 1, 2004, participants who meet the requirements of section 256J.56 are
exempt from participation requirements.
(c) Participants under paragraph (a) must develop and comply with an employment
plan under section 256J.521 or section 256J.54 in the case of a participant under the age of
20 who has not obtained a high school diploma or its equivalent.
(d) With the exception of participants under the age of 20 who must meet the
education requirements of section 256J.54, all participants must meet the hourly
participation requirements of TANF or the hourly requirements listed in clauses (1) to
(3), whichever is higher.
(1) In single-parent families with no children under six years of age, the job
counselor and the caregiver must develop an employment plan that includes deleted text begin 30 to 35 hours
per week of work activitiesdeleted text end new text begin 130 hours per month of work activitiesnew text end .
(2) In single-parent families with a child under six years of age, the job counselor
and the caregiver must develop an employment plan that includes deleted text begin 20 to 35 hours per week
of work activitiesdeleted text end new text begin 87 hours per month of work activitiesnew text end .
(3) In two-parent families, the job counselor and the caregivers must develop
employment plans which result in a combined total of at least 55 hours per week of work
activities.
(e) Failure to participate in employment services, including the requirement to
develop and comply with an employment plan, including hourly requirements, without
good cause under section 256J.57, shall result in the imposition of a sanction under section
256J.46.
Sec. 37.
new text begin
[256J.575] FAMILY STABILIZATION SERVICES.
new text end
new text begin Subdivision 1. new text end
new text begin Purpose. new text end
new text begin
(a) The family stabilization services serve families who are
not making significant progress within the Minnesota family investment program (MFIP)
due to a variety of barriers to employment.
new text end
new text begin
(b) The goal of the services is to stabilize and improve the lives of families at risk
of long-term welfare dependency or family instability due to employment barriers such
as physical disability, mental disability, age, or providing care for a disabled household
member. These services promote and support families to achieve the greatest possible
degree of self-sufficiency.
new text end
new text begin Subd. 2. new text end
new text begin Definitions. new text end
new text begin
The terms used in this section have the meanings given them
in paragraphs (a) to (d).
new text end
new text begin
(a) "Case manager" means the county-designated staff person or employment
services counselor.
new text end
new text begin
(b) "Case management" means the services provided by or through the county
agency or through the employment services agency to participating families, including
assessment, information, referrals, and assistance in the preparation and implementation
of a family stabilization plan under subdivision 5.
new text end
new text begin
(c) "Family stabilization plan" means a plan developed by a case manager and
the participant, which identifies the participant's most appropriate path to unsubsidized
employment, family stability, and barrier reduction, taking into account the family's
circumstances.
new text end
new text begin
(d) "Family stabilization services" means programs, activities, and services in this
section that provide participants and their family members with assistance regarding,
but not limited to:
new text end
new text begin
(1) obtaining and retaining unsubsidized employment;
new text end
new text begin
(2) family stability;
new text end
new text begin
(3) economic stability; and
new text end
new text begin
(4) barrier reduction.
new text end
new text begin
The goal of the services is to achieve the greatest degree of economic self-sufficiency
and family well-being possible for the family under the circumstances.
new text end
new text begin Subd. 3. new text end
new text begin Eligibility. new text end
new text begin
(a) The following MFIP or diversionary work program (DWP)
participants are eligible for the services under this section:
new text end
new text begin
(1) a participant who meets the requirements for or has been granted a hardship
extension under section 256J.425, subdivision 2 or 3, except that it is not necessary for
the participant to have reached or be approaching 60 months of eligibility for this section
to apply;
new text end
new text begin
(2) a participant who is applying for supplemental security income or Social Security
disability insurance; and
new text end
new text begin
(3) a participant who is a noncitizen who has been in the United States for 12 or
fewer months.
new text end
new text begin
(b) Families must meet all other eligibility requirements for MFIP established in
this chapter. Families are eligible for financial assistance to the same extent as if they
were participating in MFIP.
new text end
new text begin
(c) A participant under paragraph (a), clause (3), must be provided with English as a
second language opportunities and skills training for up to 12 months. After 12 months,
the case manager and participant must determine whether the participant should continue
with English as a second language classes or skills training, or both, and continue to
receive family stabilization services.
new text end
new text begin Subd. 4. new text end
new text begin Universal participation. new text end
new text begin
All caregivers must participate in family
stabilization services as defined in subdivision 2.
new text end
new text begin Subd. 5. new text end
new text begin
Case management; family stabilization plans; coordinated services.
new text end
new text begin
(a) The county agency or employment services provider shall provide family stabilization
services to families through a case management model. A case manager shall be assigned
to each participating family within 30 days after the family is determined to be eligible
for family stabilization services. The case manager, with the full involvement of the
participant, shall recommend, and the county agency shall establish and modify as
necessary, a family stabilization plan for each participating family. If a participant is
already assigned to a county case manager or a county-designated case manager in social
services, disability services, or housing services that case manager already assigned may
be the case manager for purposes of these services.
new text end
new text begin
(b) The family stabilization plan must include:
new text end
new text begin
(1) each participant's plan for long-term self-sufficiency, including an employment
goal where applicable;
new text end
new text begin
(2) an assessment of each participant's strengths and barriers, and any special
circumstances of the participant's family that impact, or are likely to impact, the
participant's progress towards the goals in the plan; and
new text end
new text begin
(3) an identification of the services, supports, education, training, and
accommodations needed to reduce or overcome any barriers to enable the family to
achieve self-sufficiency and to fulfill each caregiver's personal and family responsibilities.
new text end
new text begin
(c) The case manager and the participant shall meet within 30 days of the family's
referral to the case manager. The initial family stabilization plan must be completed within
30 days of the first meeting with the case manager. The case manager shall establish a
schedule for periodic review of the family stabilization plan that includes personal contact
with the participant at least once per month. In addition, the case manager shall review
and, if necessary, modify the plan under the following circumstances:
new text end
new text begin
(1) there is a lack of satisfactory progress in achieving the goals of the plan;
new text end
new text begin
(2) the participant has lost unsubsidized or subsidized employment;
new text end
new text begin
(3) a family member has failed or is unable to comply with a family stabilization
plan requirement;
new text end
new text begin
(4) services, supports, or other activities required by the plan are unavailable;
new text end
new text begin
(5) changes to the plan are needed to promote the well-being of the children; or
new text end
new text begin
(6) the participant and case manager determine that the plan is no longer appropriate
for any other reason.
new text end
new text begin Subd. 6. new text end
new text begin Cooperation with services requirements. new text end
new text begin
(a) To be eligible, a participant
shall comply with paragraphs (b) to (d).
new text end
new text begin
(b) Participants shall engage in family stabilization plan services for the appropriate
number of hours per week that the activities are scheduled and available, unless good
cause exists for not doing so, as defined in section 256J.57, subdivision 1. The appropriate
number of hours must be based on the participant's plan.
new text end
new text begin
(c) The case manager shall review the participant's progress toward the goals in the
family stabilization plan every six months to determine whether conditions have changed,
including whether revisions to the plan are needed.
new text end
new text begin
(d) A participant's requirement to comply with any or all family stabilization plan
requirements under this subdivision is excused when the case management services,
training and educational services, or family support services identified in the participant's
family stabilization plan are unavailable for reasons beyond the control of the participant,
including when money appropriated is not sufficient to provide the services.
new text end
new text begin Subd. 7. new text end
new text begin Sanctions. new text end
new text begin
(a) The financial assistance grant of a participating family is
reduced according to section 256J.46, if a participating adult fails without good cause to
comply or continue to comply with the family stabilization plan requirements in this
subdivision, unless compliance has been excused under subdivision 6, paragraph (e).
new text end
new text begin
(b) Given the purpose of the family stabilization services in this section and the
nature of the underlying family circumstances that act as barriers to both employment and
full compliance with program requirements, there must be a review by the county agency
prior to imposing a sanction to determine whether the plan was appropriated to the needs
of the participant and family, and that the participant in all ways had the ability to comply
with the plan, as confirmed by a behavioral health or medical professional.
new text end
new text begin
(c) Prior to the imposition of a sanction, the county agency or employment services
provider shall review the participant's case to determine if the family stabilization plan
is still appropriate and meet with the participant face-to-face. The participant may bring
an advocate to the face-to-face meeting.
new text end
new text begin
During the face-to-face meeting, the county agency shall:
new text end
new text begin
(1) determine whether the continued noncompliance can be explained and mitigated
by providing a needed family stabilization service, as defined in subdivision 2, paragraph
(d);
new text end
new text begin
(2) determine whether the participant qualifies for a good cause exception under
section 256J.57, or if the sanction is for noncooperation with child support requirements,
determine if the participant qualifies for a good cause exemption under section 256.741,
subdivision 10;
new text end
new text begin
(3) determine whether activities in the family stabilization plan are appropriate
based on the family's circumstances;
new text end
new text begin
(4) explain the consequences of continuing noncompliance;
new text end
new text begin
(5) identify other resources that may be available to the participant to meet the
needs of the family; and
new text end
new text begin
(6) inform the participant of the right to appeal under section 256J.40.
new text end
new text begin
If the lack of an identified activity or service can explain the noncompliance, the
county shall work with the participant to provide the identified activity.
new text end
new text begin
(d) If the participant fails to come to the face-to-face meeting, the case manager or a
designee shall attempt at least one home visit. If a face-to-face meeting is not conducted,
the county agency shall send the participant a written notice that includes the information
under paragraph (c).
new text end
new text begin
(e) After the requirements of paragraphs (c) and (d) are met and prior to imposition
of a sanction, the county agency shall provide a notice of intent to sanction under section
256J.57, subdivision 2, and, when applicable, a notice of adverse action under section
256J.31.
new text end
new text begin
(f) Section 256J.57 applies to this section except to the extent that it is modified
by this subdivision.
new text end
new text begin Subd. 8. new text end
new text begin Funding. new text end
new text begin
(a) The commissioner of human services shall treat MFIP
expenditures made to or on behalf of any minor child under this section, who is part of a
household that meets criteria in subdivision 3, as expenditures under a separately funded
state program. These expenditures shall not count toward the state's maintenance of effort
requirements under the federal TANF program.
new text end
new text begin
(b) A family is no longer part of a separately funded program under this section if
the caregiver no longer meets the criteria for family stabilization services in subdivision 3,
or if it is determined at recertification that a caregiver with a child under the age of six
is working at least 87 hours per month in paid or unpaid employment, or a caregiver
without a child under the age of six is working at least 130 hours per month in paid or
unpaid employment, whichever occurs sooner.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective February 1, 2008.
new text end
Sec. 38.
new text begin
[256J.621] WORK PARTICIPATION BONUS.
new text end
new text begin
(a) Upon exiting the diversionary work program (DWP) or upon terminating
MFIP cash assistance with earnings, a participant who is employed may be eligible for
transitional assistance of $75 per month to assist in meeting the family's basic needs as
the participant continues to move toward self-sufficiency.
new text end
new text begin
(b) To be eligible for a transitional assistance payment, the participant shall not
receive MFIP cash assistance or diversionary work program assistance during the month
and the participant or participants must meet the following work requirements:
new text end
new text begin
(1) if the participant is a single caregiver and has a child under six years of age, the
participant must be employed at least 87 hours per month;
new text end
new text begin
(2) if the participant is a single caregiver and does not have a child under six years of
age, the participant must be employed at least 130 hours per month; or
new text end
new text begin
(3) if the household is a two-parent family, at least one of the parents must be
employed an average of at least 130 hours per month.
new text end
new text begin
Whenever a participant exits the diversionary work program or is terminated from
MFIP cash assistance and meets the other criteria in this section, transitional assistance is
available for up to 24 consecutive months.
new text end
new text begin
(c) Expenditures on the program are maintenance of effort state funds for participants
under paragraph (b), clauses (1) and (2). Expenditures for participants under paragraph
(b), clause (3), are nonmaintenance of effort funds. Months in which a participant
receives transitional assistance under this section do not count toward the participant's
MFIP 60-month time limit.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective February 1, 2009.
new text end
Sec. 39.
Minnesota Statutes 2006, section 256J.626, subdivision 1, is amended to read:
Subdivision 1.
Consolidated fund.
The consolidated fund is established to support
counties and tribes in meeting their duties under this chapter. Counties and tribes must use
funds from the consolidated fund to develop programs and services that are designed to
improve participant outcomes as measured in section 256J.751, subdivision 2. Counties
may use the funds for any allowable expenditures under subdivision 2new text begin , including case
managementnew text end . Tribes may use the funds for any allowable expenditures under subdivision
2,new text begin including case management,new text end except those innew text begin subdivision 2, paragraph (a),new text end clauses (1)
and (6).
Sec. 40.
Minnesota Statutes 2006, section 256J.626, subdivision 2, is amended to read:
Subd. 2.
Allowable expenditures.
(a) The commissioner must restrict expenditures
under the consolidated fund to benefits and services allowed under title IV-A of the federal
Social Security Act. Allowable expenditures under the consolidated fund may include, but
are not limited to:
(1) short-term, nonrecurring shelter and utility needs that are excluded from the
definition of assistance under Code of Federal Regulations, title 45, section 260.31, for
families who meet the residency requirement in section 256J.12, subdivisions 1 and 1a.
Payments under this subdivision are not considered TANF cash assistance and are not
counted towards the 60-month time limit;
(2) transportation needed to obtain or retain employment or to participate in other
approved work activitiesnew text begin or activities under a family stabilization plannew text end ;
(3) direct and administrative costs of staff to deliver employment services for
MFIP deleted text begin ordeleted text end new text begin , new text end the diversionary work program,new text begin or family stabilization services; new text end to administer
financial assistancedeleted text begin ,deleted text end new text begin ; new text end and to provide specialized services intended to assist hard-to-employ
participants to transition to worknew text begin or transition from family stabilization services to MFIPnew text end ;
(4) costs of education and training including functional work literacy and English as
a second language;
(5) cost of work supports including tools, clothing, boots, new text begin telephone service, new text end and
other work-related expenses;
(6) county administrative expenses as defined in Code of Federal Regulations, title
45, section 260(b);
(7) services to parenting and pregnant teens;
(8) supported work;
(9) wage subsidies;
(10) child care needed for MFIP deleted text begin ordeleted text end new text begin , the new text end diversionary work programnew text begin , or family
stabilization services new text end participants to participate in social services;
(11) child care to ensure that families leaving MFIP or diversionary work program
will continue to receive child care assistance from the time the family no longer qualifies
for transition year child care until an opening occurs under the basic sliding fee child
care program; deleted text begin and
deleted text end
(12) services to help noncustodial parents who live in Minnesota and have minor
children receiving MFIP or DWP assistance, but do not live in the same household as the
child, obtain or retain employmentnew text begin ; and
new text end
new text begin (13) services to help families participating in family stabilization services achieve
the greatest possible degree of self-sufficiencynew text end .
(b) Administrative costs that are not matched with county funds as provided in
subdivision 8 may not exceed 7.5 percent of a county's or 15 percent of a tribe's allocation
under this section. The commissioner shall define administrative costs for purposes of
this subdivision.
(c) The commissioner may waive the cap on administrative costs for a county or tribe
that elects to provide an approved supported employment, unpaid work, or community
work experience program for a major segment of the county's or tribe's MFIP population.
The county or tribe must apply for the waiver on forms provided by the commissioner. In
no case shall total administrative costs exceed the TANF limits.
Sec. 41.
Minnesota Statutes 2006, section 256J.626, subdivision 3, is amended to read:
Subd. 3.
Eligibility for services.
Families with a minor child, a pregnant woman,
or a noncustodial parent of a minor child receiving assistance, with incomes below 200
percent of the federal poverty guideline for a family of the applicable size, are eligible
for services funded under the consolidated fund. Counties and tribes must give priority
to families currently receiving MFIP deleted text begin ordeleted text end new text begin , the new text end diversionary work program, new text begin or family
stabilization services, new text end and families at risk of receiving MFIP or diversionary work program.
Sec. 42.
Minnesota Statutes 2006, section 256J.626, subdivision 4, is amended to read:
Subd. 4.
County and tribal biennial service agreements.
(a) Effective January 1,
2004, and each two-year period thereafter, each county and tribe must have in place an
approved biennial service agreement related to the services and programs in this chapter.
In counties with a city of the first class with a population over 300,000, the county must
consider a service agreement that includes a jointly developed plan for the delivery of
employment services with the city. Counties may collaborate to develop multicounty,
multitribal, or regional service agreements.
(b) The service agreements will be completed in a form prescribed by the
commissioner. The agreement must include:
(1) a statement of the needs of the service population and strengths and resources
in the community;
(2) numerical goals for participant outcomes measures to be accomplished during
the biennial period. The commissioner may identify outcomes from section 256J.751,
subdivision 2, as core outcomes for all counties and tribes;
(3) strategies the county or tribe will pursue to achieve the outcome targets.
Strategies must include specification of how funds under this section will be used and may
include community partnerships that will be established or strengthened; deleted text begin and
deleted text end
(4) new text begin strategies the county or tribe will pursue under family stabilization services ; and
new text end
new text begin (5) new text end other items prescribed by the commissioner in consultation with counties and
tribes.
(c) The commissioner shall provide each county and tribe with information needed
to complete an agreement, including: (1) information on MFIP cases in the county or
tribe; (2) comparisons with the rest of the state; (3) baseline performance on outcome
measures; and (4) promising program practices.
(d) The service agreement must be submitted to the commissioner by October 15,
2003, and October 15 of each second year thereafter. The county or tribe must allow
a period of not less than 30 days prior to the submission of the agreement to solicit
comments from the public on the contents of the agreement.
(e) The commissioner must, within 60 days of receiving each county or tribal service
agreement, inform the county or tribe if the service agreement is approved. If the service
agreement is not approved, the commissioner must inform the county or tribe of any
revisions needed prior to approval.
(f) The service agreement in this subdivision supersedes the plan requirements
of section 116L.88.
Sec. 43.
Minnesota Statutes 2006, section 256J.626, subdivision 5, is amended to read:
Subd. 5.
Innovation projects.
Beginning January 1, 2005, no more than $3,000,000
of the funds annually appropriated to the commissioner for use in the consolidated fund
shall be available to the commissioner for projects testing innovative approaches to
improving outcomes for MFIP participants, new text begin family stabilization services participants, new text end and
persons at risk of receiving MFIP as detailed in subdivision 3. Projects shall be targeted to
geographic areas with poor outcomes as specified in section 256J.751, subdivision 5, or to
subgroups within the MFIP case load who are experiencing poor outcomes.
Sec. 44.
Minnesota Statutes 2006, section 256J.626, subdivision 6, is amended to read:
Subd. 6.
Base allocation to counties and tribes; definitions.
(a) For purposes of
this section, the following terms have the meanings given.
(1) "2002 historic spending base" means the commissioner's determination of
the sum of the reimbursement related to fiscal year 2002 of county or tribal agency
expenditures for the base programs listed in clause (6), items (i) through (iv), and earnings
related to calendar year 2002 in the base program listed in clause (6), item (v), and the
amount of spending in fiscal year 2002 in the base program listed in clause (6), item (vi),
issued to or on behalf of persons residing in the county or tribal service delivery area.
(2) "Adjusted caseload factor" means a factor weighted:
(i) 47 percent on the MFIP cases in each county at four points in time in the most
recent 12-month period for which data is available multiplied by the county's caseload
difficulty factor; and
(ii) 53 percent on the count of adults on MFIP in each county and tribe at four points
in time in the most recent 12-month period for which data is available multiplied by the
county or tribe's caseload difficulty factor.
(3) "Caseload difficulty factor" means a factor determined by the commissioner for
each county and tribe based upon the self-support index described in section 256J.751,
subdivision 2, clause deleted text begin (7)deleted text end new text begin (6)new text end .
(4) "Initial allocation" means the amount potentially available to each county or tribe
based on the formula in paragraphs (b) through deleted text begin (h)deleted text end new text begin (d)new text end .
(5) "Final allocation" means the amount available to each county or tribe based on
the formula in paragraphs (b) through deleted text begin (h)deleted text end new text begin (d)new text end , after adjustment by subdivision 7.
(6) "Base programs" means the:
(i) MFIP employment and training services under Minnesota Statutes 2002, section
256J.62, subdivision 1, in effect June 30, 2002;
(ii) bilingual employment and training services to refugees under Minnesota Statutes
2002, section 256J.62, subdivision 6, in effect June 30, 2002;
(iii) work literacy language programs under Minnesota Statutes 2002, section
256J.62, subdivision 7, in effect June 30, 2002;
(iv) supported work program authorized in Laws 2001, First Special Session chapter
9, article 17, section 2, in effect June 30, 2002;
(v) administrative aid program under section 256J.76 in effect December 31, 2002;
and
(vi) emergency assistance program under Minnesota Statutes 2002, section 256J.48,
in effect June 30, 2002.
(b) The commissioner shall:
(1) beginning July 1, 2003, determine the initial allocation of funds available under
this section according to clause (2);
(2) allocate all of the funds available for the period beginning July 1, 2003, and
ending December 31, 2004, to each county or tribe in proportion to the county's or tribe's
share of the statewide 2002 historic spending base;
(3) determine for calendar year 2005 the initial allocation of funds to be made
available under this section in proportion to the county or tribe's initial allocation for the
period of July 1, 2003, to December 31, 2004;
(4) determine for calendar year 2006 the initial allocation of funds to be made
available under this section based 90 percent on the proportion of the county or tribe's
share of the statewide 2002 historic spending base and ten percent on the proportion of
the county or tribe's share of the adjusted caseload factor;
(5) determine for calendar year 2007 the initial allocation of funds to be made
available under this section based 70 percent on the proportion of the county or tribe's
share of the statewide 2002 historic spending base and 30 percent on the proportion of the
county or tribe's share of the adjusted caseload factor; and
(6) determine for calendar year 2008 and subsequent years the initial allocation of
funds to be made available under this section based 50 percent on the proportion of the
county or tribe's share of the statewide 2002 historic spending base and 50 percent on the
proportion of the county or tribe's share of the adjusted caseload factor.
(c) With the commencement of a new or expanded tribal TANF program or an
agreement under section 256.01, subdivision 2, paragraph (g), in which some or all of
the responsibilities of particular counties under this section are transferred to a tribe,
the commissioner shall:
(1) in the case where all responsibilities under this section are transferred to a tribal
program, determine the percentage of the county's current caseload that is transferring to a
tribal program and adjust the affected county's allocation accordingly; and
(2) in the case where a portion of the responsibilities under this section are
transferred to a tribal program, the commissioner shall consult with the affected county or
counties to determine an appropriate adjustment to the allocation.
(d) Effective January 1, 2005, counties and tribes will have their final allocations
adjusted based on the performance provisions of subdivision 7.
Sec. 45.
Minnesota Statutes 2006, section 256J.626, subdivision 7, is amended to read:
Subd. 7.
Performance base funds.
(a) Beginning calendar year deleted text begin 2005deleted text end new text begin 2008new text end , each
county and tribe will be allocated 95 percent of their initial calendar year allocation.
Counties and tribes will be allocated additional funds based on performance as follows:
(1) deleted text begin for calendar year 2005, a county or tribe that achieves a 30 percent rate or higher
on the MFIP participation rate under section 256J.751, subdivision 2, clause (8), as
averaged across the four quarterly measurements for the most recent year for which the
measurements are available, will receive an additional allocation equal to 2.5 percent of
its initial allocation; and
deleted text end
deleted text begin
(2) for calendar year 2006, a county or tribe that achieves a 40 percent rate or a
five percentage point improvement over the previous year's MFIP participation rate
under section 256J.751, subdivision 2, clause (8), as averaged across the four quarterly
measurements for the most recent year for which the measurements are available, will
receive an additional allocation equal to 2.5 percent of its initial allocation; and
deleted text end
deleted text begin
(3) for calendar year 2007, a county or tribe that achieves a 50 percent rate or a
five percentage point improvement over the previous year's MFIP participation rate
under section 256J.751, subdivision 2, clause (8), as averaged across the four quarterly
measurements for the most recent year for which the measurements are available, will
receive an additional allocation equal to 2.5 percent of its initial allocation; and
deleted text end
deleted text begin (4)deleted text end for calendar year 2008 and yearly thereafter, a county or tribe that achieves a 50
percent MFIP participation rate new text begin or a five percentage point improvement over the previous
year's MFIP participation rate new text end under section 256J.751, subdivision 2, clause deleted text begin (8)deleted text end new text begin (7)new text end , as
averaged across the four quarterly measurements for the most recent year for which the
measurements are available, will receive an additional allocation equal to 2.5 percent of
its initial allocation; and
deleted text begin (5)deleted text end new text begin (2) new text end for calendar years 2005 and thereafter, a county or tribe that performs above
the top of its annualized range of expected performance on the three-year self-support
index under section 256J.751, subdivision 2, clause deleted text begin (7)deleted text end new text begin (6)new text end , will receive an additional
allocation equal to five percent of its initial allocation; deleted text begin ordeleted text end new text begin and
new text end
deleted text begin (6)deleted text end new text begin (3) new text end for calendar years 2005 and thereafter, a county or tribe that performs within
its range of expected performance on the annualized three-year self-support index under
section 256J.751, subdivision 2, clause deleted text begin (7)deleted text end new text begin (6)new text end , will receive an additional allocation equal
to 2.5 percent of its initial allocationnew text begin ; and
new text end
new text begin
(4) for calendar years 2008 and thereafter, a county or tribe that does not achieve
a 50 percent MFIP participation rate or a five percentage point improvement over the
previous year's MFIP participation rate under section 256J.751, subdivision 2, clause (7),
as averaged across the four quarterly measurements for the most recent year for which
the measurements are available, will not receive an additional 2.5 percent of its initial
allocation until after negotiating a multiyear improvement plan with the commissioner; or
new text end
new text begin (5) for calendar years 2008 and thereafter, a county or tribe that does not perform
within its range of expected performance on the annualized three-year self-support index
under section 256J.751, subdivision 2, clause (6), will not receive an additional allocation
equal to 2.5 percent of its initial allocation until after negotiating a multiyear improvement
plan with the commissionernew text end .
(b) Performance-based funds for a federally approved tribal TANF program in which
the state and tribe have in place a contract under section 256.01, addressing consolidated
funding, will be allocated as follows:
(1) for calendar year 2006 and yearly thereafter, a tribe that achieves the participation
rate approved in its federal TANF plan using the average of four quarterly measurements
for the most recent year for which the measurements are available, will receive an
additional allocation equal to 2.5 percent of its initial allocation; and
(2) for calendar years 2006 and thereafter, a tribe that performs above the top of its
annualized range of expected performance on the three-year self-support index under
section 256J.751, subdivision 2, clause deleted text begin (7)deleted text end new text begin (6)new text end , will receive an additional allocation equal
to five percent of its initial allocation; or
(3) for calendar years 2006 and thereafter, a tribe that performs within its range
of expected performance on the annualized three-year self-support index under section
256J.751, subdivision 2, clause deleted text begin (7)deleted text end new text begin (6)new text end , will receive an additional allocation equal to 2.5
percent of its initial allocationnew text begin ; or
new text end
new text begin
(4) for calendar year 2008 and yearly thereafter, a tribe that does not achieve the
participation rate approved in its federal TANF plan using the average of four quarterly
measurements for the most recent year for which the measurements are available, will
not receive an additional allocation equal to 2.5 percent of its initial allocation until after
negotiating a multiyear improvement plan with the commissioner; or
new text end
new text begin (5) for calendar year 2008 and yearly thereafter, a tribe that does not perform within
its range of expected performance on the annualized three-year self-support index under
section 256J.751, subdivision 2, clause (6), will not receive an additional allocation equal
to 2.5 percent until after negotiating a multiyear improvement plan with the commissionernew text end .
(c) Funds remaining unallocated after the performance-based allocations in
paragraph (a) are available to the commissioner for innovation projects under subdivision
5.
(d)(1) If available funds are insufficient to meet county and tribal allocations
under paragraph (a), the commissioner may make available for allocation funds that are
unobligated and available from the innovation projects through the end of the current
biennium.
(2) If after the application of clause (1) funds remain insufficient to meet county and
tribal allocations under paragraph (a), the commissioner must proportionally reduce the
allocation of each county and tribe with respect to their maximum allocation available
under paragraph (a).
Sec. 46.
Minnesota Statutes 2006, section 256J.751, subdivision 2, is amended to read:
Subd. 2.
Quarterly comparison report.
The commissioner shall report quarterly to
all counties on each county's performance on the following measures:
(1) percent of MFIP caseload working in paid employment;
(2) percent of MFIP caseload receiving only the food portion of assistance;
(3) number of MFIP cases that have left assistance;
(4) median placement wage rate;
(5) caseload by months of TANF assistance;
(6) percent of MFIP and diversionary work program (DWP) cases off cash assistance
or working 30 or more hours per week at one-year, two-year, and three-year follow-up
points from a baseline quarter. This measure is called the self-support index. The
commissioner shall report quarterly an expected range of performance for each county,
county grouping, and tribe on the self-support index. The expected range shall be derived
by a statistical methodology developed by the commissioner in consultation with the
counties and tribes. The statistical methodology shall control differences across counties
in economic conditions and demographics of the MFIP and DWP case load; and
(7) the deleted text begin MFIPdeleted text end new text begin TANFnew text end work participation rate, defined as the participation requirements
specified deleted text begin in title 1 of Public Law 104-193 applied to all MFIP cases except child only
casesdeleted text end new text begin under Public Law 109-171, the Deficit Reduction Act of 2005new text end .
Sec. 47.
Minnesota Statutes 2006, section 256J.751, subdivision 5, is amended to read:
Subd. 5.
Failure to meet federal performance standards.
(a) If sanctions occur
for failure to meet the performance standards specified in title 1 of Public Law 104-193
of the Personal Responsibility and Work Opportunity Act of 1996, new text begin and under Public
Law 109-171, the Deficit Reduction Act of 2005, new text end the state shall pay 88 percent of the
sanction. The remaining 12 percent of the sanction will be paid by the counties. The
county portion of the sanction will be distributed across all counties in proportion to each
county's percentage of the MFIP average monthly caseload during the period for which
the sanction was applied.
(b) If a county fails to meet the performance standards specified in title 1 of Public
Law 104-193 of the Personal Responsibility and Work Opportunity Act of 1996new text begin , and
Public Law 109-171, the Deficit Reduction Act of 2005,new text end for any year, the commissioner
shall work with counties to organize a joint state-county technical assistance team to work
with the county. The commissioner shall coordinate any technical assistance with other
departments and agencies including the Departments of Employment and Economic
Development and Education as necessary to achieve the purpose of this paragraph.
(c) For state performance measures, a low-performing county is one that:
(1) performs below the bottom of their expected range for the measure in subdivision
2, clause deleted text begin (7)deleted text end new text begin (6)new text end , in an annualized measurement reported in October of each year; or
(2) performs below 40 percent for the measure in subdivision 2, clause deleted text begin (8)deleted text end new text begin (7)new text end , as
averaged across the four quarterly measurements for the year, or the ten counties with the
lowest rates if more than ten are below 40 percent.
(d) Low-performing counties under paragraph (c) must engage in corrective action
planning as defined by the commissioner. The commissioner may coordinate technical
assistance as specified in paragraph (b) for low-performing counties under paragraph (c).
Sec. 48.
Minnesota Statutes 2006, section 256J.95, subdivision 3, is amended to read:
Subd. 3.
Eligibility for diversionary work program.
(a) Except for the categories
of family units listed below, all family units who apply for cash benefits and who
meet MFIP eligibility as required in sections 256J.11 to 256J.15 are eligible and must
participate in the diversionary work program. Family units that are not eligible for the
diversionary work program include:
(1) child only cases;
(2) a single-parent family unit that includes a child under 12 weeks of age. A parent
is eligible for this exception once in a parent's lifetime and is not eligible if the parent
has already used the previously allowed child under age one exemption from MFIP
employment services;
(3) a minor parent without a high school diploma or its equivalent;
(4) an 18- or 19-year-old caregiver without a high school diploma or its equivalent
who chooses to have an employment plan with an education option;
(5) a caregiver age 60 or over;
(6) family units with a caregiver who received DWP benefits in the 12 months prior
to the month the family applied for DWP, except as provided in paragraph (c);
(7) family units with a caregiver who received MFIP within the 12 months prior to
the month the family unit applied for DWP;
(8) a family unit with a caregiver who received 60 or more months of TANF
assistance; deleted text begin and
deleted text end
(9) a family unit with a caregiver who is disqualified from DWP or MFIP due to
frauddeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(10) refugees as defined in Code of Federal Regulations, title 45, chapter IV, section
444.43, who arrived in the United States in the 12 months prior to the date of application
for family cash assistance.
new text end
(b) A two-parent family must participate in DWP unless both caregivers meet the
criteria for an exception under paragraph (a), clauses (1) through (5), or the family unit
includes a parent who meets the criteria in paragraph (a), clause (6), (7), (8), or (9).
(c) Once DWP eligibility is determined, the four months run consecutively. If a
participant leaves the program for any reason and reapplies during the four-month period,
the county must redetermine eligibility for DWP.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2008.
new text end
Sec. 49.
Minnesota Statutes 2006, section 256K.45, is amended by adding a
subdivision to read:
new text begin Subd. 6. new text end
new text begin Funding. new text end
new text begin
Any funds appropriated for this section may be expended on
programs described under subdivisions 3 to 5, technical assistance, and capacity building.
Up to four percent of funds appropriated may be used for the purpose of monitoring and
evaluating runaway and homeless youth programs receiving funding under this section.
Funding shall be directed to meet the greatest need, with a significant share of the funding
focused on homeless youth providers in greater Minnesota.
new text end
Sec. 50.
Minnesota Statutes 2006, section 259.67, subdivision 4, is amended to read:
Subd. 4.
Eligibility conditions.
(a) The placing agency shall use the AFDC
requirements as specified in federal law as of July 16, 1996, when determining the child's
eligibility for adoption assistance under title IV-E of the Social Security Act. If the child
does not qualify, the placing agency shall certify a child as eligible for state funded
adoption assistance only if the following criteria are met:
(1) Due to the child's characteristics or circumstances it would be difficult to provide
the child an adoptive home without adoption assistance.
(2)(i) A placement agency has made reasonable efforts to place the child for adoption
without adoption assistance, but has been unsuccessful; or
(ii) the child's licensed foster parents desire to adopt the child and it is determined by
the placing agency that the adoption is in the best interest of the child.
(3)new text begin (i) new text end The child has been a ward of the commissioner, a Minnesota-licensed
child-placing agency, or a tribal social service agency of Minnesota recognized by the
Secretary of the Interiornew text begin ; or (ii) the child will be adopted according to tribal law without a
termination of parental rights or relinquishment, provided that the tribe has documented
the valid reason why the child cannot or should not be returned to the home of the child's
parentnew text end . The placing agency shall not certify a child who remains under the jurisdiction
of the sending agency pursuant to section 260.851, article 5, for state-funded adoption
assistance when Minnesota is the receiving state.
(b) For purposes of this subdivision, the characteristics or circumstances that may
be considered in determining whether a child is a child with special needs under United
States Code, title 42, chapter 7, subchapter IV, part E, or meets the requirements of
paragraph (a), clause (1), are the following:
(1) The child is a member of a sibling group to be placed as one unit in which at
least one sibling is older than 15 months of age or is described in clause (2) or (3).
(2) The child has documented physical, mental, emotional, or behavioral disabilities.
(3) The child has a high risk of developing physical, mental, emotional, or behavioral
disabilities.
deleted text begin
(4) The child is adopted according to tribal law without a termination of parental
rights or relinquishment, provided that the tribe has documented the valid reason why the
child cannot or should not be returned to the home of the child's parent.
deleted text end
new text begin
(4) The child is five years of age or older.
new text end
(c) When a child's eligibility for adoption assistance is based upon the high risk of
developing physical, mental, emotional, or behavioral disabilities, payments shall not be
made under the adoption assistance agreement unless and until the potential disability
manifests itself as documented by an appropriate health care professional.
Sec. 51.
Minnesota Statutes 2006, section 270B.14, subdivision 1, is amended to read:
Subdivision 1.
Disclosure to commissioner of human services.
(a) On the request
of the commissioner of human services, the commissioner shall disclose return information
regarding taxes imposed by chapter 290, and claims for refunds under chapter 290A, to
the extent provided in paragraph (b) and for the purposes set forth in paragraph (c).
(b) Data that may be disclosed are limited to data relating to the identity,
whereabouts, employment, income, and property of a person owing or alleged to be owing
an obligation of child support.
(c) The commissioner of human services may request data only for the purposes of
carrying out the child support enforcement program and to assist in the location of parents
who have, or appear to have, deserted their children. Data received may be used only
as set forth in section 256.978.
(d) The commissioner shall provide the records and information necessary to
administer the supplemental housing allowance to the commissioner of human services.
(e) At the request of the commissioner of human services, the commissioner of
revenue shall electronically match the Social Security numbers and names of participants
in the telephone assistance plan operated under sections 237.69 to 237.711, with those of
property tax refund filers, and determine whether each participant's household income is
within the eligibility standards for the telephone assistance plan.
(f) The commissioner may provide records and information collected under sections
295.50 to 295.59 to the commissioner of human services for purposes of the Medicaid
Voluntary Contribution and Provider-Specific Tax Amendments of 1991, Public Law
102-234. Upon the written agreement by the United States Department of Health and
Human Services to maintain the confidentiality of the data, the commissioner may provide
records and information collected under sections 295.50 to 295.59 to the Centers for
Medicare and Medicaid Services section of the United States Department of Health and
Human Services for purposes of meeting federal reporting requirements.
(g) The commissioner may provide records and information to the commissioner of
human services as necessary to administer the early refund of refundable tax credits.
(h) The commissioner may disclose information to the commissioner of human
services necessary to verify income for eligibility and premium payment under the
MinnesotaCare program, under section 256L.05, subdivision 2.
(i) The commissioner may disclose information to the commissioner of human
services necessary to verify whether applicants or recipients for the Minnesota family
investment program, general assistance, food support, deleted text begin anddeleted text end Minnesota supplemental aid
programnew text begin , and child care assistancenew text end have claimed refundable tax credits under chapter 290
and the property tax refund under chapter 290A, and the amounts of the credits.
Sec. 52. new text begin MFIP PILOT PROGRAM; WORKFORCE U.
new text end
new text begin Subdivision 1. new text end
new text begin Establishment. new text end
new text begin
A pilot program is established in Stearns and
Benton Counties to expand the Workforce U program administered by the Stearns-Benton
Employment and Training Council.
new text end
new text begin Subd. 2. new text end
new text begin Evaluation. new text end
new text begin
The Workforce U pilot program must be evaluated by a
research and evaluation organization with experience evaluating welfare programs. The
evaluation must include information on the total number of persons served, percentage
of participants exiting the program, percentage of former participants reentering the
program, average wages of program participants, and recommendations to the legislature
for possible statewide implementation of the program. The evaluation must be presented
to the legislature by February 15, 2011.
new text end
new text begin Subd. 3. new text end
new text begin Expiration. new text end
new text begin
The Workforce U pilot program expires on June 30, 2011.
new text end
Sec. 53. new text begin LEECH LAKE YOUTH TREATMENT CENTER PROPOSAL.
new text end
new text begin
(a) The commissioner of human services shall provide a planning grant to address
the unmet need for local, effective, culturally relevant alcohol and drug treatment for
American Indian youth, and develop a plan for a family-based youth treatment center in
the Leech Lake area. The planning grant must be provided to a volunteer board consisting
of at least four members appointed by the commissioner, to include at least the following:
new text end
new text begin
(1) two members of the Leech Lake Tribal Council or their designees;
new text end
new text begin
(2) one member appointed by the Cass County Social Services administrator; and
new text end
new text begin
(3) one member appointed by the Cass Lake-Bena Public School superintendent.
new text end
new text begin
(b) The plan must include:
new text end
new text begin
(1) an interest, feasibility, and suitability of location study;
new text end
new text begin
(2) defining scope of programs and services to be offered;
new text end
new text begin
(3) defining site use limitations and restrictions, including physical and capacity;
new text end
new text begin
(4) defining facilities required for programs and services offered;
new text end
new text begin
(5) identifying partners, partnership roles, and partner resources;
new text end
new text begin
(6) developing proposed operating and maintenance budgets;
new text end
new text begin
(7) identifying funding sources;
new text end
new text begin
(8) developing a long-term funding plan; and
new text end
new text begin
(9) developing a formal steering committee, structure, and bylaws.
new text end
new text begin
(c) The plan is due to the legislative committees having jurisdiction over chemical
health issues no later than September 2008 in order to provide the 12 months necessary to
complete the plan.
new text end
Sec. 54. new text begin MINNESOTA FOOD SUPPORT PROGRAM SIMPLIFIED
APPLICATION.
new text end
new text begin
The commissioner of human services shall implement a simplified application form
and process for the food support program by January 1, 2008. The commissioner shall
consult with counties and representatives of persons served by the program to develop the
simplified application form and process. The application process shall:
new text end
new text begin
(1) include a simple, short form that can be completed by individuals with limited
literacy skills;
new text end
new text begin
(2) include an application form for individuals without dependents;
new text end
new text begin
(3) include a process that does not require individuals to take time off work for a
face-to-face interview; and
new text end
new text begin
(4) minimize demands on county staff in assisting applicants.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2008.
new text end
Sec. 55. new text begin INSPECTION OF LEGAL UNLICENSED CHILD CARE PROVIDERS.
new text end
new text begin
The commissioner of human services, in consultation with the commissioner of
health and the counties, shall develop and present recommendations to the legislature in
January 2008 in order for each legally unlicensed child care provider receiving child
care assistance funds to receive a onetime home visit to receive information on health
and safety, and school readiness.
new text end
Sec. 56. new text begin COMMISSIONER OF HUMAN SERVICES DUTIES; EARLY
CHILDHOOD AND SCHOOL-AGE PROFESSIONAL DEVELOPMENT
TRAINING.
new text end
new text begin Subdivision 1. new text end
new text begin
Development and implementation of an early childhood and
school-age professional development system.
new text end
new text begin
(a) The commissioner of human services,
in cooperation with the commissioners of education and health, shall develop and phase-in
the implementation of a professional development system for practitioners serving
children in early childhood and school-age programs. The system shall provide training
options and supports for practitioners to voluntarily choose, as they complete or exceed
existing licensing requirements.
new text end
new text begin
The system must, at a minimum, include the following features:
new text end
new text begin
(1) a continuum of training content based on the early childhood and school-age
care practitioner core competencies that translates knowledge into improved practice to
support children's school success;
new text end
new text begin
(2) training strategies that provide direct feedback about practice to practitioners
through ongoing consultation, mentoring, or coaching with special emphasis on early
literacy and early mathematics;
new text end
new text begin
(3) an approval process for trainers;
new text end
new text begin
(4) a professional development registry for early childhood and school-age care
practitioners that will provide tracking and recognition of practitioner training/career
development progress;
new text end
new text begin
(5) a career lattice that includes a range of professional development and educational
opportunities that provide appropriate coursework and degree pathways;
new text end
new text begin
(6) development of a plan with public higher education institutions for an articulated
system of education, training, and professional development that includes credit for prior
learning and development of equivalences to two- and four-year degrees;
new text end
new text begin
(7) incentives and supports for early childhood and school-age care practitioners
to seek additional training and education, including TEACH, other scholarships, and
career guidance; and
new text end
new text begin
(8) coordinated and accessible delivery of training to early childhood and school-age
care practitioners.
new text end
new text begin
(b) By January 1, 2008, the commissioner, in consultation with the organizations
named in subdivision 2 shall develop additional opportunities in order to qualify more
licensed family child care providers under section 119B.13, subdivision 3a.
new text end
new text begin
(c) The commissioner of human services must evaluate the professional development
system and make continuous improvements.
new text end
new text begin
(d) Beginning July 1, 2007, as appropriations permit, the commissioner shall
phase-in the professional development system.
new text end
new text begin Subd. 2. new text end
new text begin Two-hour early childhood training. new text end
new text begin
By January 15, 2008, the
commissioner of human services, with input from the Minnesota Licensed Family Child
Care Association and the Minnesota Professional Development Council, shall identify
trainings that qualify for the two-hour early childhood development training requirement
for new child care practitioners under Minnesota Statutes, section 245A.14, subdivision
9a, paragraphs (a) and (b). For licensed family child care, the commissioner shall also
seek the input of labor unions that serve licensed family child care providers, if the union
has been recognized by a county to serve licensed family child care providers.
new text end
Sec. 57. new text begin SCHOOL READINESS SERVICE AGREEMENTS.
new text end
new text begin Subdivision 1. new text end
new text begin Overview. new text end
new text begin
(a) Effective July 1, 2007, funds must be made available
to allow the commissioner to pay higher rates to up to 50 child care providers who are
deemed by the commissioner to meet the requirements of a school readiness service
agreement (SRSA) provider and perform services that support school readiness for
children and economic stability for parents.
new text end
new text begin
(b) A provider may be paid a rate above that currently allowed under Minnesota
Statutes, section 119B.13, if:
new text end
new text begin
(1) the provider has entered into an SRSA with the commissioner;
new text end
new text begin
(2) a family using that provider receives child care assistance under any provision in
Minnesota Statutes, chapter 119B, except Minnesota Statutes, section 119B.035;
new text end
new text begin
(3) the family using that provider meets the criteria in this section; and
new text end
new text begin
(4) funding is available under this section.
new text end
new text begin Subd. 2. new text end
new text begin Provider eligibility. new text end
new text begin
(a) To be considered for an SRSA, a provider shall
apply to the commissioner. To be eligible to apply for an SRSA, a provider shall:
new text end
new text begin
(1) be eligible for child care assistance payments under Minnesota Statutes, chapter
119B;
new text end
new text begin
(2) have at least 25 percent of the children enrolled with the provider subsidized
through the child care assistance program;
new text end
new text begin
(3) provide full-time, full-year child care services; and
new text end
new text begin
(4) serve at least one child who is subsidized through the child care assistance
program and who is expected to enter kindergarten within the following 30 months.
new text end
new text begin
(b) The commissioner may waive the 25 percent requirement in paragraph (a), clause
(2), if necessary to achieve geographic distribution of SRSA providers and diversity of
types of care provided by SRSA providers.
new text end
new text begin
(c) An eligible provider who would like to enter into an SRSA with the commissioner
shall submit an SRSA application. To determine whether to enter into an SRSA with a
provider, the commissioner shall evaluate the following factors:
new text end
new text begin
(1) the qualifications of the provider and the provider's staff;
new text end
new text begin
(2) the provider's staff-child ratios;
new text end
new text begin
(3) the provider's curriculum;
new text end
new text begin
(4) the provider's current or planned parent education activities;
new text end
new text begin
(5) the provider's current or planned social service and employment linkages;
new text end
new text begin
(6) the provider's child development assessment plan;
new text end
new text begin
(7) the geographic distribution needed for SRSA providers;
new text end
new text begin
(8) the inclusion of a variety of child care delivery models; and
new text end
new text begin
(9) other related factors determined by the commissioner.
new text end
new text begin Subd. 3. new text end
new text begin Family and child eligibility. new text end
new text begin
(a) A family eligible to choose an SRSA
provider for their children shall:
new text end
new text begin
(1) be eligible to receive child care assistance under any provision in Minnesota
Statutes, chapter 119B, except Minnesota Statutes, section 119B.035;
new text end
new text begin
(2) be in an authorized activity for an average of at least 35 hours per week when
initial eligibility is determined; and
new text end
new text begin
(3) include a child who has not yet entered kindergarten.
new text end
new text begin
(b) A family who is determined to be eligible to choose an SRSA provider remains
eligible to be paid at a higher rate through the SRSA provider when the following
conditions exist:
new text end
new text begin
(1) the child attends child care with the SRSA provider a minimum of 25 hours per
week, on average;
new text end
new text begin
(2) the family has a child who has not yet entered kindergarten; and
new text end
new text begin
(3) the family maintains eligibility under Minnesota Statutes, chapter 119B, except
Minnesota Statutes, section 119B.035.
new text end
new text begin
(c) For the 12 months after initial eligibility has been determined, a decrease in
the family's authorized activities to an average of less than 35 hours per week does not
result in ineligibility for the SRSA rate.
new text end
new text begin
(d) A family that moves between counties but continues to use the same SRSA
provider shall continue to receive SRSA funding for the increased payments.
new text end
new text begin Subd. 4. new text end
new text begin Requirements of providers. new text end
new text begin
An SRSA must include assessment,
evaluation, and reporting requirements that promote the goals of improved school
readiness and movement toward appropriate child development milestones. A provider
who enters into an SRSA shall comply with the assessment, evaluation, and reporting
requirements in the SRSA.
new text end
new text begin Subd. 5. new text end
new text begin Relationship to current law. new text end
new text begin
(a) The following provisions in Minnesota
Statutes, chapter 119B, must be waived or modified for families receiving services under
this section.
new text end
new text begin
(b) Notwithstanding Minnesota Statutes, section 119B.13, subdivisions 1 and 1a,
maximum weekly rates under this section are 125 percent of the existing maximum
weekly rate for like-care. Providers eligible for a differential rate under Minnesota
Statutes, section 119B.13, subdivision 3a, remain eligible for the differential above the
rate identified in this section. Only care for children who have not yet entered kindergarten
may be paid at the maximum rate under this section. The provider's charge for service
provided through an SRSA may not exceed the rate that the provider charges a private-pay
family for like-care arrangements.
new text end
new text begin
(c) A family or child care provider may not be assessed an overpayment for care
provided through an SRSA unless:
new text end
new text begin
(1) there was an error in the amount of care authorized for the family; or
new text end
new text begin
(2) the family or provider did not timely report a change as required under the law.
new text end
new text begin
(d) Care provided through an SRSA is authorized on a weekly basis.
new text end
new text begin
(e) Funds appropriated under this section to serve families eligible under Minnesota
Statutes, section 119B.03, are not allocated through the basic sliding fee formula under
Minnesota Statutes, section 119B.03. Funds appropriated under this section are used to
offset increased costs when payments are made under SRSA's.
new text end
new text begin
(f) Notwithstanding Minnesota Statutes, section 119B.09, subdivision 6, the
maximum amount of child care assistance that may be authorized for a child receiving
care through an SRSA in a two-week period is 160 hours per child.
new text end
new text begin Subd. 6. new text end
new text begin Establishment of service agreements. new text end
new text begin
(a) The commissioner shall
approve SRSA's for up to 50 providers that represent diverse parts of the state and a
variety of child care delivery models. Entering into a service agreement does not guarantee
that a provider will receive payment at a higher rate for families receiving child care
assistance. A family eligible under this section shall choose a provider participating in an
SRSA in order for a higher rate to be paid. Payments through SRSA's are also limited by
the availability of SRSA funds.
new text end
new text begin
(b) Nothing in this section shall be construed to limit parent choice as defined in
Minnesota Statutes, section 119B.09, subdivision 5.
new text end
new text begin
(c) The commissioner may allow for startup time for some providers if failing to
do so would limit geographic diversity of SRSA providers or a variety of child care
delivery models.
new text end
Sec. 58. new text begin FAMILY, FRIEND, AND NEIGHBOR GRANT PROGRAM.
new text end
new text begin Subdivision 1. new text end
new text begin Establishment. new text end
new text begin
A family, friend, and neighbor (FFN) grant program
is established to promote children's early literacy, healthy development, and school
readiness, and to foster community partnerships to promote children's school readiness.
The commissioner shall attempt to ensure that grants are made in all areas of the state. The
commissioner of human services shall make grants available to fund: community-based
organizations, nonprofit organizations, and Indian tribes working with FFN caregivers
under subdivision 2, paragraph (a); and community-based partnerships to implement early
literacy programs under subdivision 2, paragraph (b).
new text end
new text begin Subd. 2. new text end
new text begin Program components. new text end
new text begin
(a)(1) Grants that the commissioner awards under
this section must be used by community-based organizations, nonprofit organizations, and
Indian tribes working with FFN caregivers in local communities, cultural communities,
and Indian tribes to:
new text end
new text begin
(i) provide training, support, and resources to FFN caregivers in order to improve
and promote children's health, safety, nutrition, and school readiness;
new text end
new text begin
(ii) connect FFN caregivers and children's families with appropriate community
resources that support the families' health, mental health, economic, and developmental
needs;
new text end
new text begin
(iii) connect FFN caregivers and children's families to early childhood screening
programs and facilitate referrals where appropriate;
new text end
new text begin
(iv) provide FFN caregivers and children's families with information about early
learning guidelines from the Departments of Human Services and Education;
new text end
new text begin
(v) provide FFN caregivers and children's families with information about becoming
a licensed family child care provider; and
new text end
new text begin
(vi) provide FFN caregivers and children's families with information about early
learning allowances and enrollment opportunities in high quality community-based
child-care and preschool programs.
new text end
new text begin
(2) Grants that the commissioner awards under this paragraph also may be used for:
new text end
new text begin
(i) health and safety and early learning kits for FFN caregivers;
new text end
new text begin
(ii) play-and-learn groups with FFN caregivers;
new text end
new text begin
(iii) culturally appropriate early childhood training for FFN caregivers;
new text end
new text begin
(iv) transportation for FFN caregivers and children's families to school readiness and
other early childhood training activities;
new text end
new text begin
(v) other activities that promote school readiness;
new text end
new text begin
(vi) data collection and evaluation;
new text end
new text begin
(vii) staff outreach and outreach activities;
new text end
new text begin
(viii) translation needs; or
new text end
new text begin
(ix) administrative costs that equal up to 12 percent of the recipient's grant award.
new text end
new text begin
(b) Grants that the commissioner awards under this section also must be used to fund
partnerships among Minnesota public and regional library systems, community-based
organizations, nonprofit organizations, and Indian tribes to implement early literacy
programs in low-income communities, including tribal communities, to:
new text end
new text begin
(1) purchase and equip early childhood read-mobiles that provide FFN caregivers
and children's families with books, training, and early literacy activities;
new text end
new text begin
(2) provide FFN caregivers and children's families with translations of early
childhood books, training, and early literacy activities in native languages; or
new text end
new text begin
(3) provide FFN caregivers and children's families with early literacy activities in
local libraries.
new text end
new text begin Subd. 3. new text end
new text begin Grant awards. new text end
new text begin
Interested entities eligible to receive a grant under
this section may apply to the commissioner in the form and manner the commissioner
determines. The commissioner shall awards grants to eligible entities consistent with
the requirements of this section.
new text end
new text begin Subd. 4. new text end
new text begin Evaluation. new text end
new text begin
The commissioner, in consultation with early childhood
care and education experts at the University of Minnesota, must evaluate the impact of
the grants under subdivision 2 on children's school readiness and submit a written report
to the human services and education finance and policy committees of the legislature by
February 15, 2010.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 59. new text begin CHILD CARE PROVIDER STUDY.
new text end
new text begin
If sufficient resources to support the costs are provided by one or more
nongovernmental entities, the commissioner of human services is directed to study the
implications of restricting the use of state subsidies in center-based child care to centers
meeting state quality standards under Minnesota Statutes, section 124D.175, paragraph
(c), and to publish the results no later than January 1, 2010. The study must include:
new text end
new text begin
(1) the likelihood of there being sufficient child care providers meeting the standards;
new text end
new text begin
(2) the cost to bring providers up to the standards and how this cost would be funded;
new text end
new text begin
(3) how the standards and the ratings would be communicated to both parents and
the general public; and
new text end
new text begin
(4) a determination whether a similar system could be implemented for
non-center-based care.
new text end
Sec. 60. new text begin DIRECTION TO COMMISSIONER.
new text end
new text begin
(a) The commissioner of human services shall offer a request for proposals to
identify a research and evaluation firm with experience working with:
new text end
new text begin
(1) homeless youth providers;
new text end
new text begin
(2) data; and
new text end
new text begin
(3) the topics of housing, homelessness, and a continuum of care for youth.
new text end
new text begin
(b) The research and evaluation firm identified under paragraph (a) shall monitor and
evaluate the programs receiving funding under Minnesota Statutes, section 256K.45.
new text end
Sec. 61. new text begin NOT ASSESSING TANF PENALTIES AGAINST COUNTIES.
new text end
new text begin
From October 2006 through October 2007, if the state does not meet the federal
work participation requirements, and the state is penalized by a reduction in the TANF
grant, the state shall not assess penalties against the counties.
new text end
Sec. 62. new text begin PREKINDERGARTEN EXPLORATORY PROJECTS.
new text end
new text begin Subdivision 1. new text end
new text begin Early childhood allowance. new text end
new text begin
The commissioners of human services
and education shall establish three prekindergarten exploratory projects to be conducted in
partnership with the Minnesota Early Learning Foundation to promote children's school
readiness. The exploratory projects shall be designed and evaluated by the Minnesota
Early Learning Foundation.
new text end
new text begin Subd. 2. new text end
new text begin Family eligibility. new text end
new text begin
Parents or legal guardians with incomes less than or
equal to 185 percent of the federal poverty guidelines are eligible to receive allowances to
pay for their children's education in a quality early education program, in an amount not
to exceed $4,000 per child per year. The allowance must be used during the 12 months
following receipt of the allowance by the claimant for a child who is age 3 or 4 on August
31, to pay for services designed to promote school readiness in a quality early education
setting. A quality program is one that meets the standards in subdivision 3.
new text end
new text begin Subd. 3. new text end
new text begin Quality standards. new text end
new text begin
(a) A quality early care and education setting is any
service or program that receives a quality rating from the Department of Human Services
under the Minnesota Early Learning Foundation quality rating system administered by
the Department of Human Services and agrees to accept a prekindergarten education
allowance to pay for services. For fiscal years 2008 and 2009 only, a provider may satisfy
the quality rating system requirements and be deemed eligible to participate in this
program if the provider has received a provisional quality rating system approval from
either the Department of Human Services or the Department of Education.
new text end
new text begin
(b) For the purposes of receiving a provisional quality rating, a child care program or
provider must be approved by the commissioner of human services and a school readiness
program or a Head Start program must be approved by the commissioner of education.
Programs and providers must apply for approval in the form and manner prescribed by the
commissioners. To receive approval, the commissioners must determine that applicants:
new text end
new text begin
(1) use research-based curricula that are aligned with the education standards under
Minnesota Statutes, section 120B.021, instruction, and child assessment instruments
approved by the Department of Education and the Department of Human Services, in
consultation with the Minnesota Early Learning Foundation;
new text end
new text begin
(2) provide a program of sufficient intensity and duration to improve the school
readiness of participating children;
new text end
new text begin
(3) provide opportunities for parent involvement; and
new text end
new text begin
(4) meet other research-based criteria determined necessary by the commissioners.
new text end
new text begin
(c) For 2008 and 2009, notwithstanding paragraph (b), Head Start programs
meeting Head Start performance standards and accredited child care centers are granted
a provisional quality rating for the purposes of receiving a prekindergarten education
allowance under this statute.
new text end
new text begin
(d) A provider deemed eligible to receive a prekindergarten education allowance
under paragraphs (a) to (c) may use the allowance to enhance services above the current
quality levels, increase the duration of services provided, or expand the number of children
to whom services are provided.
new text end
new text begin
(e) For fiscal years 2008 and 2009 only, when no quality program is available, a
recipient may direct the prekindergarten education allowance to a provider or program for
school readiness quality improvements that will make the provider or program eligible
for a quality rating according to the quality rating system. Allowable expenditures that
will increase the capacity of the provider or program to help children be ready for school
include purchase of curricula and assessment tools, training on the use of curriculum and
assessment tools, purchase of materials to improve the learning environment, or other
expenditures approved by the commissioner of human services for child care providers
and the commissioner of education for school readiness programs.
new text end
new text begin Subd. 4. new text end
new text begin Eligibility; applications. new text end
new text begin
Eligible families must have incomes less than or
equal to 185 percent of the federal poverty guidelines. Allowances paid to families under
this program may not be counted as earned income for the purposes of medical assistance,
MinnesotaCare, MFIP, child care assistance, or Head Start programs.
new text end
new text begin Subd. 5. new text end
new text begin Expenditures. new text end
new text begin
This program shall operate during fiscal years 2008 and
2009.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 63. new text begin REPEALER.
new text end
new text begin
(a) Minnesota Statutes 2006, sections 119B.08, subdivision 4; 256J.29; and
256J.626, subdivision 9,
new text end
new text begin
are repealed.
new text end
new text begin
(b) Minnesota Statutes 2006, section 256J.37, subdivision 3b,
new text end
new text begin
is repealed effective
February 1, 2008.
new text end
new text begin
(c) Laws 1997, chapter 8, section 1,
new text end
new text begin
is repealed.
new text end
new text begin
(d) Minnesota Rules, part 9560.0102, subpart 2, item C,
new text end
new text begin
is repealed.
new text end
Sec. 64. new text begin EFFECTIVE DATE.
new text end
new text begin
Section 27 (Minnesota Statutes, section 256J.20, subdivision 3) is effective January
1, 2008. Section 13 (Minnesota Statutes, section 119B.13, subdivision 7) is effective
January 1, 2009.
new text end
ARTICLE 3
LICENSING
Section 1.
Minnesota Statutes 2006, section 245A.035, is amended to read:
245A.035 deleted text begin RELATIVE FOSTER CARE;deleted text end new text begin UNLICENSEDnew text end EMERGENCY
deleted text begin LICENSEdeleted text end new text begin RELATIVE PLACEMENTnew text end .
Subdivision 1.
deleted text begin Grant ofdeleted text end Emergency deleted text begin licensedeleted text end new text begin placementnew text end .
Notwithstanding section
245A.03, subdivision 2a, or 245C.13, subdivision 2, a county agency may place a child
deleted text begin for foster caredeleted text end with a relative who is not licensed to provide foster care, provided the
requirements of deleted text begin subdivision 2deleted text end new text begin this sectionnew text end are met. As used in this section, the term
"relative" has the meaning given it under section 260C.007, subdivision 27.
Subd. 2.
Cooperation with emergency deleted text begin licensingdeleted text end new text begin placementnew text end process.
(a) A county
agency that places a child with a relative who is not licensed to provide foster care must
deleted text begin begin the process of securing an emergency license for the relative as soon as possible
and mustdeleted text end conduct the initial inspection required by subdivision 3, clause (1), whenever
possible, prior to placing the child in the relative's home, but no later than three working
days after placing the child in the home. A child placed in the home of a relative who is
not licensed to provide foster care must be removed from that home if the relative fails
to cooperate with the county agency deleted text begin in securing an emergency foster care license. The
commissioner may issue an emergency foster care license to a relative with whom the
county agency wishes to place or has placed a child for foster care, or to a relative with
whom a child has been placed by court orderdeleted text end .
(b) If a child is to be placed in the home of a relative not licensed to provide foster
care, either the placing agency or the county agency in the county in which the relative
lives shall conduct the emergency deleted text begin licensingdeleted text end new text begin placementnew text end process as required in this section.
Subd. 3.
Requirements for emergency deleted text begin licensedeleted text end new text begin placementnew text end .
Before an emergency
deleted text begin licensedeleted text end new text begin placementnew text end may be deleted text begin issueddeleted text end new text begin madenew text end , the following requirements must be met:
(1) the county agency must conduct an initial inspection of the premises where
the deleted text begin foster caredeleted text end new text begin placementnew text end is to be deleted text begin provideddeleted text end new text begin madenew text end to ensure the health and safety of any
child placed in the home. The county agency shall conduct the inspection using a form
developed by the commissioner;
(2) at the time of the inspection or placement, whichever is earlier,new text begin the county
agency must providenew text end the relative being considered for an emergency deleted text begin license shall receivedeleted text end new text begin
placementnew text end an application form for a child foster care license;
(3) whenever possible, prior to placing the child in the relative's home, the relative
being considered for an emergency deleted text begin licensedeleted text end new text begin placementnew text end shall provide the information
required by section 245C.05; and
(4) if the county determines, prior to the deleted text begin issuance of andeleted text end emergency deleted text begin licensedeleted text end new text begin
placementnew text end , that anyone requiring a background study deleted text begin may bedeleted text end new text begin prior to licensure of the
home is new text end disqualified under deleted text begin section 245C.14 anddeleted text end chapter 245C, and the disqualification
is one which the commissioner cannot set aside, an emergency deleted text begin license shalldeleted text end new text begin placement
mustnew text end not be deleted text begin issueddeleted text end new text begin madenew text end .
Subd. 4.
Applicant study.
When the county agency has received the information
required by section 245C.05, the county agency shall deleted text begin begin an applicant study according to
the procedures in chapter 245C. The commissioner may issue an emergency license upon
recommendation of the county agency once the initial inspection has been successfully
completed and the information necessary to begin the applicant background study has been
provided. If the county agency does not recommend that the emergency license be granted,
the agency shall notify the relative in writing that the agency is recommending denial to the
commissioner; shall remove any child who has been placed in the home prior to licensure;
and shall inform the relative in writing of the procedure to request review pursuant to
subdivision 6. An emergency license shall be effective until a child foster care license is
granted or denied, but shall in no case remain in effect more than 120 days from the date
of placementdeleted text end new text begin submit the information to the commissioner according to section 245C.05new text end .
Subd. 5.
Child foster care license application.
(a) Thenew text begin relatives with whom thenew text end
emergency deleted text begin license holderdeleted text end new text begin placement has been madenew text end shall complete the child foster care
license application and necessary paperwork within ten days of the placement. The county
agency shall assist the deleted text begin emergency license holderdeleted text end new text begin applicantnew text end to complete the application.
The granting of a child foster care license to a relative shall be under the procedures in this
chapter and according to the standards deleted text begin set forth by foster care ruledeleted text end new text begin in Minnesota Rules,
chapter 2960new text end . In licensing a relative, the commissioner shall consider the importance of
maintaining the child's relationship with relatives as an additional significant factor in
determining whether deleted text begin todeleted text end new text begin a background study disqualification should benew text end set aside deleted text begin a licensing
disqualifierdeleted text end under section 245C.22, or deleted text begin to grantdeleted text end a variance deleted text begin of licensing requirementsdeleted text end new text begin should
be grantednew text end under deleted text begin sections 245C.21 to 245C.27deleted text end new text begin section 245C.30new text end .
(b) When the county or private child-placing agency is processing an application
for child foster care licensure of a relative as defined in section 260B.007, subdivision
12, or 260C.007, subdivision 27, the county agency or child-placing agency must explain
the licensing process to the prospective licensee, including the background study process
and the procedure for reconsideration of an initial disqualification for licensure. The
county or private child-placing agency must also provide the prospective relative licensee
with information regarding appropriate options for legal representation in the pertinent
geographic area. If a relative is initially disqualified under section 245C.14, the deleted text begin county
or child-placing agencydeleted text end new text begin commissionernew text end must provide written notice of the reasons for the
disqualification and the right to request a reconsideration by the commissioner as required
under section 245C.17.
(c) The commissioner shall maintain licensing data so that activities related to
applications and licensing actions for relative foster care providers may be distinguished
from other child foster care settings.
deleted text begin Subd. 6. deleted text end
deleted text begin Denial of emergency license. deleted text end
deleted text begin
If the commissioner denies an application
for an emergency foster care license under this section, that denial must be in writing and
must include reasons for the denial. Denial of an emergency license is not subject to
appeal under chapter 14. The relative may request a review of the denial by submitting
to the commissioner a written statement of the reasons an emergency license should be
granted. The commissioner shall evaluate the request for review and determine whether
to grant the emergency license. The commissioner's review shall be based on a review
of the records submitted by the county agency and the relative. Within 15 working
days of the receipt of the request for review, the commissioner shall notify the relative
requesting review in written form whether the emergency license will be granted. The
commissioner's review shall be based on a review of the records submitted by the county
agency and the relative. A child shall not be placed or remain placed in the relative's home
while the request for review is pending. Denial of an emergency license shall not preclude
an individual from reapplying for an emergency license or from applying for a child foster
care license. The decision of the commissioner is the final administrative agency action.
deleted text end
Sec. 2.
Minnesota Statutes 2006, section 245A.10, subdivision 2, is amended to read:
Subd. 2.
County fees for background studies and licensing inspections.
(a) For
purposes of family and group family child care licensing under this chapter, a county
agency may charge a fee to an applicant or license holder to recover the actual cost of
background studies, but in any case not to exceed $100 annually. A county agency may
also charge a new text begin licensenew text end fee to an applicant or license holder deleted text begin to recover the actual cost of
licensing inspections, but in any casedeleted text end not to exceed deleted text begin $150 annuallydeleted text end new text begin $50 for a one-year
license or $100 for a two-year licensenew text end .
(b) A county agency may charge a fee to a legal nonlicensed child care provider or
applicant for authorization to recover the actual cost of background studies completed
under section 119B.125, but in any case not to exceed $100 annually.
(c) Counties may elect to reduce or waive the fees in paragraph (a) or (b):
(1) in cases of financial hardship;
(2) if the county has a shortage of providers in the county's area;
(3) for new providers; or
(4) for providers who have attained at least 16 hours of training before seeking
initial licensure.
(d) Counties may allow providers to pay the applicant fees in paragraph (a) or (b) on
an installment basis for up to one year. If the provider is receiving child care assistance
payments from the state, the provider may have the fees under paragraph (a) or (b)
deducted from the child care assistance payments for up to one year and the state shall
reimburse the county for the county fees collected in this manner.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2008.
new text end
Sec. 3.
Minnesota Statutes 2006, section 245A.16, subdivision 1, is amended to read:
Subdivision 1.
Delegation of authority to agencies.
(a) County agencies and
private agencies that have been designated or licensed by the commissioner to perform
licensing functions and activities under section 245A.04 deleted text begin anddeleted text end new text begin background studies for
adult foster care, family adult day services, and family child care, undernew text end chapter 245Cdeleted text begin ,deleted text end new text begin ;new text end
to recommend denial of applicants under section 245A.05deleted text begin ,deleted text end new text begin ;new text end to issue correction orders,
to issue variances, and recommend a conditional license under section 245A.06, or to
recommend suspending or revoking a license or issuing a fine under section 245A.07,
shall comply with rules and directives of the commissioner governing those functions and
with this section. The following variances are excluded from the delegation of variance
authority and may be issued only by the commissioner:
(1) dual licensure of family child care and child foster care, dual licensure of child
and adult foster care, and adult foster care and family child care;
(2) adult foster care maximum capacity;
(3) adult foster care minimum age requirement;
(4) child foster care maximum age requirement;
(5) variances regarding disqualified individuals except that county agencies may
issue variances under section 245C.30 regarding disqualified individuals when the county
is responsible for conducting a consolidated reconsideration according to sections 245C.25
and 245C.27, subdivision 2, clauses (a) and (b), of a county maltreatment determination
and a disqualification based on serious or recurring maltreatment; and
(6) the required presence of a caregiver in the adult foster care residence during
normal sleeping hours.
(b) County agencies must report:
deleted text begin (1)deleted text end information about disqualification reconsiderations under sections 245C.25 and
245C.27, subdivision 2, deleted text begin clausesdeleted text end new text begin paragraphsnew text end (a) and (b), and variances granted under
paragraph (a), clause (5), to the commissioner at least monthly in a format prescribed by
the commissionerdeleted text begin ; anddeleted text end new text begin .
new text end
deleted text begin
(2) for relative child foster care applicants and license holders, the number of
relatives, as defined in section deleted text begin 260C.007, subdivision 27deleted text end , and household members of
relatives who are disqualified under section ; the disqualifying characteristics
under section ; the number of these individuals who requested reconsideration
under section ; the number of set-asides under section ; and variances
under section issued. This information shall be reported to the commissioner
annually by January 15 of each year in a format prescribed by the commissioner.
deleted text end
(c) For family day care programs, the commissioner may authorize licensing reviews
every two years after a licensee has had at least one annual review.
(d) For family adult day services programs, the commissioner may authorize
licensing reviews every two years after a licensee has had at least one annual review.
(e) A license issued under this section may be issued for up to two years.
Sec. 4.
Minnesota Statutes 2006, section 245A.16, subdivision 3, is amended to read:
Subd. 3.
Recommendations to the commissioner.
The county or private agency
shall not make recommendations to the commissioner regarding licensure without
first conducting an inspection,new text begin and for adult foster care, family adult day services, and
family child care, a backgroundnew text end study of the applicantdeleted text begin , and evaluation pursuant todeleted text end new text begin undernew text end
chapter 245C. The county or private agency must forward its recommendation to the
commissioner regarding the appropriate licensing action within 20 working days of
receipt of a completed application.
Sec. 5.
Minnesota Statutes 2006, section 245C.02, is amended by adding a subdivision
to read:
new text begin Subd. 14a. new text end
new text begin Private agency. new text end
new text begin
"Private agency" has the meaning given in section
245A.02, subdivision 12.
new text end
Sec. 6.
Minnesota Statutes 2006, section 245C.04, subdivision 1, is amended to read:
Subdivision 1.
Licensed programs.
(a) The commissioner shall conduct a
background study of an individual required to be studied under section 245C.03,
subdivision 1, at least upon application for initial license for all license types.
(b) The commissioner shall conduct a background study of an individual required
to be studied under section 245C.03, subdivision 1, at reapplication for a license for
deleted text begin family child care,deleted text end deleted text begin child foster care, anddeleted text end adult foster carenew text begin , family adult day services, and
family child carenew text end .
(c) The commissioner is not required to conduct a study of an individual at the time
of reapplication for a license if the individual's background study was completed by the
commissioner of human services for an adult foster care license holder that is also:
(1) registered under chapter 144D; or
(2) licensed to provide home and community-based services to people with
disabilities at the foster care location and the license holder does not reside in the foster
care residence; and
(3) the following conditions are met:
(i) a study of the individual was conducted either at the time of initial licensure or
when the individual became affiliated with the license holder;
(ii) the individual has been continuously affiliated with the license holder since
the last study was conducted; and
(iii) the last study of the individual was conducted on or after October 1, 1995.
(d) new text begin From July 1, 2007, to June 30, 2009, the commissioner of human services shall
conduct a study of an individual required to be studied under section 245C.03, at the
time of reapplication for a child foster care license. The county or private agency shall
collect and forward to the commissioner the information required under section 245C.05,
subdivisions 1, paragraphs (a) and (b), and 5, paragraphs (a) and (b). The background
study conducted by the commissioner of human services under this paragraph must
include a review of the information required under section 245C.08, subdivisions 1,
paragraph (a), clauses (1) to (5), 3, and 4.
new text end
new text begin
(e) The commissioner of human services shall conduct a background study of an
individual specified under section 245C.03, subdivision 1, paragraph (a), clauses (2)
to (6), who is newly affiliated with a child foster care license holder. The county or
private agency shall collect and forward to the commissioner the information required
under section 245C.05, subdivisions 1 and 5. The background study conducted by the
commissioner of human services under this paragraph must include a review of the
information required under section 245C.08, subdivisions 1, 3, and 4.
new text end
new text begin (f) new text end Applicants for licensure, license holders, and other entities as provided in this
chapter must submit completed background study forms to the commissioner before
individuals specified in section 245C.03, subdivision 1, begin positions allowing direct
contact in any licensed program.
deleted text begin (e)deleted text end new text begin (g)new text end For purposes of this section, a physician licensed under chapter 147 is
considered to be continuously affiliated upon the license holder's receipt from the
commissioner of health or human services of the physician's background study results.
Sec. 7.
Minnesota Statutes 2006, section 245C.05, subdivision 1, is amended to read:
Subdivision 1.
Individual studied.
(a) The individual who is the subject of the
background study must provide the applicant, license holder, or other entity under section
245C.04 with sufficient information to ensure an accurate study, including:
(1) the individual's first, middle, and last name and all other names by which the
individual has been known;
(2) home address, city, and state of residence;
(3) zip code;
(4) sex;
(5) date of birth; and
(6) Minnesota driver's license number or state identification number.
(b) Every subject of a background study conductednew text begin or initiatednew text end by counties or private
agencies under this chapter must also provide the home address, city, county, and state of
residence for the past five years.
new text begin
(c) Every subject of a background study related to private agency adoptions or
related to child foster care licensed through a private agency, who is 18 years of age
or older, shall also provide the commissioner a signed consent for the release of any
information received from national crime information databases to the private agency that
initiated the background study.
new text end
new text begin
(d) The subject of a background study shall provide fingerprints as required in
subdivision 5, paragraph (c).
new text end
Sec. 8.
Minnesota Statutes 2006, section 245C.05, is amended by adding a subdivision
to read:
new text begin Subd. 2a. new text end
new text begin County or private agency. new text end
new text begin
For background studies related to child foster
care, county and private agencies must collect the information under subdivision 1 and
forward it to the commissioner.
new text end
Sec. 9.
Minnesota Statutes 2006, section 245C.05, subdivision 4, is amended to read:
Subd. 4.
Electronic transmission.
For background studies conducted by the
Department of Human Services, the commissioner shall implement a system for the
electronic transmission of:
(1) background study information to the commissioner; deleted text begin and
deleted text end
(2) background study results to the license holderdeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(3) background study results to county and private agencies for background studies
conducted by the commissioner for child foster care.
new text end
Sec. 10.
Minnesota Statutes 2006, section 245C.05, subdivision 5, is amended to read:
Subd. 5.
Fingerprints.
(a)new text begin Except as provided in paragraph (c),new text end for any background
study completed under this chapter, when the commissioner has reasonable cause to
believe that further pertinent information may exist on the subject of the background
study, the subject shall provide the commissioner with a set of classifiable fingerprints
obtained from an authorized deleted text begin law enforcementdeleted text end agency.
(b) For purposes of requiring fingerprints, the commissioner has reasonable cause
when, but not limited to, the:
(1) information from the Bureau of Criminal Apprehension indicates that the subject
is a multistate offender;
(2) information from the Bureau of Criminal Apprehension indicates that multistate
offender status is undetermined; or
(3) commissioner has received a report from the subject or a third party indicating
that the subject has a criminal history in a jurisdiction other than Minnesota.
new text begin
(c) Except as specified under section 245C.04, subdivision 1, paragraph (d), for
background studies conducted by the commissioner for child foster care or adoptions,
the subject of the background study, who is 18 years of age or older, shall provide the
commissioner with a set of classifiable fingerprints obtained from an authorized agency.
new text end
Sec. 11.
Minnesota Statutes 2006, section 245C.05, subdivision 7, is amended to read:
Subd. 7.
Probation officer and corrections agent.
(a) A probation officer or
corrections agent shall notify the commissioner of an individual's conviction if the
individual is:
(1) affiliated with a program or facility regulated by the Department of Human
Services or Department of Health, a facility serving children or youth licensed by the
Department of Corrections, or any type of home care agency or provider of personal care
assistance services; and
(2) convicted of a crime constituting a disqualification under section 245C.14.
(b) For the purpose of this subdivision, "conviction" has the meaning given it
in section 609.02, subdivision 5.
(c) The commissioner, in consultation with the commissioner of corrections, shall
develop forms and information necessary to implement this subdivision and shall provide
the forms and information to the commissioner of corrections for distribution to local
probation officers and corrections agents.
(d) The commissioner shall inform individuals subject to a background study that
criminal convictions for disqualifying crimes will be reported to the commissioner by the
corrections system.
(e) A probation officer, corrections agent, or corrections agency is not civilly or
criminally liable for disclosing or failing to disclose the information required by this
subdivision.
(f) Upon receipt of disqualifying information, the commissioner shall provide the
notice required under section 245C.17, as appropriate, to agencies on record as having
initiated a background study or making a request for documentation of the background
study status of the individual.
(g) This subdivision does not apply to family child care deleted text begin and child foster caredeleted text end
programs.
Sec. 12.
Minnesota Statutes 2006, section 245C.08, subdivision 1, is amended to read:
Subdivision 1.
Background studies conducted by commissioner of human
services.
(a) For a background study conducted by the commissioner, the commissioner
shall review:
(1) information related to names of substantiated perpetrators of maltreatment of
vulnerable adults that has been received by the commissioner as required under section
626.557, subdivision 9c, paragraph (i);
(2) the commissioner's records relating to the maltreatment of minors in licensed
programs, and from deleted text begin county agencydeleted text end findings of maltreatment of minors as indicated
through the social service information system;
(3) information from juvenile courts as required in subdivision 4 for individuals
listed in section 245C.03, subdivision 1, clauses (2), (5), and (6); deleted text begin and
deleted text end
(4) information from the Bureau of Criminal Apprehensiondeleted text begin .deleted text end new text begin ;
new text end
new text begin
(5) except as provided in clause (6), information from the national crime information
system when the commissioner has reasonable cause as defined under section 245C.05,
subdivision 5; and
new text end
new text begin
(6) for a background study related to a child foster care application for licensure or
adoptions, the commissioner shall also review:
new text end
new text begin
(i) information from the child abuse and neglect registry for any state in which the
background study subject has resided for the past five years; and
new text end
new text begin
(ii) information from national crime information databases, when the background
study object is 18 years of age or older.
new text end
(b) Notwithstanding expungement by a court, the commissioner may consider
information obtained under paragraph (a), clauses (3) and (4), unless the commissioner
received notice of the petition for expungement and the court order for expungement is
directed specifically to the commissioner.
Sec. 13.
Minnesota Statutes 2006, section 245C.08, subdivision 2, is amended to read:
Subd. 2.
Background studies conducted by a county deleted text begin or privatedeleted text end agency.
(a)
For a background study conducted by a county deleted text begin or privatedeleted text end agency for deleted text begin child foster care,deleted text end
adult foster care,new text begin family adult day services,new text end and family child care deleted text begin homesdeleted text end new text begin servicesnew text end , the
commissioner shall review:
(1) information from the county agency's record of substantiated maltreatment
of adults and the maltreatment of minors;
(2) information from juvenile courts as required in subdivision 4 for individuals
listed in section 245C.03, subdivision 1, clauses (2), (5), and (6);
(3) information from the Bureau of Criminal Apprehension; and
(4) arrest and investigative records maintained by the Bureau of Criminal
Apprehension, county attorneys, county sheriffs, courts, county agencies, local police, the
National Criminal Records Repository, and criminal records from other states.
(b) If the individual has resided in the county for less than five years, the study shall
include the records specified under paragraph (a) for the previous county or counties of
residence for the past five years.
(c) Notwithstanding expungement by a court, the county deleted text begin or privatedeleted text end agency may
consider information obtained under paragraph (a), clauses (3) and (4), unless the
commissioner received notice of the petition for expungement and the court order for
expungement is directed specifically to the commissioner.
Sec. 14.
Minnesota Statutes 2006, section 245C.10, is amended by adding a
subdivision to read:
new text begin Subd. 4. new text end
new text begin
Temporary personnel agencies, educational programs, and professional
services agencies.
new text end
new text begin
The commissioner shall recover the cost of the background studies
initiated by temporary personnel agencies, educational programs, and professional
services agencies that initiate background studies under section 245C.03, subdivision 4,
through a fee of no more than $20 per study charged to the agency. The fees collected
under this subdivision are appropriated to the commissioner for the purpose of conducting
background studies.
new text end
Sec. 15.
Minnesota Statutes 2006, section 245C.11, subdivision 1, is amended to read:
Subdivision 1.
new text begin Adult new text end foster care; criminal conviction data.
For individuals who
are required to have background studies under section 245C.03, subdivisions 1 and 2, and
who have been continuously affiliated with deleted text begin adeleted text end new text begin an adultnew text end foster care provider that is licensed
in more than one county, criminal conviction data may be shared among those counties in
which thenew text begin adultnew text end foster care programs are licensed. A county agency's receipt of criminal
conviction data from another county agency shall meet the criminal data background
study requirements of this chapter.
Sec. 16.
Minnesota Statutes 2006, section 245C.11, subdivision 2, is amended to read:
Subd. 2.
Jointly licensed programs.
A county agency may accept a background
study completed by the commissioner under this chapter in place of the background study
required under section 245A.16, subdivision 3, in programs with joint licensure as home
and community-based services and adult foster care for people with developmental
disabilities when the license holder does not reside in thenew text begin adultnew text end foster care residence and
the subject of the study has been continuously affiliated with the license holder since the
date of the commissioner's study.
Sec. 17.
Minnesota Statutes 2006, section 245C.12, is amended to read:
245C.12 BACKGROUND STUDY; TRIBAL ORGANIZATIONS.
new text begin (a) new text end For the purposes of background studies completed by tribal organizations
performing licensing activities otherwise required of the commissioner under this chapter,
after obtaining consent from the background study subject, tribal licensing agencies shall
have access to criminal history data in the same manner as county licensing agencies and
private licensing agencies under this chapter.
new text begin
(b) Tribal organizations may contract with the commissioner to obtain background
study data on individuals under tribal jurisdiction related to adoptions according to
section 245C.34. Tribal organizations may also contract with the commissioner to obtain
background study data on individuals under tribal jurisdiction related to child foster care
according to section 245C.34.
new text end
Sec. 18.
Minnesota Statutes 2006, section 245C.16, subdivision 1, is amended to read:
Subdivision 1.
Determining immediate risk of harm.
(a) If the commissioner
determines that the individual studied has a disqualifying characteristic, the commissioner
shall review the information immediately available and make a determination as to the
subject's immediate risk of harm to persons served by the program where the individual
studied will have direct contact.
(b) The commissioner shall consider all relevant information available, including the
following factors in determining the immediate risk of harm:
(1) the recency of the disqualifying characteristic;
(2) the recency of discharge from probation for the crimes;
(3) the number of disqualifying characteristics;
(4) the intrusiveness or violence of the disqualifying characteristic;
(5) the vulnerability of the victim involved in the disqualifying characteristic;
(6) the similarity of the victim to the persons served by the program where the
individual studied will have direct contact; and
(7) whether the individual has a disqualification from a previous background study
that has not been set aside.
(c) This section does not apply when the subject of a background study is regulated
by a health-related licensing board as defined in chapter 214, and the subject is determined
to be responsible for substantiated maltreatment under section 626.556 or 626.557.
(d)new text begin This section does not apply to a background study related to an initial application
for a child foster care license.
new text end
new text begin (e) new text end If the commissioner has reason to believe, based on arrest information or an
active maltreatment investigation, that an individual poses an imminent risk of harm to
persons receiving services, the commissioner may order that the person be continuously
supervised or immediately removed pending the conclusion of the maltreatment
investigation or criminal proceedings.
Sec. 19.
Minnesota Statutes 2006, section 245C.17, is amended by adding a
subdivision to read:
new text begin Subd. 5. new text end
new text begin Notice to county or private agency. new text end
new text begin
For studies on individuals related to a
license to provide child foster care, the commissioner shall also provide a notice of the
background study results to the county or private agency that initiated the background
study.
new text end
Sec. 20.
Minnesota Statutes 2006, section 245C.21, is amended by adding a
subdivision to read:
new text begin Subd. 1a. new text end
new text begin
Submission of reconsideration request to county or private agency.
new text end
new text begin
(a) For disqualifications related to studies conducted by county agencies, and for
disqualifications related to studies conducted by the commissioner for child foster care,
the individual shall submit the request for reconsideration to the county or private agency
that initiated the background study.
new text end
new text begin
(b) A reconsideration request shall be submitted within 30 days of the individual's
receipt of the disqualification notice or the time frames specified in subdivision 2,
whichever time frame is shorter.
new text end
new text begin
(c) The county or private agency shall forward the individual's request for
reconsideration and provide the commissioner with a recommendation whether to set aside
the individual's disqualification.
new text end
Sec. 21.
Minnesota Statutes 2006, section 245C.23, subdivision 2, is amended to read:
Subd. 2.
Commissioner's notice of disqualification that is not set aside.
(a) The
commissioner shall notify the license holder of the disqualification and order the license
holder to immediately remove the individual from any position allowing direct contact
with persons receiving services from the license holder if:
(1) the individual studied does not submit a timely request for reconsideration
under section 245C.21;
(2) the individual submits a timely request for reconsideration, but the commissioner
does not set aside the disqualification for that license holder under section 245C.22;
(3) an individual who has a right to request a hearing under sections 245C.27 and
256.045, or 245C.28 and chapter 14 for a disqualification that has not been set aside, does
not request a hearing within the specified time; or
(4) an individual submitted a timely request for a hearing under sections 245C.27
and 256.045, or 245C.28 and chapter 14, but the commissioner does not set aside the
disqualification under section 245A.08, subdivision 5, or 256.045.
(b) If the commissioner does not set aside the disqualification under section 245C.22,
and the license holder was previously ordered under section 245C.17 to immediately
remove the disqualified individual from direct contact with persons receiving services or
to ensure that the individual is under continuous, direct supervision when providing direct
contact services, the order remains in effect pending the outcome of a hearing under
sections 245C.27 and 256.045, or 245C.28 and chapter 14.
new text begin
(c) For background studies related to child foster care, the commissioner shall
also notify the county or private agency that initiated the study of the results of the
reconsideration.
new text end
Sec. 22.
new text begin
[245C.33] ADOPTION BACKGROUND STUDY REQUIREMENTS.
new text end
new text begin Subdivision 1. new text end
new text begin Background studies conducted by commissioner. new text end
new text begin
Before
placement of a child for purposes of adoption, the commissioner shall conduct a
background study on individuals listed in section 259.41, subdivision 3, for county
agencies and private agencies licensed to place children for adoption.
new text end
new text begin Subd. 2. new text end
new text begin Information and data provided to county or private agency. new text end
new text begin
The subject
of the background study shall provide the information specified in section 245C.05.
new text end
new text begin Subd. 3. new text end
new text begin Information and data provided to commissioner. new text end
new text begin
The county or private
agency shall forward the data collected under subdivision 2 to the commissioner.
new text end
new text begin Subd. 4. new text end
new text begin Information commissioner reviews. new text end
new text begin
(a) The commissioner shall review
the following information regarding the background study subject:
new text end
new text begin
(1) the information under section 245C.08, subdivisions 1, 3, and 4;
new text end
new text begin
(2) information from the child abuse and neglect registry for any state in which the
subject has resided for the past five years; and
new text end
new text begin
(3) information from national crime information databases, when required under
section 245C.08.
new text end
new text begin
(b) The commissioner shall provide any information collected under this subdivision
to the county or private agency that initiated the background study. The commissioner
shall indicate if the information collected shows that the subject of the background study
has a conviction listed in United States Code, title 42, section 671(a)(20)(A).
new text end
Sec. 23.
new text begin
[245C.34] ADOPTION AND CHILD FOSTER CARE BACKGROUND
STUDIES; TRIBAL ORGANIZATIONS.
new text end
new text begin Subdivision 1. new text end
new text begin Background studies may be conducted by commissioner. new text end
new text begin
(a)
Tribal organizations may contract with the commissioner under section 245C.12 to obtain
background study data on individuals under tribal jurisdiction related to adoptions.
new text end
new text begin
(b) Tribal organizations may contract with the commissioner under section 245C.12
to obtain background study data on individuals under tribal jurisdiction related to child
foster care.
new text end
new text begin
(c) Background studies initiated by tribal organizations under paragraphs (a) and (b)
must be conducted as provided in subdivisions 2 and 3.
new text end
new text begin Subd. 2. new text end
new text begin Information and data provided to tribal organization. new text end
new text begin
The background
study subject must provide the information specified in section 245C.05.
new text end
new text begin Subd. 3. new text end
new text begin Information and data provided to commissioner. new text end
new text begin
The tribal organization
shall forward the data collected under subdivision 2 to the commissioner.
new text end
new text begin Subd. 4. new text end
new text begin Information commissioner reviews. new text end
new text begin
(a) The commissioner shall review
the following information regarding the background study subject:
new text end
new text begin
(1) the information under section 245C.08, subdivisions 1, 3, and 4;
new text end
new text begin
(2) information from the child abuse and neglect registry for any state in which the
subject has resided for the past five years; and
new text end
new text begin
(3) information from national crime information databases, when required under
section 245C.08.
new text end
new text begin
(b) The commissioner shall provide any information collected under this subdivision
to the tribal organization that initiated the background study. The commissioner shall
indicate if the information collected shows that the subject of the background study has a
conviction listed in United States Code, title 42, section 671(a)(20)(A).
new text end
Sec. 24.
Minnesota Statutes 2006, section 259.20, subdivision 2, is amended to read:
Subd. 2.
Other applicable law.
new text begin (a) new text end Portions of chapters 245A, 245C, 257, 260, and
317A may also affect the adoption of a particular child.
new text begin (b) new text end Provisions of the Indian Child Welfare Act, United States Code, title 25, chapter
21, sections 1901-1923, may also apply in the adoption of an Indian child, and may
preempt specific provisions of this chapter.
new text begin
(c) Consistent with section 245C.33 and Public Law 109-248, a completed
background study is required before the approval of any foster or adoptive placement in
a related or an unrelated home.
new text end
Sec. 25.
Minnesota Statutes 2006, section 259.29, subdivision 1, is amended to read:
Subdivision 1.
Best interests of the child.
(a) The policy of the state of Minnesota
is to ensure that the best interests of the child are met by requiring individualized
determination of the needs of the child and of how the adoptive placement will serve the
needs of the child.
(b) Among the factors the agency shall consider in determining the needs of the child
are those specified under section 260C.193, subdivision 3, paragraph (b).
new text begin
(c) Except for emergency placements provided for in section 245A.035, a completed
background study is required under section 245C.33 before the approval of an adoptive
placement in a home.
new text end
Sec. 26.
Minnesota Statutes 2006, section 259.41, is amended to read:
259.41 ADOPTION STUDY.
Subdivision 1.
Study required before placement; certain relatives excepted.
(a)
Annew text begin approvednew text end adoption studynew text begin ; completed background study, as required under section
245C.33;new text end and written report must be completed before the child is placed in a prospective
adoptive home under this chapter, except as allowed by section 259.47, subdivision 6.
In an agency placement, the report must be filed with the court at the time the adoption
petition is filed. In a direct adoptive placement, the report must be filed with the court in
support of a motion for temporary preadoptive custody under section 259.47, subdivision
3, or, if the study and report are complete, in support of an emergency order under section
259.47, subdivision 6. The study and report shall be completed by a licensed child-placing
agency and must be thorough and comprehensive. The study and report shall be paid for
by the prospective adoptive parent, except as otherwise required under section 259.67
or 259.73.
(b) A placement for adoption with an individual who is related to the child, as
defined by section 245A.02, subdivision 13, is not subject to this section except as required
by deleted text begin sectiondeleted text end new text begin sections 245C.33 andnew text end 259.53, subdivision 2, paragraph (c).
(c) In the case of a licensed foster parent seeking to adopt a child who is in the foster
parent's care, any portions of the foster care licensing process that duplicate requirements
of the home study may be submitted in satisfaction of the relevant requirements of this
section.
Subd. 2.
Form of study.
(a) The adoption study must include at least one in-home
visit with the prospective adoptive parent. At a minimum, the study must deleted text begin includedeleted text end new text begin
documentnew text end the followingnew text begin informationnew text end about the prospective adoptive parent:
(1) a background deleted text begin checkdeleted text end new text begin studynew text end as required by subdivision 3new text begin and section 245C.33new text end ,
deleted text begin anddeleted text end new text begin including:
new text end
new text begin (i)new text end an deleted text begin evaluationdeleted text end new text begin assessment of the data and information provided by section
245C.33, subdivision 4, to determine if the prospective adoptive parent and any other
person over the age of 13 living in the home has a felony conviction consistent with
subdivision 3 and section 471(a)(2) of the Social Security Act; and
new text end
new text begin (ii) an assessmentnew text end of the effect of deleted text begin adeleted text end new text begin anynew text end conviction or finding of substantiated
maltreatment on the deleted text begin ability todeleted text end new text begin capacity of the prospective adoptive parent to safelynew text end care
fornew text begin and parentnew text end a child;
(2) a medical and social history and assessment of current health;
(3) an assessment of potential parenting skills;
(4) an assessment of ability to provide adequate financial support for a child; and
(5) an assessment of the level of knowledge and awareness of adoption issues
including, where appropriate, matters relating to interracial, cross-cultural, and special
needs adoptions.
(b) The adoption study is the basis for completion of a written report. The report
must be in a format specified by the commissioner and must contain recommendations
regarding the suitability of the subject of the study to be an adoptive parent.
Subd. 3.
Background deleted text begin check; affidavit of historydeleted text end new text begin studynew text end .
(a) At the time an adoption
study is commenced, each prospective adoptive parent must:
(1) authorize access by the agency to any private data needed to complete the study;
(2) provide all addresses at which the prospective adoptive parent and anyone in the
household over the age of 13 has resided in the previous five years; and
(3) disclose any names used previously other than the name used at the time of
the study.
(b) When the requirements of paragraph (a) have been met, the agency shall
immediately deleted text begin begindeleted text end new text begin initiatenew text end a background deleted text begin check,deleted text end new text begin study under section 245C.33 to be
completed by the commissionernew text end on each person over the age of 13 living in the homedeleted text begin ,
consisting, at a minimum, of the following:deleted text end new text begin . As required under section 245C.33 and Public
Law 109-248, a completed background study is required before the approval of any foster
or adoptive placement in a related or an unrelated home. The required background study
must be completed as part of the home study.
new text end
deleted text begin
(1) a check of criminal conviction data with the Bureau of Criminal Apprehension
and local law enforcement authorities;
deleted text end
deleted text begin
(2) a check for data on substantiated maltreatment of a child or vulnerable adult
and domestic violence data with local law enforcement and social services agencies and
district courts; and
deleted text end
deleted text begin
(3) for those persons under the age of 25, a check of juvenile court records.
deleted text end
deleted text begin
Notwithstanding the provisions of section or , the Bureau of
Criminal Apprehension, local law enforcement and social services agencies, district courts,
and juvenile courts shall release the requested information to the agency completing
the adoption study.
deleted text end
deleted text begin
(c) When paragraph (b) requires checking the data or records of local law
enforcement and social services agencies and district and juvenile courts, the agency
shall check with the law enforcement and social services agencies and courts whose
jurisdictions cover the addresses under paragraph (a), clause (2). In the event that the
agency is unable to complete any of the record checks required by paragraph (b), the
agency shall document the fact and the agency's efforts to obtain the information.
deleted text end
deleted text begin
(d) For a study completed under this section, when the agency has reasonable
cause to believe that further information may exist on the prospective adoptive parent or
household member over the age of 13 that may relate to the health, safety, or welfare of
the child, the prospective adoptive parent or household member over the age of 13 shall
provide the agency with a set of classifiable fingerprints obtained from an authorized law
enforcement agency and the agency may obtain criminal history data from the National
Criminal Records Repository by submitting fingerprints to the Bureau of Criminal
Apprehension. The agency has reasonable cause when, but not limited to, the:
deleted text end
deleted text begin
(1) information from the Bureau of Criminal Apprehension indicates that the
prospective adoptive parent or household member over the age of 13 is a multistate
offender;
deleted text end
deleted text begin
(2) information from the Bureau of Criminal Apprehension indicates that multistate
offender status is undetermined;
deleted text end
deleted text begin
(3) the agency has received a report from the prospective adoptive parent or
household member over the age of 13 or a third party indicating that the prospective
adoptive parent or household member over the age of 13 has a criminal history in a
jurisdiction other than Minnesota; or
deleted text end
deleted text begin
(4) the prospective adoptive parent or household member over the age of 13 is or has
been a resident of a state other than Minnesota in the prior five years.
deleted text end
deleted text begin
(e) At any time prior to completion of the background check required under
paragraph (b), a prospective adoptive parent may submit to the agency conducting the
study a sworn affidavit stating whether they or any person residing in the household have
been convicted of a crime. The affidavit shall also state whether the adoptive parent or any
other person residing in the household is the subject of an open investigation of, or have
been the subject of a substantiated allegation of, child or vulnerable-adult maltreatment
within the past ten years. A complete description of the crime, open investigation, or
substantiated abuse, and a complete description of any sentence, treatment, or disposition
must be included. The affidavit must contain an acknowledgment that if, at any time
before the adoption is final, a court receives evidence leading to a conclusion that a
prospective adoptive parent knowingly gave false information in the affidavit, it shall be
determined that the adoption of the child by the prospective adoptive parent is not in the
best interests of the child.
deleted text end
deleted text begin
(f) For the purposes of subdivision 1 and section deleted text begin 259.47, subdivisions 3 and 6deleted text end , an
adoption study is complete for placement, even though the background checks required by
paragraph (b) have not been completed, if each prospective adoptive parent has completed
the affidavit allowed by paragraph (e) and the other requirements of this section have been
met. The background checks required by paragraph (b) must be completed before an
adoption petition is filed. If an adoption study has been submitted to the court under section
deleted text begin 259.47, subdivision 3deleted text end or 6, before the background checks required by paragraph (b) were
complete, an updated adoption study report which includes the results of the background
check must be filed with the adoption petition. In the event that an agency is unable to
complete any of the records checks required by paragraph (b), the agency shall submit with
the petition to adopt an affidavit documenting the agency's efforts to complete the checks.
deleted text end
new text begin
(c) A home study under paragraph (b) used to consider placement of any child
on whose behalf Title IV-E adoption assistance payments are to be made must not be
approved if a background study reveals a felony conviction at any time for:
new text end
new text begin
(1) child abuse or neglect;
new text end
new text begin
(2) spousal abuse;
new text end
new text begin
(3) a crime against children, including child pornography; or
new text end
new text begin
(4) a crime involving violence, including rape, sexual assault, or homicide, but not
including other physical assault or battery.
new text end
new text begin
(d) A home study under paragraph (b) used to consider placement of any child
on whose behalf Title IV-E adoption assistance payments are to be made must not be
approved if a background study reveals a felony conviction within the past five years for:
new text end
new text begin
(1) physical assault or battery; or
new text end
new text begin
(2) a drug-related offense.
new text end
Subd. 4.
Updates to adoption study; period of validity.
An agency may update
an adoption study and report as needed, regardless of when the original study and report
or most recent update was completed. An update must be in a format specified by the
commissioner and must verify the continuing accuracy of the elements of the original
report and document any changes to elements of the original report. An update to a study
and report not originally completed under this section must ensure that the study and
report, as updated, meet the requirements of this section. An adoption study is valid if the
report has been completed or updated within the previous 12 months.
Sec. 27.
Minnesota Statutes 2006, section 259.53, subdivision 2, is amended to read:
Subd. 2.
Adoption agencies; postplacement assessment and report.
(a) The
agency to which the petition has been referred under subdivision 1 shall conduct a
postplacement assessment and file a report with the court within 90 days of receipt
of a copy of the adoption petition. The agency shall send a copy of the report to the
commissioner at the time it files the report with the court. The assessment and report
must evaluate the environment and antecedents of the child to be adopted, the home of
the petitioners, whether placement with the petitioners meets the needs of the child as
described in section 259.57, subdivision 2. The report must include a recommendation to
the court as to whether the petition should or should not be granted.
In making evaluations and recommendations, the postplacement assessment and
report must, at a minimum, address the following:
(1) the level of adaptation by the prospective adoptive parents to parenting the child;
(2) the health and well-being of the child in the prospective adoptive parents' home;
(3) the level of incorporation by the child into the prospective adoptive parents'
home, extended family, and community; and
(4) the level of inclusion of the child's previous history into the prospective adoptive
home, such as cultural or ethnic practices, or contact with former foster parents or
biological relatives.
(b) A postplacement adoption report is valid for 12 months following its date
of completion.
deleted text begin
(c) If the petitioner is an individual who is related to the child, as defined by section
deleted text begin 245A.02, subdivision 13deleted text end , the agency, as part of its postplacement assessment and report
under paragraph (a), shall conduct a background check meeting the requirements of
section deleted text begin 259.41, subdivision 3deleted text end , paragraph (b). The prospective adoptive parent shall
cooperate in the completion of the background check by supplying the information and
authorizations described in section deleted text begin 259.41, subdivision 3deleted text end , paragraph (a).
deleted text end
deleted text begin (d)deleted text end new text begin (c)new text end If the report recommends that the court not grant the petition to adopt the
child, the provisions of this paragraph apply. Unless the assessment and report were
completed by the local social services agency, the agency completing the report, at the
time it files the report with the court under paragraph (a), must provide a copy of the report
to the local social services agency in the county where the prospective adoptive parent
lives. The agency or local social services agency may recommend that the court dismiss
the petition. If the local social services agency determines that continued placement in the
home endangers the child's physical or emotional health, the agency shall seek a court
order to remove the child from the home.
deleted text begin (e)deleted text end new text begin (d)new text end If, through no fault of the petitioner, the agency to whom the petition was
referred under subdivision 1, paragraph (b), fails to complete the assessment and file the
report within 90 days of the date it received a copy of the adoption petition, the court may
hear the petition upon giving the agency and the local social services agency, if different,
five days' notice by mail of the time and place of the hearing.
Sec. 28.
Minnesota Statutes 2006, section 259.57, subdivision 2, is amended to read:
Subd. 2.
Protection of child's best interests.
(a) The policy of the state of
Minnesota is to ensure that the best interests of children are met by requiring an
individualized determination of the needs of the child and how the adoptive placement
will serve the needs of the child.
(b) Among the factors the court shall consider in determining the needs of the child
are those specified under section 260C.193, subdivision 3, paragraph (b).new text begin Consistent with
section 245C.33 and Public Law 109-248, a complete background study is required before
the approval of an adoptive placement in a home.
new text end
(c) In reviewing adoptive placement and in determining appropriate adoption,
the court shall consider placement, consistent with the child's best interests and in the
following order, with (1) a relative or relatives of the child, or (2) an important friend with
whom the child has resided or had significant contact. Placement of a child cannot be
delayed or denied based on race, color, or national origin of the adoptive parent or the
child. Whenever possible, siblings should be placed together unless it is determined
not to be in the best interests of a sibling.
(d) If the child's birth parent or parents explicitly request that relatives and important
friends not be considered, the court shall honor that request consistent with the best
interests of the child.
If the child's birth parent or parents express a preference for placing the child in an
adoptive home of the same or a similar religious background to that of the birth parent
or parents, the court shall place the child with a family that also meets the birth parent's
religious preference. Only if no family is available as described in clause (a) or (b)
may the court give preference to a family described in clause (c) that meets the parent's
religious preference.
(e) This subdivision does not affect the Indian Child Welfare Act, United States
Code, title 25, sections 1901 to 1923, and the Minnesota Indian Family Preservation
Act, sections 260.751 to 260.835.
Sec. 29.
Minnesota Statutes 2006, section 260C.209, is amended to read:
260C.209 BACKGROUND CHECKS.
Subdivision 1.
Subjects.
The responsible social services agency must deleted text begin conductdeleted text end new text begin
initiatenew text end a background deleted text begin checkdeleted text end new text begin study to be completed by the commissionernew text end under deleted text begin this section
ofdeleted text end new text begin chapter 245C onnew text end the followingnew text begin individualsnew text end :
(1) a noncustodial parent or nonadjudicated parent who is being assessed for
purposes of providing day-to-day care of a child temporarily or permanently under section
260C.212, subdivision 4, and any member of the parent's household who is over the age of
13 when there is a reasonable cause to believe that the parent or household member over
age 13 has a criminal history or a history of maltreatment of a child or vulnerable adult
which would endanger the child's health, safety, or welfare;
(2) an individual whose suitability for relative placement under section 260C.212,
subdivision 5, is being determined and any member of the relative's household who is
over the age of 13 when:
(i) the relative must be licensed for foster care; or
(ii) the deleted text begin agency must conduct adeleted text end background studynew text begin is requirednew text end under section 259.53,
subdivision 2; or
(iii) the agencynew text begin or the commissionernew text end has reasonable cause to believe the relative
or household member over the age of 13 has a criminal history which would not make
transfer of permanent legal and physical custody to the relative under section 260C.201,
subdivision 11, in the child's best interest; and
(3) a parent, following an out-of-home placement, when the responsible social
services agency has reasonable cause to believe that the parent has been convicted of a
crime directly related to the parent's capacity to maintain the child's health, safety, or
welfare or the parent is the subject of an open investigation of, or has been the subject
of a substantiated allegation of, child or vulnerable-adult maltreatment within the past
ten years.
"Reasonable cause" means that the agency has received information or a report from the
subject or a third person that creates an articulable suspicion that the individual has a
history that may pose a risk to the health, safety, or welfare of the child. The information
or report must be specific to the potential subject of the background check and shall not
be based on the race, religion, ethnic background, age, class, or lifestyle of the potential
subject.
Subd. 2.
General procedures.
(a) When deleted text begin conductingdeleted text end new text begin initiatingnew text end a background check
under subdivision 1, the agency deleted text begin maydeleted text end new text begin shallnew text end require the individual being assessed to provide
sufficient information to ensure an accurate assessment under this section, including:
(1) the individual's first, middle, and last name and all other names by which the
individual has been known;
(2) home address, zip code, city, county, and state of residence for the past deleted text begin tendeleted text end new text begin fivenew text end
years;
(3) sex;
(4) date of birth; and
(5) driver's license number or state identification number.
(b) When notified by thenew text begin commissioner or thenew text end responsible social services agency that
it is conducting an assessment under this section, the Bureau of Criminal Apprehension,
commissioners of health and human services, law enforcement, and county agencies must
provide thenew text begin commissioner or thenew text end responsible social services agency or county attorney
with the following information on the individual being assessed: criminal history data,
reports about the maltreatment of adults substantiated under section 626.557, and reports
of maltreatment of minors substantiated under section 626.556.
Subd. 3.
Multistate information.
deleted text begin (a)deleted text end For deleted text begin any assessmentdeleted text end new text begin every background studynew text end
completed under this section, deleted text begin if the responsible social services agency has reasonable
cause to believe that the individual is a multistate offender, the individual mustdeleted text end new text begin the subject
of the background study shallnew text end provide the responsible social services agency deleted text begin or the
county attorneydeleted text end with a set of classifiable fingerprints obtained from an authorized deleted text begin law
enforcementdeleted text end agency. The responsible social services agency deleted text begin or county attorney maydeleted text end new text begin shall
provide the fingerprints to the commissioner, and the commissioner shallnew text end obtain criminal
history data from the National Criminal Records Repository by submitting the fingerprints
to the Bureau of Criminal Apprehension.
deleted text begin
(b) For purposes of this subdivision, the responsible social services agency has
reasonable cause when, but not limited to:
deleted text end
deleted text begin
(1) information from the Bureau of Criminal Apprehension indicates that the
individual is a multistate offender;
deleted text end
deleted text begin
(2) information from the Bureau of Criminal Apprehension indicates that multistate
offender status is undetermined;
deleted text end
deleted text begin
(3) the social services agency has received a report from the individual or a third
party indicating that the individual has a criminal history in a jurisdiction other than
Minnesota; or
deleted text end
deleted text begin
(4) the individual is or has been a resident of a state other than Minnesota at any
time during the prior ten years.
deleted text end
Subd. 4.
Notice upon receipt.
The deleted text begin responsible social services agencydeleted text end new text begin commissionernew text end
must provide the subject of the background study with the results of the studynew text begin as requirednew text end
under deleted text begin this section within 15 business days of receipt or at least 15 days prior to the hearing
at which the results will be presented, whichever comes first. The subject may provide
written information to the agency that the results are incorrect and may provide additional
or clarifying information to the agency and to the court through a party to the proceeding.
This provision does not apply to any background study conducted under chapters 245A
anddeleted text end new text begin chapternew text end 245C.
Sec. 30.
Minnesota Statutes 2006, section 260C.212, subdivision 2, is amended to read:
Subd. 2.
Placement decisions based on best interest of the child.
(a) The policy
of the state of Minnesota is to ensure that the child's best interests are met by requiring an
individualized determination of the needs of the child and of how the selected placement
will serve the needs of the child being placed. The authorized child-placing agency shall
place a child, released by court order or by voluntary release by the parent or parents, in
a family foster home selected by considering placement with relatives and important
friends in the following order:
(1) with an individual who is related to the child by blood, marriage, or adoption; or
(2) with an individual who is an important friend with whom the child has resided or
had significant contact.
(b) Among the factors the agency shall consider in determining the needs of the
child are the following:
(1) the child's current functioning and behaviors;
(2) the medical, educational, and developmental needs of the child;
(3) the child's history and past experience;
(4) the child's religious and cultural needs;
(5) the child's connection with a community, school, and church;
(6) the child's interests and talents;
(7) the child's relationship to current caretakers, parents, siblings, and relatives; and
(8) the reasonable preference of the child, if the court, or the child-placing agency
in the case of a voluntary placement, deems the child to be of sufficient age to express
preferences.
(c) Placement of a child cannot be delayed or denied based on race, color, or national
origin of the foster parent or the child.
(d) Siblings should be placed together for foster care and adoption at the earliest
possible time unless it is determined not to be in the best interests of a sibling or unless it
is not possible after appropriate efforts by the responsible social services agency.
new text begin
(e) Except for emergency placement as provided for in section 245A.035, a
completed background study is required under section 245C.08 before the approval of a
foster placement in a related or unrelated home.
new text end
Sec. 31. new text begin LICENSING MORATORIUM.
new text end
new text begin
A program operated by a nonpublic school for children 33 months or older is
exempt from the human services licensing requirements in Minnesota Statutes, chapter
245A, until July 1, 2009. Nothing in this section prohibits an already licensed nonpublic
school program from continuing its licensure or a nonpublic school program from seeking
licensure.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This moratorium is effective the day following final
enactment.
new text end
Sec. 32. new text begin ANNUAL LICENSE REVIEW.
new text end
new text begin
The commissioner of human services shall work with counties to determine the cost
and propose an ongoing funding allocation from the general fund to cover the cost to
counties to implement an annual license review for licensed family child care providers.
The commissioner shall solicit input from counties to determine the outcome. The
commissioner shall report to the house and senate committees having jurisdiction over
early childhood programs by January 15, 2008, as to the costs and the funding allocation
recommended for future use.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
ARTICLE 4
HEALTH CARE POLICY
Section 1.
Minnesota Statutes 2006, section 16A.724, subdivision 2, is amended to
read:
Subd. 2.
Transfers.
(a) Notwithstanding section 295.581, to the extent available
resources in the health care access fund exceed expenditures in that fund, effective deleted text begin withdeleted text end
new text begin for new text end the biennium beginning July 1, 2007, the commissioner of finance shall transfer the
excess funds from the health care access fund to the general fund on June 30 of each year,
provided that the amount transferred in any fiscal biennium shall not exceed $96,000,000.new text begin
The purpose of this transfer is to meet the rate increase required under Laws 2003, First
Special Session chapter 14, article 13C, section 2, subdivision 6.
new text end
(b) For fiscal years 2006 to 2009, MinnesotaCare shall be a forecasted program, and,
if necessary, the commissioner shall reduce these transfers from the health care access
fund to the general fund to meet annual MinnesotaCare expenditures or, if necessary,
transfer sufficient funds from the general fund to the health care access fund to meet
annual MinnesotaCare expenditures.
Sec. 2.
new text begin
[254A.171] INTERVENTION AND ADVOCACY PROGRAM.
new text end
new text begin
Within the limit of money available, the commissioner shall fund voluntary outreach
programs targeted at women who deliver children affected by prenatal alcohol or drug use.
The programs shall help women obtain treatment, stay in recovery, and plan any future
pregnancies. An advocate shall be assigned to each woman in the program to provide
guidance and advice with respect to treatment programs, child safety and parenting,
housing, family planning, and any other personal issues that are barriers to remaining free
of chemical dependency.
new text end
Sec. 3.
Minnesota Statutes 2006, section 256B.055, subdivision 14, is amended to read:
Subd. 14.
Persons detained by law.
(a) Medical assistance may be paid for an
inmate of a correctional facility who is conditionally released as authorized under section
241.26, 244.065, or 631.425, if the individual does not require the security of a public
detention facility and is housed in a halfway house or community correction center, or
under house arrest and monitored by electronic surveillance in a residence approved
by the commissioner of corrections, and if the individual meets the other eligibility
requirements of this chapter.
(b) new text begin An individual who is enrolled in medical assistance, and who is charged with a
crime and incarcerated for less than 12 months shall be suspended from eligibility at the
time of incarceration until the individual is released. Upon release, medical assistance
eligibility is reinstated without reapplication using a reinstatement process and form, if the
individual is otherwise eligible.
new text end
new text begin (c) new text end An individual, regardless of age, who is considered an inmate of a public
institution as defined in Code of Federal Regulations, title 42, section 435.1009, is not
eligible for medical assistance.
Sec. 4.
Minnesota Statutes 2006, section 256B.056, is amended by adding a
subdivision to read:
new text begin Subd. 1d. new text end
new text begin Treatment of certain monetary gifts. new text end
new text begin
The commissioner shall disregard
as income any portion of a monetary gift received by an applicant or enrollee that is
designated to purchase a prosthetic device not covered by insurance, other third-party
payers, or medical assistance.
new text end
Sec. 5.
Minnesota Statutes 2006, section 256B.0625, subdivision 13c, is amended to
read:
Subd. 13c.
Formulary committee.
The commissioner, after receiving
recommendations from professional medical associations and professional pharmacy
associations, and consumer groups shall designate a Formulary Committee to carry
out duties as described in subdivisions 13 to 13g. The Formulary Committee shall be
comprised of four licensed physicians actively engaged in the practice of medicine in
Minnesota one of whom must be actively engaged in the treatment of persons with mental
illness; at least three licensed pharmacists actively engaged in the practice of pharmacy
in Minnesota; and one consumer representative; the remainder to be made up of health
care professionals who are licensed in their field and have recognized knowledge in the
clinically appropriate prescribing, dispensing, and monitoring of covered outpatient drugs.
Members of the Formulary Committee shall not be employed by the Department of
Human Services, but the committee shall be staffed by an employee of the department
who shall serve as an ex officio, nonvoting member of the deleted text begin boarddeleted text end new text begin committeenew text end . The
department's medical director shall also serve as an ex officio, nonvoting member for the
committee. Committee members shall serve three-year terms and may be reappointed
by the commissioner. The Formulary Committee shall meet at least quarterly. The
commissioner may require more frequent Formulary Committee meetings as needed. An
honorarium of $100 per meeting and reimbursement for mileage shall be paid to each
committee member in attendance.
Sec. 6.
Minnesota Statutes 2006, section 256B.0625, subdivision 13d, is amended to
read:
Subd. 13d.
Drug formulary.
new text begin (a) new text end The commissioner shall establish a drug
formulary. Its establishment and publication shall not be subject to the requirements of the
Administrative Procedure Act, but the Formulary Committee shall review and comment
on the formulary contents.
new text begin (b) new text end The formulary shall not include:
(1) drugs or products for which there is no federal funding;
(2) over-the-counter drugs, except as provided in subdivision 13;
(3) drugs used for weight loss, except that medically necessary lipase inhibitors may
be covered for a recipient with type II diabetes;
(4) drugs when used for the treatment of impotence or erectile dysfunction;
(5) drugs for which medical value has not been established; and
(6) drugs from manufacturers who have not signed a rebate agreement with the
Department of Health and Human Services pursuant to section 1927 of title XIX of the
Social Security Act.
new text begin
(c) If a single-source drug used by at least two percent of the fee-for-service
medical assistance recipients is removed from the formulary due to the failure of the
manufacturer to sign a rebate agreement with the Department of Health and Human
Services, the commissioner shall notify prescribing practitioners within 30 days of
receiving notification from the Centers for Medicare and Medicaid Services (CMS) that a
rebate agreement was not signed.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 7.
Minnesota Statutes 2006, section 256B.0625, is amended by adding a
subdivision to read:
new text begin Subd. 49. new text end
new text begin Community health worker. new text end
new text begin
(a) Medical assistance covers the care
coordination and patient education services provided by a community health worker if
the community health worker has:
new text end
new text begin
(1) received a certificate from the Minnesota State Colleges and Universities System
approved community health worker curriculum; or
new text end
new text begin
(2) at least five years of supervised experience with an enrolled physician, registered
nurse, or advanced practice registered nurse.
new text end
new text begin
Community health workers eligible for payment under clause (2) must complete the
certification program by January 1, 2010, to continue to be eligible for payment.
new text end
new text begin
(b) Community health workers must work under the supervision of a medical
assistance enrolled physician, registered nurse, or advanced practice registered nurse.
new text end
Sec. 8.
Minnesota Statutes 2006, section 256L.03, subdivision 5, is amended to read:
Subd. 5.
Co-payments and coinsurance.
(a) Except as provided in paragraphs (b)
and (c), the MinnesotaCare benefit plan shall include the following co-payments and
coinsurance requirements for all enrollees:
(1) ten percent of the paid charges for inpatient hospital services for adult enrollees,
subject to an annual inpatient out-of-pocket maximum of $1,000 per individual and
$3,000 per family;
(2) $3 per prescription for adult enrollees;
(3) $25 for eyeglasses for adult enrollees;
(4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an
episode of service which is required because of a recipient's symptoms, diagnosis, or
established illness, and which is delivered in an ambulatory setting by a physician or
physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse,
audiologist, optician, or optometrist; and
(5) $6 for nonemergency visits to a hospital-based emergency room.
(b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of
children under the age of 21 in households with family income equal to or less than 175
percent of the federal poverty guidelines. Paragraph (a), clause (1), does not apply to
parents and relative caretakers of children under the age of 21 in households with family
income greater than 175 percent of the federal poverty guidelines for inpatient hospital
admissions occurring on or after January 1, 2001.
(c) Paragraph (a)deleted text begin , clauses (1) to (4), dodeleted text end new text begin does new text end not apply to pregnant women and
children under the age of 21.
(d) Adult enrollees with family gross income that exceeds 175 percent of the
federal poverty guidelines and who are not pregnant shall be financially responsible for
the coinsurance amount, if applicable, and amounts which exceed the $10,000 inpatient
hospital benefit limit.
(e) When a MinnesotaCare enrollee becomes a member of a prepaid health plan,
or changes from one prepaid health plan to another during a calendar year, any charges
submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket
expenses incurred by the enrollee for inpatient services, that were submitted or incurred
prior to enrollment, or prior to the change in health plans, shall be disregarded.
Sec. 9.
Minnesota Statutes 2006, section 256L.04, subdivision 12, is amended to read:
Subd. 12.
Persons in detention.
Beginning January 1, 1999, an applicant residing
in a correctional or detention facility is not eligible for MinnesotaCare. An enrollee
residing in a correctional or detention facility is not eligible at renewal of eligibility under
section 256L.05, subdivision deleted text begin 3bdeleted text end new text begin 3anew text end .
Sec. 10.
Minnesota Statutes 2006, section 256L.17, subdivision 3, is amended to read:
Subd. 3.
Documentation.
(a) The commissioner of human services shall require
individuals and families, at the time of application or renewal, to indicate on a checkoff
form developed by the commissioner whether they satisfy the MinnesotaCare asset
requirement. deleted text begin This form must include the following or similar language: "To be eligible for
MinnesotaCare, individuals and families must not own net assets in excess of $30,000
for a household of two or more persons or $15,000 for a household of one person, not
including a homestead, household goods and personal effects, assets owned by children,
vehicles used for employment, court-ordered settlements up to $10,000, individual
retirement accounts, and capital and operating assets of a trade or business up to $200,000.
Do you and your household own net assets in excess of these limits?"
deleted text end
(b) The commissioner may require individuals and families to provide any
information the commissioner determines necessary to verify compliance with the asset
requirement, if the commissioner determines that there is reason to believe that an
individual or family has assets that exceed the program limit.
ARTICLE 5
HEALTH CARE
Section 1.
Minnesota Statutes 2006, section 16A.724, subdivision 2, is amended to
read:
Subd. 2.
Transfers.
(a) Notwithstanding section 295.581, to the extent available
resources in the health care access fund exceed expenditures in that fund, effective deleted text begin withdeleted text end
new text begin for new text end the biennium beginning July 1, 2007, the commissioner of finance shall transfer the
excess funds from the health care access fund to the general fund on June 30 of each year,
provided that the amount transferred in any fiscal biennium shall not exceed $96,000,000.new text begin
The purpose of this transfer is to meet the rate increase required under Laws 2003, First
Special Session chapter 14, article 13C, section 2, subdivision 6.
new text end
(b) For fiscal years 2006 to deleted text begin 2009deleted text end new text begin 2011new text end , MinnesotaCare shall be a forecasted
program, and, if necessary, the commissioner shall reduce these transfers from the health
care access fund to the general fund to meet annual MinnesotaCare expenditures or, if
necessary, transfer sufficient funds from the general fund to the health care access fund to
meet annual MinnesotaCare expenditures.
Sec. 2.
new text begin
[256.962] MINNESOTA HEALTH CARE PROGRAMS OUTREACH.
new text end
new text begin Subdivision 1. new text end
new text begin Public awareness and education. new text end
new text begin
The commissioner, in consultation
with community organizations, health plans, and other public entities experienced in
outreach to the uninsured, shall design and implement a statewide campaign to raise public
awareness on the availability of health coverage through medical assistance, general
assistance medical care, and MinnesotaCare and to educate the public on the importance of
obtaining and maintaining health care coverage. The campaign shall include multimedia
messages directed to the general population.
new text end
new text begin Subd. 2. new text end
new text begin Outreach grants. new text end
new text begin
(a) The commissioner shall award grants to public and
private organizations, regional collaboratives, and regional health care outreach centers
for outreach activities, including, but not limited to:
new text end
new text begin
(1) providing information, applications, and assistance in obtaining coverage
through Minnesota public health care programs;
new text end
new text begin
(2) collaborating with public and private entities such as hospitals, providers, health
plans, legal aid offices, pharmacies, insurance agencies, and faith-based organizations to
develop outreach activities and partnerships to ensure the distribution of information
and applications and provide assistance in obtaining coverage through Minnesota health
care programs; and
new text end
new text begin
(3) providing or collaborating with public and private entities to provide multilingual
and culturally specific information and assistance to applicants in areas of high
uninsurance in the state or populations with high rates of uninsurance.
new text end
new text begin
(b) The commissioner shall ensure that all outreach materials are available in
languages other than English.
new text end
new text begin
(c) The commissioner shall establish an outreach trainer program to provide
training to designated individuals from the community and public and private entities on
application assistance in order for these individuals to provide training to others in the
community on an as-needed basis.
new text end
new text begin Subd. 3. new text end
new text begin Application and assistance. new text end
new text begin
(a) The Minnesota health care programs
application must be made available at provider offices, local human services agencies,
school districts, public and private elementary schools in which 25 percent or more of
the students receive free or reduced price lunches, community health offices, Women,
Infants and Children (WIC) program sites, Head Start program sites, public housing
councils, child care centers, early childhood education and preschool program sites, legal
aid offices, and libraries. The commissioner shall ensure that applications are available
in languages other than English.
new text end
new text begin
(b) Local human service agencies, hospitals, and health care community clinics
receiving state funds must provide direct assistance in completing the application
form, including the free use of a copy machine and a drop box for applications. These
locations must ensure that the drop box is checked at least weekly and any applications
are submitted to the commissioner. The commissioner shall provide these entities with
an identification number to stamp on each application to identify the entity that provided
assistance. Other locations where applications are required to be available shall either
provide direct assistance in completing the application form or provide information on
where an applicant can receive application assistance.
new text end
new text begin
(c) Counties must offer applications and application assistance when providing
child support collection services.
new text end
new text begin
(d) Local public health agencies and counties that provide immunization clinics must
offer applications and application assistance during these clinics.
new text end
new text begin
(e) The commissioner shall coordinate with the commissioner of health to ensure
that maternal and child health outreach efforts include information on Minnesota health
care programs and application assistance, when needed.
new text end
new text begin Subd. 4. new text end
new text begin Statewide toll-free telephone number. new text end
new text begin
The commissioner shall provide
funds for a statewide toll-free telephone number to provide information on public and
private health coverage options and sources of free and low-cost health care. The
statewide telephone number must provide the option of obtaining this information in
languages other than English.
new text end
new text begin Subd. 5. new text end
new text begin Incentive program. new text end
new text begin
Beginning January 1, 2008, the commissioner
shall establish an incentive program for organizations that directly identify and assist
potential enrollees in filling out and submitting an application. For each applicant who is
successfully enrolled in MinnesotaCare, medical assistance, or general assistance medical
care, the commissioner, within the available appropriation, shall pay the organization
a $20 application assistance bonus. The organization may provide an applicant a gift
certificate or other incentive upon enrollment.
new text end
new text begin Subd. 6. new text end
new text begin School districts. new text end
new text begin
(a) At the beginning of each school year, a school district
shall provide information to each student on the availability of health care coverage
through the Minnesota health care programs.
new text end
new text begin
(b) For each child who is determined to be eligible for a free or reduced priced lunch,
the district shall provide the child's family with an application for the Minnesota health
care programs and information on how to obtain application assistance.
new text end
new text begin
(c) A district shall also ensure that applications and information on application
assistance are available at early childhood education sites and public schools located
within the district's jurisdiction.
new text end
new text begin
(d) Each district shall designate an enrollment specialist to provide application
assistance and follow-up services with families who are eligible for the reduced or free
lunch program or who have indicated an interest in receiving information or an application
for the Minnesota health care program.
new text end
new text begin
(e) Each school district shall provide on their Web site a link to information on how
to obtain an application and application assistance.
new text end
new text begin Subd. 7. new text end
new text begin Renewal notice. new text end
new text begin
(a) Beginning December 1, 2007, the commissioner shall
mail a renewal notice to enrollees notifying the enrollees that the enrollees eligibility must
be renewed. A notice shall be sent at least 90 days prior to the renewal date and at least
60 days prior to the renewal date.
new text end
new text begin
(b) For enrollees who are receiving services through managed care plans, the
managed care plan must provide a follow-up renewal call at least 60 days prior to the
enrollees' renewal dates.
new text end
new text begin
(c) The commissioner shall include the end of coverage dates on the monthly rosters
of enrollees provided to managed care organizations.
new text end
Sec. 3.
new text begin
[256.963] PRIMARY CARE ACCESS INITIATIVE.
new text end
new text begin Subdivision 1. new text end
new text begin Establishment. new text end
new text begin
(a) The commissioner shall award a grant to
implement in Hennepin and Ramsey Counties a Web-based primary care access pilot
project designed as a collaboration between private and public sectors to connect, where
appropriate, a patient with a primary care medical home, and schedule patients into
available community-based appointments as an alternative to nonemergency use of the
hospital emergency room. The grantee must establish a program that diverts patients
presenting at an emergency room for nonemergency care to more appropriate outpatient
settings. The program must refer the patient to an appropriate health care professional
based on the patient's health care needs and situation. The program must provide the
patient with a scheduled appointment that is timely, with an appropriate provider who is
conveniently located. If the patient is uninsured and potentially eligible for a Minnesota
health care program, the program must connect the patient to a primary care provider,
community clinic, or agency that can assist the patient with the application process. The
program must also ensure that discharged patients are connected with a community-based
primary care provider and assist in scheduling any necessary follow-up visits before
the patient is discharged.
new text end
new text begin
(b) The program must not require a provider to pay a fee for accepting charity care
patients or patients enrolled in a Minnesota public health care program.
new text end
new text begin Subd. 2. new text end
new text begin Evaluation. new text end
new text begin
(a) The grantee must report to the commissioner on a quarterly
basis the following information:
new text end
new text begin
(1) the total number of appointments available for scheduling by specialty;
new text end
new text begin
(2) the average length of time between scheduling and actual appointment;
new text end
new text begin
(3) the total number of patients referred and whether the patient was insured or
uninsured; and
new text end
new text begin
(4) the total number of appointments resulting in visits completed and number of
patients continuing services with the referring clinic.
new text end
new text begin
(b) The commissioner, in consultation with the Minnesota Hospital Association,
shall conduct an evaluation of the emergency room diversion pilot project and submit the
results to the legislature by January 15, 2009. The evaluation shall compare the number of
nonemergency visits and repeat visits to hospital emergency rooms for the period before
the commencement of the project and one year after the commencement, and an estimate
of the costs saved from any documented reductions.
new text end
Sec. 4.
Minnesota Statutes 2006, section 256.969, subdivision 9, is amended to read:
Subd. 9.
Disproportionate numbers of low-income patients served.
(a) For
admissions occurring on or after October 1, 1992, through December 31, 1992, the
medical assistance disproportionate population adjustment shall comply with federal law
and shall be paid to a hospital, excluding regional treatment centers and facilities of the
federal Indian Health Service, with a medical assistance inpatient utilization rate in excess
of the arithmetic mean. The adjustment must be determined as follows:
(1) for a hospital with a medical assistance inpatient utilization rate above the
arithmetic mean for all hospitals excluding regional treatment centers and facilities of the
federal Indian Health Service but less than or equal to one standard deviation above the
mean, the adjustment must be determined by multiplying the total of the operating and
property payment rates by the difference between the hospital's actual medical assistance
inpatient utilization rate and the arithmetic mean for all hospitals excluding regional
treatment centers and facilities of the federal Indian Health Service; and
(2) for a hospital with a medical assistance inpatient utilization rate above one
standard deviation above the mean, the adjustment must be determined by multiplying
the adjustment that would be determined under clause (1) for that hospital by 1.1. If
federal matching funds are not available for all adjustments under this subdivision, the
commissioner shall reduce payments on a pro rata basis so that all adjustments qualify for
federal match. The commissioner may establish a separate disproportionate population
operating payment rate adjustment under the general assistance medical care program.
For purposes of this subdivision medical assistance does not include general assistance
medical care. The commissioner shall report annually on the number of hospitals likely to
receive the adjustment authorized by this paragraph. The commissioner shall specifically
report on the adjustments received by public hospitals and public hospital corporations
located in cities of the first class.
(b) For admissions occurring on or after July 1, 1993, the medical assistance
disproportionate population adjustment shall comply with federal law and shall be paid to
a hospital, excluding regional treatment centers and facilities of the federal Indian Health
Service, with a medical assistance inpatient utilization rate in excess of the arithmetic
mean. The adjustment must be determined as follows:
(1) for a hospital with a medical assistance inpatient utilization rate above the
arithmetic mean for all hospitals excluding regional treatment centers and facilities of the
federal Indian Health Service but less than or equal to one standard deviation above the
mean, the adjustment must be determined by multiplying the total of the operating and
property payment rates by the difference between the hospital's actual medical assistance
inpatient utilization rate and the arithmetic mean for all hospitals excluding regional
treatment centers and facilities of the federal Indian Health Service;
(2) for a hospital with a medical assistance inpatient utilization rate above one
standard deviation above the mean, the adjustment must be determined by multiplying
the adjustment that would be determined under clause (1) for that hospital by 1.1. The
commissioner may establish a separate disproportionate population operating payment
rate adjustment under the general assistance medical care program. For purposes of this
subdivision, medical assistance does not include general assistance medical care. The
commissioner shall report annually on the number of hospitals likely to receive the
adjustment authorized by this paragraph. The commissioner shall specifically report on
the adjustments received by public hospitals and public hospital corporations located
in cities of the first class;
(3) for a hospital that had medical assistance fee-for-service payment volume during
calendar year 1991 in excess of 13 percent of total medical assistance fee-for-service
payment volume, a medical assistance disproportionate population adjustment shall be
paid in addition to any other disproportionate payment due under this subdivision as
follows: $1,515,000 due on the 15th of each month after noon, beginning July 15, 1995.
For a hospital that had medical assistance fee-for-service payment volume during calendar
year 1991 in excess of eight percent of total medical assistance fee-for-service payment
volume and was the primary hospital affiliated with the University of Minnesota, a
medical assistance disproportionate population adjustment shall be paid in addition to any
other disproportionate payment due under this subdivision as follows: $505,000 due on
the 15th of each month after noon, beginning July 15, 1995; and
(4) effective August 1, 2005, the payments in paragraph (b), clause (3), shall be
reduced to zero.
(c) The commissioner shall adjust rates paid to a health maintenance organization
under contract with the commissioner to reflect rate increases provided in paragraph (b),
clauses (1) and (2), on a nondiscounted hospital-specific basis but shall not adjust those
rates to reflect payments provided in clause (3).
(d) If federal matching funds are not available for all adjustments under paragraph
(b), the commissioner shall reduce payments under paragraph (b), clauses (1) and (2), on a
pro rata basis so that all adjustments under paragraph (b) qualify for federal match.
(e) For purposes of this subdivision, medical assistance does not include general
assistance medical care.
(f) For hospital services occurring on or after July 1, 2005, to June 30, 2007deleted text begin , deleted text end new text begin :
new text end
new text begin (1) new text end general assistance medical care expenditures new text begin for fee-for-service inpatient
and outpatient hospital payments new text end made by the department deleted text begin and by prepaid health
plans participating in general assistance medical caredeleted text end shall be considered Medicaid
disproportionate share hospital payments, except as limited below:
deleted text begin (1)deleted text end new text begin (i)new text end only the portion of Minnesota's disproportionate share hospital allotment
under section 1923(f) of the Social Security Act that is not spent on the disproportionate
population adjustments in paragraph (b), clauses (1) and (2), may be used for general
assistance medical care expenditures;
deleted text begin (2)deleted text end new text begin (ii)new text end only those general assistance medical care expenditures made to hospitals that
qualify for disproportionate share payments under section 1923 of the Social Security Act
and the Medicaid state plan may be considered disproportionate share hospital payments;
deleted text begin (3)deleted text end new text begin (iii)new text end only those general assistance medical care expenditures made to an
individual hospital that would not cause the hospital to exceed its individual hospital limits
under section 1923 of the Social Security Act may be considered; and
deleted text begin (4)deleted text end new text begin (iv)new text end general assistance medical care expenditures may be considered only to the
extent of Minnesota's aggregate allotment under section 1923 of the Social Security Act.
All hospitals and prepaid health plans participating in general assistance medical care
must provide any necessary expenditure, cost, and revenue information required by the
commissioner as necessary for purposes of obtaining federal Medicaid matching funds for
general assistance medical care expendituresnew text begin ; and
new text end
new text begin (2) certified public expenditures made by Hennepin County Medical Center shall
be considered Medicaid disproportionate share hospital payments. Hennepin County
and Hennepin County Medical Center shall report by June 15, 2007, on payments made
beginning July 1, 2005, or another date specified by the commissioner, that may qualify
for reimbursement under federal law. Based on these reports, the commissioner shall
apply for federal matching fundsnew text end .
(g) Upon federal approval of the related state plan amendment, paragraph (f) is
effective retroactively from July 1, 2005, or the earliest effective date approved by the
Centers for Medicare and Medicaid Services.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective retroactively from July 1, 2005.
new text end
Sec. 5.
Minnesota Statutes 2006, section 256.969, subdivision 27, is amended to read:
Subd. 27.
Quarterly payment adjustment.
(a) In addition to any other payment
under this section, the commissioner shall make the following payments effective July
1, 2007:
(1) for a hospital located in Minnesota and not eligible for payments under
subdivision 20, with a medical assistance inpatient utilization rate greater than 17.8
percent of total patient days as of the base year in effect on July 1, 2005, a payment equal
to 13 percent of the total of the operating and property payment rates;
(2) for a hospital located in Minnesota in a specified urban area outside of the
seven-county metropolitan area and not eligible for payments under subdivision 20, with
a medical assistance inpatient utilization rate less than or equal to 17.8 percent of total
patient days as of the base year in effect on July 1, 2005, a payment equal to ten percent
of the total of the operating and property payment rates. For purposes of this clause, the
following cities are specified urban areas: Detroit Lakes, Rochester, Willmar, Alexandria,
Austin, Cambridge, Brainerd, Hibbing, Mankato, Duluth, St. Cloud, Grand Rapids,
Wyoming, Fergus Falls, Albert Lea, Winona, Virginia, Thief River Falls, and Wadena; deleted text begin and
deleted text end
(3) for a hospital located in Minnesota but not located in a specified urban area
under clause (2), with a medical assistance inpatient utilization rate less than or equal to
17.8 percent of total patient days as of the base year in effect on July 1, 2005, a payment
equal to four percent of the total of the operating and property payment rates. A hospital
located in Woodbury and not in existence during the base year shall be reimbursed under
this clausedeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(4) in addition to any payments under clauses (1) to (3), for a hospital located in
Minnesota and not eligible for payments under subdivision 20 with a medical assistance
inpatient utilization rate of 17.9 percent of total patient days as of the base year in effect
on July 1, 2005, a payment equal to eight percent of the total of the operating and property
payment rates, and for a hospital located in Minnesota and not eligible for payments
under subdivision 20 with a medical assistance inpatient utilization rate of 59.6 percent
of total patient days as of the base year in effect on July 1, 2005, a payment equal to
nine percent of the total of the operating and property payment rates. After making any
ratable adjustments required under paragraph (b), the commissioner shall proportionately
reduce payments under clauses (2) and (3) by an amount needed to make payments under
this clause.
new text end
(b) The state share of payments under paragraph (a) shall be equal to federal
reimbursements to the commissioner to reimburse deleted text begin nonstatedeleted text end expenditures reported under
section 256B.199. The commissioner shall ratably reduce or increase payments under this
subdivision in order to ensure that these payments equal the amount of reimbursement
received by the commissioner under section 256B.199, except that payments shall be
ratably reduced by an amount equivalent to the state share of a four percent reduction in
MinnesotaCare and medical assistance payments for inpatient hospital services.new text begin Effective
July 1, 2009, the ratable reduction shall be equivalent to the state share of a three percent
reduction in these payments.
new text end
(c) The payments under paragraph (a) shall be paid quarterly new text begin based on each hospital's
operating and property payments from the second previous quarter, new text end beginning on July
15, 2007, or upon federal approval of federal reimbursements under section 256B.199,
whichever occurs later.
(d) The commissioner shall not adjust rates paid to a prepaid health plan under
contract with the commissioner to reflect payments provided in paragraph (a).
(e) The commissioner shall maximize the use of available federal money for
disproportionate share hospital payments and shall maximize payments to qualifying
hospitals. In order to accomplish these purposes, the commissioner may, in consultation
with the nonstate entities identified in section 256B.199, adjust, on a pro rata basis
if feasible, the amounts reported by nonstate entities under section 256B.199 when
application for reimbursement is made to the federal government, and otherwise adjust
the provisions of this subdivision.new text begin The commissioner shall utilize a settlement process
based on finalized data to maximize revenue under section 256B.199 and payments
under this section.
new text end
(f) deleted text begin By January 15 of each year, beginning January 15, 2006, the commissioner
deleted text end deleted text begin shall report to the chairs of the house and senate finance committees and divisions with
deleted text end deleted text begin jurisdiction over funding for the Department of Human Services the following estimates
deleted text end deleted text begin for the current and upcoming federal and state fiscal years:
deleted text end
deleted text begin
(1) the difference between the Medicare upper payment limit and actual or
deleted text end
deleted text begin
anticipated medical assistance payments for hospital services;
deleted text end
deleted text begin
(2) the amount of federal disproportionate share hospital funding available to
deleted text end
deleted text begin
Minnesota and the amount expected to be claimed by the state; and
deleted text end
deleted text begin
(3) the methodology used to calculate the results reported for clauses (1) and (2).
deleted text end
deleted text begin (g)deleted text end For purposes of this subdivision, medical assistance does not include general
assistance medical care.
deleted text begin
(h) This section sunsets on June 30, 2009. The commissioner shall report to
the legislature by December 15, 2008, with recommendations for maximizing federal
disproportionate share hospital payments after June 30, 2009.
deleted text end
Sec. 6.
Minnesota Statutes 2006, section 256B.04, subdivision 14, is amended to read:
Subd. 14.
Competitive bidding.
(a) When determined to be effective, economical,
and feasible, the commissioner may utilize volume purchase through competitive bidding
and negotiation under the provisions of chapter 16C, to provide items under the medical
assistance program including but not limited to the following:
(1) eyeglasses;
(2) oxygen. The commissioner shall provide for oxygen needed in an emergency
situation on a short-term basis, until the vendor can obtain the necessary supply from
the contract dealer;
(3) hearing aids and supplies; and
(4) durable medical equipment, including but not limited to:
(i) hospital beds;
(ii) commodes;
(iii) glide-about chairs;
(iv) patient lift apparatus;
(v) wheelchairs and accessories;
(vi) oxygen administration equipment;
(vii) respiratory therapy equipment;
(viii) electronic diagnostic, therapeutic and life support systems;
(5) deleted text begin specialdeleted text end new text begin nonemergency medical new text end transportation deleted text begin servicesdeleted text end new text begin level of need
determinations, disbursement of public transportation passes and tokens, and volunteer
and recipient mileage and parking reimbursementsnew text end ; and
(6) drugs.
(b) Rate changes under this chapter and chapters 256D and 256L do not affect
contract payments under this subdivision unless specifically identified.
new text begin
(c) The commissioner may not utilize volume purchase through competitive bidding
and negotiation for special transportation services under the provisions of chapter 16C.
new text end
Sec. 7.
Minnesota Statutes 2006, section 256B.04, is amended by adding a subdivision
to read:
new text begin Subd. 14a. new text end
new text begin Level of need determination. new text end
new text begin
Nonemergency medical transportation
level of need determinations must be performed by a physician, a registered nurse working
under direct supervision of a physician, a physician's assistant, a nurse practitioner, a
licensed practical nurse, or a discharge planner. Nonemergency medical transportation
level of need determinations must not be performed more than semiannually on any
individual, unless the individual's circumstances have sufficiently changed so as to require
a new level of need determination. Individuals residing in licensed nursing facilities are
exempt from a level of need determination and are eligible for special transportation
services until the individual no longer resides in a licensed nursing facility. If a person
authorized by this subdivision to perform a level of need determination determines that an
individual requires stretcher transportation, the individual is presumed to maintain that
level of need until otherwise determined by a person authorized to perform a level of need
determination, or for six months, whichever is sooner.
new text end
Sec. 8.
Minnesota Statutes 2006, section 256B.056, subdivision 10, is amended to read:
Subd. 10.
Eligibility verification.
(a) The commissioner shall require women who
are applying for the continuation of medical assistance coverage following the end of the
60-day postpartum period to update their income and asset information and to submit
any required income or asset verification.
(b) The commissioner shall determine the eligibility of private-sector health care
coverage for infants less than one year of age eligible under section 256B.055, subdivision
10, or 256B.057, subdivision 1, paragraph (d), and shall pay for private-sector coverage
if this is determined to be cost-effective.
(c) The commissioner shall deleted text begin modify the application for Minnesota health care
programs to require more detailed information related to verification of assets and income,
and shalldeleted text end verify assets and income for all applicants, and for all recipients upon renewal.
deleted text begin
(d) The commissioner shall require Minnesota health care program recipients to
report new or an increase in earned income within ten days of the change, and to verify new
or an increase in earned income that affects eligibility within ten days of notification by
the agency that the new or increased earned income affects eligibility. Recipients who fail
to verify new or an increase in earned income that affects eligibility shall be disenrolled.
deleted text end
Sec. 9.
Minnesota Statutes 2006, section 256B.0625, subdivision 3f, is amended to
read:
Subd. 3f.
Circumcision deleted text begin for newbornsdeleted text end .
deleted text begin Newborndeleted text end Circumcision is not covered,
unless the procedure is medically necessary deleted text begin or required because of a well-established
religious practicedeleted text end .
Sec. 10.
Minnesota Statutes 2006, section 256B.0631, subdivision 1, is amended to
read:
Subdivision 1.
Co-payments.
(a) Except as provided in subdivision 2, the medical
assistance benefit plan shall include the following co-payments for all recipients, effective
for services provided on or after October 1, 2003new text begin , and before January 1, 2009new text end :
(1) $3 per nonpreventive visit. For purposes of this subdivision, a visit means an
episode of service which is required because of a recipient's symptoms, diagnosis, or
established illness, and which is delivered in an ambulatory setting by a physician or
physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse,
audiologist, optician, or optometrist;
(2) $3 for eyeglasses;
(3) $6 for nonemergency visits to a hospital-based emergency room; and
(4) $3 per brand-name drug prescription and $1 per generic drug prescription,
subject to a $12 per month maximum for prescription drug co-payments. No co-payments
shall apply to antipsychotic drugs when used for the treatment of mental illness.
(b) new text begin Except as provided in subdivision 2, the medical assistance benefit plan shall
include the following co-payments for all recipients, effective for services provided on
or after January 1, 2009:
new text end
new text begin
(1) $6 for nonemergency visits to a hospital-based emergency room; and
new text end
new text begin
(2) $3 per brand-name drug prescription and $1 per generic drug prescription,
subject to a $7 per month maximum for prescription drug co-payments. No co-payments
shall apply to antipsychotic drugs when used for the treatment of mental illness.
new text end
new text begin (c) new text end Recipients of medical assistance are responsible for all co-payments in this
subdivision.
Sec. 11.
Minnesota Statutes 2006, section 256B.0631, subdivision 3, is amended to
read:
Subd. 3.
Collection.
new text begin (a) new text end The medical assistance reimbursement to the provider shall
be reduced by the amount of the co-payment, except that reimbursement for prescription
drugs shall not be reduced once a recipient has reached the $12 per month maximum new text begin or
the $7 per month maximum effective January 1, 2009,new text end for prescription drug co-payments.
new text begin (b) new text end The provider collects the co-payment from the recipient. Providers may not
deny services to recipients who are unable to pay the co-paymentdeleted text begin , except as provided in
subdivision 4deleted text end .
new text begin
(c) Medical assistance reimbursement to fee-for-service providers and payments to
managed care plans shall not be increased as a result of the removal of the co-payments
effective January 1, 2009.
new text end
Sec. 12.
Minnesota Statutes 2006, section 256B.0644, is amended to read:
256B.0644 REIMBURSEMENT UNDER OTHER STATE HEALTH CARE
PROGRAMS.
new text begin (a) new text end A vendor of medical care, as defined in section 256B.02, subdivision 7, and a
health maintenance organization, as defined in chapter 62D, must participate as a provider
or contractor in the medical assistance program, general assistance medical care program,
and MinnesotaCare as a condition of participating as a provider in health insurance plans
and programs or contractor for state employees established under section 43A.18, the
public employees insurance program under section 43A.316, for health insurance plans
offered to local statutory or home rule charter city, county, and school district employees,
the workers' compensation system under section 176.135, and insurance plans provided
through the Minnesota Comprehensive Health Association under sections 62E.01 to
62E.19. The limitations on insurance plans offered to local government employees shall
not be applicable in geographic areas where provider participation is limited by managed
care contracts with the Department of Human Services.
new text begin (b) new text end For providers other than health maintenance organizations, participation in the
medical assistance program means thatnew text begin :
new text end
(1) the provider accepts new medical assistance, general assistance medical care,
and MinnesotaCare patients deleted text begin ordeleted text end new text begin ;new text end
(2) for providers other than dental service providers, at least 20 percent of the
provider's patients are covered by medical assistance, general assistance medical care, and
MinnesotaCare as their primary source of coveragedeleted text begin , ordeleted text end new text begin ; ornew text end
(3) for dental service providers, at least ten percent of the provider's patients are
covered by medical assistance, general assistance medical care, and MinnesotaCare as
their primary source of coveragenew text begin , or the provider accepts new medical assistance and
MinnesotaCare patients who are children with special health care needs. For purposes
of this section, "children with special health care needs" means children up to age 18
who: (i) require health and related services beyond that required by children generally;
and (ii) have or are at risk for a chronic physical, developmental, behavioral, or emotional
condition, including: bleeding and coagulation disorders; immunodeficiency disorders;
cancer; endocrinopathy; developmental disabilities; epilepsy, cerebral palsy, and other
neurological diseases; visual impairment or deafness; Down syndrome and other genetic
disorders; autism; fetal alcohol syndrome; and other conditions designated by the
commissioner after consultation with representatives of pediatric dental providers and
consumersnew text end .
new text begin (c) new text end Patients seen on a volunteer basis by the provider at a location other than the
provider's usual place of practice may be considered in meeting deleted text begin thisdeleted text end new text begin thenew text end participation
requirementnew text begin in this sectionnew text end . The commissioner shall establish participation requirements
for health maintenance organizations. The commissioner shall provide lists of
participating medical assistance providers on a quarterly basis to the commissioner of
employee relations, the commissioner of labor and industry, and the commissioner of
commerce. Each of the commissioners shall develop and implement procedures to exclude
as participating providers in the program or programs under their jurisdiction those
providers who do not participate in the medical assistance program. The commissioner
of employee relations shall implement this section through contracts with participating
health and dental carriers.
Sec. 13.
Minnesota Statutes 2006, section 256B.199, is amended to read:
256B.199 PAYMENTS REPORTED BY GOVERNMENTAL ENTITIES.
(a)new text begin Effective July 1, 2007, the commissioner shall apply for federal matching funds
for the expenditures in paragraphs (b) and (c).
new text end
new text begin
(b) The commissioner shall apply for federal matching funds for certified public
expenditures as follows:
new text end
new text begin (1) new text end Hennepin County, Hennepin County Medical Center, Ramsey County, Regions
Hospital, the University of Minnesota, and Fairview-University Medical Center shall
report quarterly to the commissioner beginning June 1, 2007, payments made during the
second previous quarter that may qualify for reimbursement under federal lawdeleted text begin .deleted text end new text begin ;
new text end
deleted text begin (b)deleted text end new text begin (2) new text end based on these reports, the commissioner shall apply for federal matching
funds. These funds are appropriated to the commissioner for the payments under section
256.969, subdivision 27deleted text begin .deleted text end new text begin ; and
new text end
deleted text begin (c)deleted text end new text begin (3)new text end by May 1 of each year, beginning May 1, 2007, the commissioner shall inform
the nonstate entities listed in paragraph (a) of the amount of federal disproportionate share
hospital payment money expected to be available in the current federal fiscal year.
new text begin
(c) The commissioner shall apply for federal matching funds for general assistance
medical care expenditures as follows:
new text end
new text begin
(1) for hospital services occurring on or after July 1, 2007, general assistance medical
care expenditures for fee-for-service inpatient and outpatient hospital payments made by
the department shall be used to apply for federal matching funds, except as limited below:
new text end
new text begin
(i) only those general assistance medical care expenditures made to an individual
hospital that would not cause the hospital to exceed its individual hospital limits under
section 1923 of the Social Security Act may be considered; and
new text end
new text begin
(ii) general assistance medical care expenditures may be considered only to the extent
of Minnesota's aggregate allotment under section 1923 of the Social Security Act; and
new text end
new text begin
(2) all hospitals must provide any necessary expenditure, cost, and revenue
information required by the commissioner as necessary for purposes of obtaining federal
Medicaid matching funds for general assistance medical care expenditures.
new text end
deleted text begin
(d) This section sunsets on June 30, 2009. The commissioner shall report to
the legislature by December 15, 2008, with recommendations for maximizing federal
disproportionate share hospital payments after June 30, 2009.
deleted text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 14.
Minnesota Statutes 2006, section 256B.76, is amended to read:
256B.76 PHYSICIAN AND DENTAL REIMBURSEMENT.
(a) Effective for services rendered on or after October 1, 1992, the commissioner
shall make payments for physician services as follows:
(1) payment for level one Centers for Medicare and Medicaid Services' common
procedural coding system codes titled "office and other outpatient services," "preventive
medicine new and established patient," "delivery, antepartum, and postpartum care,"
"critical care," cesarean delivery and pharmacologic management provided to psychiatric
patients, and level three codes for enhanced services for prenatal high risk, shall be paid
at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June
30, 1992. If the rate on any procedure code within these categories is different than the
rate that would have been paid under the methodology in section 256B.74, subdivision 2,
then the larger rate shall be paid;
(2) payments for all other services shall be paid at the lower of (i) submitted charges,
or (ii) 15.4 percent above the rate in effect on June 30, 1992;
(3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th
percentile of 1989, less the percent in aggregate necessary to equal the above increases
except that payment rates for home health agency services shall be the rates in effect
on September 30, 1992;
(4) effective for services rendered on or after January 1, 2000, payment rates for
physician and professional services shall be increased by three percent over the rates in
effect on December 31, 1999, except for home health agency and family planning agency
services; and
(5) the increases in clause (4) shall be implemented January 1, 2000, for managed
care.
(b) Effective for services rendered on or after October 1, 1992, the commissioner
shall make payments for dental services as follows:
(1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25
percent above the rate in effect on June 30, 1992;
(2) dental rates shall be converted from the 50th percentile of 1982 to the 50th
percentile of 1989, less the percent in aggregate necessary to equal the above increases;
(3) effective for services rendered on or after January 1, 2000, payment rates for
dental services shall be increased by three percent over the rates in effect on December
31, 1999;
(4) the commissioner shall award grants to community clinics or other nonprofit
community organizations, political subdivisions, professional associations, or other
organizations that demonstrate the ability to provide dental services effectively to public
program recipients. Grants may be used to fund the costs related to coordinating access for
recipients, developing and implementing patient care criteria, upgrading or establishing
new facilities, acquiring furnishings or equipment, recruiting new providers, or other
development costs that will improve access to dental care in a region. In awarding grants,
the commissioner shall give priority to applicants that plan to serve areas of the state in
which the number of dental providers is not currently sufficient to meet the needs of
recipients of public programs or uninsured individuals. The commissioner shall consider
the following in awarding the grants:
(i) potential to successfully increase access to an underserved population;
(ii) the ability to raise matching funds;
(iii) the long-term viability of the project to improve access beyond the period
of initial funding;
(iv) the efficiency in the use of the funding; and
(v) the experience of the proposers in providing services to the target population.
The commissioner shall monitor the grants and may terminate a grant if the grantee
does not increase dental access for public program recipients. The commissioner shall
consider grants for the following:
(i) implementation of new programs or continued expansion of current access
programs that have demonstrated success in providing dental services in underserved
areas;
(ii) a pilot program for utilizing hygienists outside of a traditional dental office to
provide dental hygiene services; and
(iii) a program that organizes a network of volunteer dentists, establishes a system to
refer eligible individuals to volunteer dentists, and through that network provides donated
dental care services to public program recipients or uninsured individuals;
(5) beginning October 1, 1999, the payment for tooth sealants and fluoride treatments
shall be the lower of (i) submitted charge, or (ii) 80 percent of median 1997 charges;
(6) the increases listed in clauses (3) and (5) shall be implemented January 1, 2000,
for managed care; and
(7) effective for services provided on or after January 1, 2002, payment for
diagnostic examinations and dental x-rays provided to children under age 21 shall be the
lower of (i) the submitted charge, or (ii) 85 percent of median 1999 charges.
(c) Effective for dental services rendered on or after January 1, 2002, the
commissioner deleted text begin may, within the limits of available appropriation,deleted text end new text begin shall new text end increase
reimbursements to dentists and dental clinics deemed by the commissioner to be critical
access dental providers.deleted text begin Reimbursement to a critical access dental provider may be
deleted text end deleted text begin increased by not more than 50 percent above the reimbursement rate that would deleted text end deleted text begin otherwise
be paid to the provider. Payments to health plan companies shall be adjusted todeleted text end new text begin For dental
services rendered on or after July 1, 2007, the commissioner shall increase reimbursement
by 30 percent above the reimbursement rate that would otherwise be paid to the critical
access dental provider. The commissioner shall pay the health plan companies in amounts
sufficient to new text end reflect increased reimbursements to critical access dental providers as
approved by the commissioner. In determining which dentists and dental clinics shall be
deemed critical access dental providers, the commissioner shall review:
(1) the utilization rate in the service area in which the dentist or dental clinic operates
for dental services to patients covered by medical assistance, general assistance medical
care, or MinnesotaCare as their primary source of coverage;
(2) the level of services provided by the dentist or dental clinic to patients covered
by medical assistance, general assistance medical care, or MinnesotaCare as their primary
source of coverage; and
(3) whether the level of services provided by the dentist or dental clinic is critical to
maintaining adequate levels of patient access within the service area.
In the absence of a critical access dental provider in a service area, the commissioner may
designate a dentist or dental clinic as a critical access dental provider if the dentist or
dental clinic is willing to provide care to patients covered by medical assistance, general
assistance medical care, or MinnesotaCare at a level which significantly increases access
to dental care in the service area.
deleted text begin
The commissioner shall annually establish a reimbursement schedule for critical
deleted text end
deleted text begin
access dental providers and provider-specific limits on total reimbursement received
deleted text end
deleted text begin
under the reimbursement schedule, and shall notify each critical access dental provider
deleted text end
deleted text begin
of the schedule and limit.
deleted text end
(d) An entity that operates both a Medicare certified comprehensive outpatient
rehabilitation facility and a facility which was certified prior to January 1, 1993, that is
licensed under Minnesota Rules, parts 9570.2000 to 9570.3600, and for whom at least 33
percent of the clients receiving rehabilitation services in the most recent calendar year are
medical assistance recipients, shall be reimbursed by the commissioner for rehabilitation
services at rates that are 38 percent greater than the maximum reimbursement rate
allowed under paragraph (a), clause (2), when those services are (1) provided within the
comprehensive outpatient rehabilitation facility and (2) provided to residents of nursing
facilities owned by the entity.
(e) Effective for services rendered on or after January 1, 2007, the commissioner
shall make payments for physician and professional services based on the Medicare
relative value units (RVU's). This change shall be budget neutral and the cost of
implementing RVU's will be incorporated in the established conversion factor.
Sec. 15.
new text begin
[256B.764] REIMBURSEMENT FOR FAMILY PLANNING SERVICES.
new text end
new text begin
Effective for services rendered on or after July 1, 2007, payment rates for family
planning services shall be increased by 25 percent over the rates in effect June 30, 2007,
when these services are provided by a community clinic as defined in section 145.9268,
subdivision 1.
new text end
Sec. 16.
Minnesota Statutes 2006, section 256D.03, subdivision 3, is amended to read:
Subd. 3.
General assistance medical care; eligibility.
(a) General assistance
medical care may be paid for any person who is not eligible for medical assistance under
chapter 256B, including eligibility for medical assistance based on a spenddown of excess
income according to section 256B.056, subdivision 5, or MinnesotaCare as defined in
paragraph (b), except as provided in paragraph (c), and:
(1) who is receiving assistance under section 256D.05, except for families with
children who are eligible under Minnesota family investment program (MFIP), or who is
having a payment made on the person's behalf under sections 256I.01 to 256I.06; or
(2) who is a resident of Minnesota; and
(i) who has gross countable income not in excess of 75 percent of the federal poverty
guidelines for the family size, using a six-month budget period and whose equity in assets
is not in excess of $1,000 per assistance unit. General assistance medical care is not
available for applicants or enrollees who are otherwise eligible for medical assistance but
fail to verify their assets. Enrollees who become eligible for medical assistance shall be
terminated and transferred to medical assistance. Exempt assets, the reduction of excess
assets, and the waiver of excess assets must conform to the medical assistance program in
section 256B.056, subdivision 3, with the following exception: the maximum amount of
undistributed funds in a trust that could be distributed to or on behalf of the beneficiary by
the trustee, assuming the full exercise of the trustee's discretion under the terms of the
trust, must be applied toward the asset maximum;
(ii) who has gross countable income above 75 percent of the federal poverty
guidelines but not in excess of 175 percent of the federal poverty guidelines for the
family size, using a six-month budget period, whose equity in assets is not in excess
of the limits in section 256B.056, subdivision 3c, and who applies during an inpatient
hospitalization; or
(iii) the commissioner shall adjust the income standards under this section each July
1 by the annual update of the federal poverty guidelines following publication by the
United States Department of Health and Human Services.
(b) Effective for applications and renewals processed on or after September 1, 2006,
general assistance medical care may not be paid for applicants or recipients who are adults
with dependent children under 21 whose gross family income is equal to or less than 275
percent of the federal poverty guidelines who are not described in paragraph (e).
(c) Effective for applications and renewals processed on or after September 1, 2006,
general assistance medical care may be paid for applicants and recipients who meet all
eligibility requirements of paragraph (a), clause (2), item (i), for a temporary period
beginning the date of application. Immediately following approval of general assistance
medical care, enrollees shall be enrolled in MinnesotaCare under section 256L.04,
subdivision 7, with covered services as provided in section 256L.03 for the rest of the
six-month new text begin general assistance medical care new text end eligibility period, until their six-month renewal.
(d) To be eligible for general assistance medical care following enrollment in
MinnesotaCare as required by paragraph (c), an individual must complete a new
application.
(e) Applicants and recipients eligible under paragraph (a), clause (1); who have
applied for and are awaiting a determination of blindness or disability by the state medical
review team or a determination of eligibility for Supplemental Security Income or Social
Security Disability Insurance by the Social Security Administration; who fail to meet the
requirements of section 256L.09, subdivision 2; new text begin who are homeless as defined by United
States Code, title 42, section 11301, et seq.;new text end who are classified as end-stage renal disease
beneficiaries in the Medicare program; who are enrolled in private health care coverage as
defined in section 256B.02, subdivision 9; who are eligible under paragraph (j); or who
receive treatment funded pursuant to section 254B.02 are exempt from the MinnesotaCare
enrollment requirements of this subdivision.
(f) For applications received on or after October 1, 2003, eligibility may begin no
earlier than the date of application. For individuals eligible under paragraph (a), clause
(2), item (i), a redetermination of eligibility must occur every 12 months. Individuals are
eligible under paragraph (a), clause (2), item (ii), only during inpatient hospitalization but
may reapply if there is a subsequent period of inpatient hospitalization.
(g) Beginning September 1, 2006, Minnesota health care program applications and
renewals completed by recipients and applicants who are persons described in paragraph
(c) and submitted to the county agency shall be determined for MinnesotaCare eligibility
by the county agency. If all other eligibility requirements of this subdivision are met,
eligibility for general assistance medical care shall be available in any month during which
MinnesotaCare enrollment is pending. Upon notification of eligibility for MinnesotaCare,
notice of termination for eligibility for general assistance medical care shall be sent to
an applicant or recipient. If all other eligibility requirements of this subdivision are
met, eligibility for general assistance medical care shall be available until enrollment in
MinnesotaCare subject to the provisions of paragraphs (c), (e), and (f).
(h) The date of an initial Minnesota health care program application necessary to
begin a determination of eligibility shall be the date the applicant has provided a name,
address, and Social Security number, signed and dated, to the county agency or the
Department of Human Services. If the applicant is unable to provide a name, address,
Social Security number, and signature when health care is delivered due to a medical
condition or disability, a health care provider may act on an applicant's behalf to establish
the date of an initial Minnesota health care program application by providing the county
agency or Department of Human Services with provider identification and a temporary
unique identifier for the applicant. The applicant must complete the remainder of the
application and provide necessary verification before eligibility can be determined. The
county agency must assist the applicant in obtaining verification if necessary.
(i) County agencies are authorized to use all automated databases containing
information regarding recipients' or applicants' income in order to determine eligibility for
general assistance medical care or MinnesotaCare. Such use shall be considered sufficient
in order to determine eligibility and premium payments by the county agency.
(j) General assistance medical care is not available for a person in a correctional
facility unless the person is detained by law for less than one year in a county correctional
or detention facility as a person accused or convicted of a crime, or admitted as an
inpatient to a hospital on a criminal hold order, and the person is a recipient of general
assistance medical care at the time the person is detained by law or admitted on a criminal
hold order and as long as the person continues to meet other eligibility requirements
of this subdivision.
(k) General assistance medical care is not available for applicants or recipients who
do not cooperate with the county agency to meet the requirements of medical assistance.
(l) In determining the amount of assets of an individual eligible under paragraph
(a), clause (2), item (i), there shall be included any asset or interest in an asset, including
an asset excluded under paragraph (a), that was given away, sold, or disposed of for
less than fair market value within the 60 months preceding application for general
assistance medical care or during the period of eligibility. Any transfer described in this
paragraph shall be presumed to have been for the purpose of establishing eligibility for
general assistance medical care, unless the individual furnishes convincing evidence to
establish that the transaction was exclusively for another purpose. For purposes of this
paragraph, the value of the asset or interest shall be the fair market value at the time it
was given away, sold, or disposed of, less the amount of compensation received. For any
uncompensated transfer, the number of months of ineligibility, including partial months,
shall be calculated by dividing the uncompensated transfer amount by the average monthly
per person payment made by the medical assistance program to skilled nursing facilities
for the previous calendar year. The individual shall remain ineligible until this fixed period
has expired. The period of ineligibility may exceed 30 months, and a reapplication for
benefits after 30 months from the date of the transfer shall not result in eligibility unless
and until the period of ineligibility has expired. The period of ineligibility begins in the
month the transfer was reported to the county agency, or if the transfer was not reported,
the month in which the county agency discovered the transfer, whichever comes first. For
applicants, the period of ineligibility begins on the date of the first approved application.
(m) When determining eligibility for any state benefits under this subdivision,
the income and resources of all noncitizens shall be deemed to include their sponsor's
income and resources as defined in the Personal Responsibility and Work Opportunity
Reconciliation Act of 1996, title IV, Public Law 104-193, sections 421 and 422, and
subsequently set out in federal rules.
(n) Undocumented noncitizens and nonimmigrants are ineligible for general
assistance medical care. For purposes of this subdivision, a nonimmigrant is an individual
in one or more of the classes listed in United States Code, title 8, section 1101(a)(15), and
an undocumented noncitizen is an individual who resides in the United States without the
approval or acquiescence of the Immigration and Naturalization Service.
(o) Notwithstanding any other provision of law, a noncitizen who is ineligible for
medical assistance due to the deeming of a sponsor's income and resources, is ineligible
for general assistance medical care.
(p) Effective July 1, 2003, general assistance medical care emergency services end.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2007.
new text end
Sec. 17.
Minnesota Statutes 2006, section 256D.03, subdivision 4, is amended to read:
Subd. 4.
General assistance medical care; services.
(a)(i) For a person who is
eligible under subdivision 3, paragraph (a), clause (2), item (i), general assistance medical
care covers, except as provided in paragraph (c):
(1) inpatient hospital services;
(2) outpatient hospital services;
(3) services provided by Medicare certified rehabilitation agencies;
(4) prescription drugs and other products recommended through the process
established in section 256B.0625, subdivision 13;
(5) equipment necessary to administer insulin and diagnostic supplies and equipment
for diabetics to monitor blood sugar level;
(6) eyeglasses and eye examinations provided by a physician or optometrist;
(7) hearing aids;
(8) prosthetic devices;
(9) laboratory and X-ray services;
(10) physician's services;
(11) medical transportation except special transportation;
(12) chiropractic services as covered under the medical assistance program;
(13) podiatric services;
(14) dental services as covered under the medical assistance program;
(15) outpatient services provided by a mental health center or clinic that is under
contract with the county board and is established under section 245.62;
(16) day treatment services for mental illness provided under contract with the
county board;
(17) prescribed medications for persons who have been diagnosed as mentally ill as
necessary to prevent more restrictive institutionalization;
(18) psychological services, medical supplies and equipment, and Medicare
premiums, coinsurance and deductible payments;
(19) medical equipment not specifically listed in this paragraph when the use of
the equipment will prevent the need for costlier services that are reimbursable under
this subdivision;
(20) services performed by a certified pediatric nurse practitioner, a certified family
nurse practitioner, a certified adult nurse practitioner, a certified obstetric/gynecological
nurse practitioner, a certified neonatal nurse practitioner, or a certified geriatric nurse
practitioner in independent practice, if (1) the service is otherwise covered under this
chapter as a physician service, (2) the service provided on an inpatient basis is not included
as part of the cost for inpatient services included in the operating payment rate, and (3) the
service is within the scope of practice of the nurse practitioner's license as a registered
nurse, as defined in section 148.171;
(21) services of a certified public health nurse or a registered nurse practicing in
a public health nursing clinic that is a department of, or that operates under the direct
authority of, a unit of government, if the service is within the scope of practice of the
public health nurse's license as a registered nurse, as defined in section 148.171;
(22) telemedicine consultations, to the extent they are covered under section
256B.0625, subdivision 3b; deleted text begin and
deleted text end
(23) mental health telemedicine and psychiatric consultation as covered under
section 256B.0625, subdivisions 46 and 48deleted text begin .deleted text end new text begin ;
new text end
new text begin
(24) care coordination and patient education services provided by a community
health worker according to section 256B.0625, subdivision 49; and
new text end
new text begin
(25) regardless of the number of employees that an enrolled health care provider
may have, sign language interpreter services when provided by an enrolled health care
provider during the course of providing a direct, person-to-person covered health care
service to an enrolled recipient who has a hearing loss and uses interpreting services.
new text end
(ii) Effective October 1, 2003, for a person who is eligible under subdivision 3,
paragraph (a), clause (2), item (ii), general assistance medical care coverage is limited
to inpatient hospital services, including physician services provided during the inpatient
hospital stay. A $1,000 deductible is required for each inpatient hospitalization.
(b) Effective August 1, 2005, sex reassignment surgery is not covered under this
subdivision.
(c) In order to contain costs, the commissioner of human services shall select
vendors of medical care who can provide the most economical care consistent with high
medical standards and shall where possible contract with organizations on a prepaid
capitation basis to provide these services. The commissioner shall consider proposals by
counties and vendors for prepaid health plans, competitive bidding programs, block grants,
or other vendor payment mechanisms designed to provide services in an economical
manner or to control utilization, with safeguards to ensure that necessary services are
provided. Before implementing prepaid programs in counties with a county operated or
affiliated public teaching hospital or a hospital or clinic operated by the University of
Minnesota, the commissioner shall consider the risks the prepaid program creates for the
hospital and allow the county or hospital the opportunity to participate in the program in a
manner that reflects the risk of adverse selection and the nature of the patients served by
the hospital, provided the terms of participation in the program are competitive with the
terms of other participants considering the nature of the population served. Payment for
services provided pursuant to this subdivision shall be as provided to medical assistance
vendors of these services under sections 256B.02, subdivision 8, and 256B.0625. For
payments made during fiscal year 1990 and later years, the commissioner shall consult
with an independent actuary in establishing prepayment rates, but shall retain final control
over the rate methodology.
new text begin
(d) Effective January 1, 2008, drug coverage under general assistance medical care
is limited to prescription drugs that:
new text end
new text begin
(i) are covered under the medical assistance program as described in section
256B.0625, subdivisions 13 and 13d; and
new text end
new text begin
(ii) are provided by manufacturers that have fully executed general assistance
medical care rebate agreements with the commissioner and comply with the agreements.
Prescription drug coverage under general assistance medical care must conform to
coverage under the medical assistance program according to section 256B.0625,
subdivisions 13 to 13g.
new text end
deleted text begin (d)deleted text end new text begin (e)new text end Recipients eligible under subdivision 3, paragraph (a), shall pay the following
co-payments for services provided on or after October 1, 2003new text begin , and before January 1, 2009new text end :
(1) $25 for eyeglasses;
(2) $25 for nonemergency visits to a hospital-based emergency room;
(3) $3 per brand-name drug prescription and $1 per generic drug prescription,
subject to a $12 per month maximum for prescription drug co-payments. No co-payments
shall apply to antipsychotic drugs when used for the treatment of mental illness; and
(4) 50 percent coinsurance on restorative dental services.
deleted text begin (e)deleted text end new text begin (f) Recipients eligible under subdivision 3, paragraph (a), shall include the
following co-payments for services provided on or after January 1, 2009:
new text end
new text begin
(1) $25 for nonemergency visits to a hospital-based emergency room; and
new text end
new text begin
(2) $3 per brand-name drug prescription and $1 per generic drug prescription,
subject to a $7 per month maximum for prescription drug co-payments. No co-payments
shall apply to antipsychotic drugs when used for the treatment of mental illness.
new text end
new text begin (g) new text end Co-payments shall be limited to one per day per provider for nonpreventive visits,
eyeglasses, and nonemergency visits to a hospital-based emergency room. Recipients of
general assistance medical care are responsible for all co-payments in this subdivision.
The general assistance medical care reimbursement to the provider shall be reduced by the
amount of the co-payment, except that reimbursement for prescription drugs shall not be
reduced once a recipient has reached the $12 per month maximum for prescription drug
co-payments. The provider collects the co-payment from the recipient. Providers may
not deny services to recipients who are unable to pay the co-paymentdeleted text begin , except as provided
in paragraph (f)deleted text end .new text begin This paragraph expires January 1, 2009.
new text end
deleted text begin
(f) If it is the routine business practice of a provider to refuse service to an individual
with uncollected debt, the provider may include uncollected co-payments under this
section. A provider must give advance notice to a recipient with uncollected debt before
services can be denied.
deleted text end
new text begin
(h) Effective January 1, 2009, co-payments shall be limited to one per day per
provider for nonemergency visits to a hospital-based emergency room. Recipients of
general assistance medical care are responsible for all co-payments in this subdivision.
The general assistance medical care reimbursement to the provider shall be reduced by the
amount of the co-payment, except that reimbursement for prescription drugs shall not be
reduced once a recipient has reached the $7 per month maximum for prescription drug
co-payments. The provider collects the co-payment from the recipient. Providers may not
deny services to recipients who are unable to pay the co-payment.
new text end
new text begin
(i) General assistance medical care reimbursement to fee-for-service providers
and payments to managed care plans shall not be increased as a result of the removal of
the co-payments effective January 1, 2009.
new text end
deleted text begin (g)deleted text end new text begin (j) new text end Any county may, from its own resources, provide medical payments for
which state payments are not made.
deleted text begin (h)deleted text end new text begin (k) new text end Chemical dependency services that are reimbursed under chapter 254B must
not be reimbursed under general assistance medical care.
deleted text begin (i)deleted text end new text begin (l) new text end The maximum payment for new vendors enrolled in the general assistance
medical care program after the base year shall be determined from the average usual and
customary charge of the same vendor type enrolled in the base year.
deleted text begin (j)deleted text end new text begin (m) new text end The conditions of payment for services under this subdivision are the same
as the conditions specified in rules adopted under chapter 256B governing the medical
assistance program, unless otherwise provided by statute or rule.
deleted text begin (k)deleted text end new text begin (n)new text end Inpatient and outpatient payments shall be reduced by five percent, effective
July 1, 2003. This reduction is in addition to the five percent reduction effective July 1,
2003, and incorporated by reference in paragraph deleted text begin (i)deleted text end new text begin (l)new text end .
deleted text begin (l)deleted text end new text begin (o) new text end Payments for all other health services except inpatient, outpatient, and
pharmacy services shall be reduced by five percent, effective July 1, 2003.
deleted text begin (m)deleted text end new text begin (p) new text end Payments to managed care plans shall be reduced by five percent for services
provided on or after October 1, 2003.
deleted text begin (n)deleted text end new text begin (q) new text end A hospital receiving a reduced payment as a result of this section may apply
the unpaid balance toward satisfaction of the hospital's bad debts.
deleted text begin (o)deleted text end new text begin (r) new text end Fee-for-service payments for nonpreventive visits shall be reduced by $3
for services provided on or after January 1, 2006. For purposes of this subdivision, a
visit means an episode of service which is required because of a recipient's symptoms,
diagnosis, or established illness, and which is delivered in an ambulatory setting by
a physician or physician ancillary, chiropractor, podiatrist, advance practice nurse,
audiologist, optician, or optometrist.
deleted text begin (p)deleted text end new text begin (s) new text end Payments to managed care plans shall not be increased as a result of the
removal of the $3 nonpreventive visit co-payment effective January 1, 2006.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2007, unless another effective
date is explicit.
new text end
Sec. 18.
Minnesota Statutes 2006, section 256L.01, subdivision 1, is amended to read:
Sec. 19.
Minnesota Statutes 2006, section 256L.01, subdivision 4, is amended to read:
Subd. 4.
Gross individual or gross family income.
(a) "Gross individual or gross
family income" for nonfarm self-employed means income calculated for the deleted text begin six-monthdeleted text end
new text begin 12-month new text end period of eligibility using the net profit or loss reported on the applicant's
federal income tax form for the previous year and using the medical assistance families
with children methodology for determining allowable and nonallowable self-employment
expenses and countable income.
(b) "Gross individual or gross family income" for farm self-employed means income
calculated for the deleted text begin six-monthdeleted text end new text begin 12-month new text end period of eligibility using as the baseline the
adjusted gross income reported on the applicant's federal income tax form for the previous
year deleted text begin and adding back in reported depreciation amounts that apply to the business in which
the family is currently engageddeleted text end .
(c) "Gross individual or gross family income" means the total income for all family
members, calculated for the deleted text begin six-monthdeleted text end new text begin 12-month new text end period of eligibility.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2007, or upon federal
approval, whichever is later.
new text end
Sec. 20.
Minnesota Statutes 2006, section 256L.03, subdivision 1, is amended to read:
Subdivision 1.
Covered health services.
deleted text begin For individuals under section 256L.04,
subdivision 7, with income no greater than 75 percent of the federal poverty guidelines
or for families with children under section 256L.04, subdivision 1, all subdivisions of
this section apply.deleted text end "Covered health services" means the health services reimbursed
under chapter 256B, with the exception of inpatient hospital services, special education
services, private duty nursing services, adult dental care services other than services
covered under section 256B.0625, subdivision 9, orthodontic services, nonemergency
medical transportation services, personal care assistant and case management services,
nursing home or intermediate care facilities services, inpatient mental health services,
and chemical dependency services. Outpatient mental health services covered under the
MinnesotaCare program are limited to diagnostic assessments, psychological testing,
explanation of findings, mental health telemedicine, psychiatric consultation, medication
management by a physician, day treatment, partial hospitalization, and individual, family,
and group psychotherapy.
No public funds shall be used for coverage of abortion under MinnesotaCare
except where the life of the female would be endangered or substantial and irreversible
impairment of a major bodily function would result if the fetus were carried to term; or
where the pregnancy is the result of rape or incest.
Covered health services shall be expanded as provided in this section.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2008.
new text end
Sec. 21.
Minnesota Statutes 2006, section 256L.03, subdivision 3, is amended to read:
Subd. 3.
Inpatient hospital services.
(a) Covered health services shall include
inpatient hospital services, including inpatient hospital mental health services and inpatient
hospital and residential chemical dependency treatment, subject to those limitations
necessary to coordinate the provision of these services with eligibility under the medical
assistance spenddown. deleted text begin Prior to July 1, 1997, the inpatient hospital benefit for adult
enrollees is subject to an annual benefit limit of $10,000.deleted text end The inpatient hospital benefit for
adult enrollees who qualify under section 256L.04, subdivision 7, or who qualify under
section 256L.04, subdivisions 1 and 2, with family gross income that exceeds deleted text begin 175deleted text end new text begin 200new text end
percent of the federal poverty guidelines new text begin or 215 percent of the federal poverty guidelines
on or after July 1, 2009, new text end and who are not pregnant, is subject to an annual limit of $10,000.
(b) Admissions for inpatient hospital services paid for under section 256L.11,
subdivision 3, must be certified as medically necessary in accordance with Minnesota
Rules, parts 9505.0500 to 9505.0540, except as provided in clauses (1) and (2):
(1) all admissions must be certified, except those authorized under rules established
under section 254A.03, subdivision 3, or approved under Medicare; and
(2) payment under section 256L.11, subdivision 3, shall be reduced by five percent
for admissions for which certification is requested more than 30 days after the day of
admission. The hospital may not seek payment from the enrollee for the amount of the
payment reduction under this clause.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2008.
new text end
Sec. 22.
Minnesota Statutes 2006, section 256L.03, subdivision 5, is amended to read:
Subd. 5.
Co-payments and coinsurance.
(a) Except as provided in paragraphs (b)
and (c), the MinnesotaCare benefit plan shall include the following co-payments and
coinsurance requirements for all enrollees:
(1) ten percent of the paid charges for inpatient hospital services for adult enrollees,
subject to an annual inpatient out-of-pocket maximum of $1,000 per individual and
$3,000 per family;
(2) $3 per prescription for adult enrollees;
(3) $25 for eyeglasses for adult enrollees;
(4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an
episode of service which is required because of a recipient's symptoms, diagnosis, or
established illness, and which is delivered in an ambulatory setting by a physician or
physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse,
audiologist, optician, or optometrist; and
(5) $6 for nonemergency visits to a hospital-based emergency room.
(b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of
children under the age of 21 deleted text begin in households with family income equal to or less than 175
percent of the federal poverty guidelines. Paragraph (a), clause (1), does not apply to
parents and relative caretakers of children under the age of 21 in households with family
income greater than 175 percent of the federal poverty guidelines for inpatient hospital
admissions occurring on or after January 1, 2001deleted text end .
(c) Paragraph (a)deleted text begin , clauses (1) to (4), dodeleted text end new text begin doesnew text end not apply to pregnant women and
children under the age of 21.
(d) Adult enrollees with family gross income that exceeds deleted text begin 175deleted text end new text begin 200new text end percent of the
federal poverty guidelines new text begin or 215 percent of the federal poverty guidelines on or after July
1, 2009, new text end and who are not pregnant shall be financially responsible for the coinsurance
amount, if applicable, and amounts which exceed the $10,000 inpatient hospital benefit
limit.
(e) When a MinnesotaCare enrollee becomes a member of a prepaid health plan,
or changes from one prepaid health plan to another during a calendar year, any charges
submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket
expenses incurred by the enrollee for inpatient services, that were submitted or incurred
prior to enrollment, or prior to the change in health plans, shall be disregarded.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2008.
new text end
Sec. 23.
Minnesota Statutes 2006, section 256L.04, subdivision 7, is amended to read:
Subd. 7.
Single adults and households with no children.
The definition of eligible
persons includes all individuals and households with no children who have gross family
incomes that are equal to or less than deleted text begin 175deleted text end new text begin 200new text end percent of the federal poverty guidelines.new text begin
Effective July 1, 2009, the definition of eligible persons includes all individuals and
households with no children who have gross family incomes that are equal to or less than
215 percent of the federal poverty guidelines.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2008.
new text end
Sec. 24.
Minnesota Statutes 2006, section 256L.05, subdivision 1, is amended to read:
Subdivision 1.
Application and information availability.
Applications and deleted text begin other
informationdeleted text end new text begin application assistancenew text end must be made available deleted text begin todeleted text end new text begin atnew text end provider offices, local
human services agencies, school districts, public and private elementary schools in which
25 percent or more of the students receive free or reduced price lunches, community health
offices, deleted text begin anddeleted text end Women, Infants and Children (WIC) program sitesnew text begin , Head Start program sites,
public housing councils, crisis nurseries, child care centers, early childhood education
and preschool program sites, legal aid offices, and librariesnew text end . These sites may accept
applications and forward the forms to the commissionernew text begin or local county human services
agencies that choose to participate as an enrollment sitenew text end . Otherwise, applicants may apply
directly to the commissionernew text begin or to participating local county human services agenciesnew text end .
deleted text begin Beginning January 1, 2000, MinnesotaCare enrollment sites will be expanded to include
local county human services agencies which choose to participate.
deleted text end
Sec. 25.
Minnesota Statutes 2006, section 256L.05, subdivision 1b, is amended to read:
Subd. 1b.
MinnesotaCare enrollment by county agencies.
Beginning September
1, 2006, county agencies shall enroll single adults and households with no children
formerly enrolled in general assistance medical care in MinnesotaCare according to
section 256D.03, subdivision 3. County agencies shall perform all duties necessary
to administer the MinnesotaCare program ongoing for these enrollees, including the
redetermination of MinnesotaCare eligibility at deleted text begin six-monthdeleted text end renewal.
Sec. 26.
Minnesota Statutes 2006, section 256L.05, subdivision 2, is amended to read:
Subd. 2.
Commissioner's duties.
deleted text begin (a)deleted text end The commissioner or county agency shall
use electronic verification as the primary method of income verification. If there is a
discrepancy between reported income and electronically verified income, an individual
may be required to submit additional verification. In addition, the commissioner shall
perform random audits to verify reported income and eligibility. The commissioner
may execute data sharing arrangements with the Department of Revenue and any other
governmental agency in order to perform income verification related to eligibility and
premium payment under the MinnesotaCare program.
deleted text begin
(b) In determining eligibility for MinnesotaCare, the commissioner shall require
applicants and enrollees seeking renewal of eligibility to verify both earned and unearned
income. The commissioner shall also require applicants and enrollees to submit the names
of their employers and a contact name with a telephone number for each employer for
purposes of verifying whether the applicant or enrollee, and any dependents, are eligible
for employer-subsidized coverage. Data collected is nonpublic data as defined in section
deleted text begin 13.02, subdivision 9deleted text end .
deleted text end
Sec. 27.
Minnesota Statutes 2006, section 256L.05, subdivision 3a, is amended to read:
Subd. 3a.
Renewal of eligibility.
(a) Beginning deleted text begin January 1, 1999deleted text end new text begin July 1, 2007new text end , an
enrollee's eligibility must be renewed every 12 months. The 12-month period begins in
the month after the month the application is approved.
(b) deleted text begin Beginning October 1, 2004, an enrollee's eligibility must be renewed every
six months. The first six-month period of eligibility begins the month the application is
received by the commissioner. The effective date of coverage within the first six-month
period of eligibility is as provided in subdivision 3.deleted text end Each new period of eligibility must
take into account any changes in circumstances that impact eligibility and premium
amount. An enrollee must provide all the information needed to redetermine eligibility by
the first day of the month that ends the eligibility period. The premium for the new period
of eligibility must be received as provided in section 256L.06 in order for eligibility to
continue.
(c) For single adults and households with no children formerly enrolled in general
assistance medical care and enrolled in MinnesotaCare according to section 256D.03,
subdivision 3, the first deleted text begin six-monthdeleted text end period of eligibility begins the month the enrollee
submitted the application or renewal for general assistance medical care.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2007, or upon federal
approval, whichever is later.
new text end
Sec. 28.
Minnesota Statutes 2006, section 256L.07, subdivision 1, is amended to read:
Subdivision 1.
General requirements.
(a) Children enrolled in the original
children's health plan as of September 30, 1992, children who enrolled in the
MinnesotaCare program after September 30, 1992, pursuant to Laws 1992, chapter 549,
article 4, section 17, and children who have family gross incomes that are equal to or
less than 150 percent of the federal poverty guidelines are eligible without meeting
the requirements of subdivision 2 and the four-month requirement in subdivision 3, as
long as they maintain continuous coverage in the MinnesotaCare program or medical
assistance. Children who apply for MinnesotaCare on or after the implementation date
of the employer-subsidized health coverage program as described in Laws 1998, chapter
407, article 5, section 45, who have family gross incomes that are equal to or less than 150
percent of the federal poverty guidelines, must meet the requirements of subdivision 2 to
be eligible for MinnesotaCare.
deleted text begin (b)deleted text end Families enrolled in MinnesotaCare under section 256L.04, subdivision 1, whose
income increases above 275 percent of the federal poverty guidelines, are no longer
eligible for the program and shall be disenrolled by the commissioner. new text begin Beginning January
1, 2008, new text end individuals enrolled in MinnesotaCare under section 256L.04, subdivision 7,
whose income increases above deleted text begin 175deleted text end new text begin 200new text end percent of the federal poverty guidelines new text begin or 215
percent of the federal poverty guidelines on or after July 1, 2009, new text end are no longer eligible for
the program and shall be disenrolled by the commissioner. For persons disenrolled under
this subdivision, MinnesotaCare coverage terminates the last day of the calendar month
following the month in which the commissioner determines that the income of a family or
individual exceeds program income limits.
deleted text begin (c)deleted text end new text begin (b) new text end Notwithstanding paragraph deleted text begin (b)deleted text end new text begin (a)new text end , children may remain enrolled in
MinnesotaCare if ten percent of their gross individual or gross family income as defined
in section 256L.01, subdivision 4, is less than the new text begin annual new text end premium for a deleted text begin six-monthdeleted text end
policy with a $500 deductible available through the Minnesota Comprehensive Health
Association. Children who are no longer eligible for MinnesotaCare under this clause shall
be given a 12-month notice period from the date that ineligibility is determined before
disenrollment. The premium for children remaining eligible under this clause shall be the
maximum premium determined under section 256L.15, subdivision 2, paragraph (b).
deleted text begin (d)deleted text end new text begin (c)new text end Notwithstanding paragraphs deleted text begin (b)deleted text end new text begin (a)new text end and deleted text begin (c)deleted text end new text begin (b)new text end , parents are not eligible for
MinnesotaCare if gross household income exceeds deleted text begin $25,000 for the six-monthdeleted text end new text begin $50,000
for the twelve-monthnew text end period of eligibility.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2007, or upon federal
approval, whichever is later.
new text end
Sec. 29.
Minnesota Statutes 2006, section 256L.07, subdivision 6, is amended to read:
Subd. 6.
Exception for certain adults.
Single adults and households with
no children formerly enrolled in general assistance medical care and enrolled in
MinnesotaCare according to section 256D.03, subdivision 3, are eligible without meeting
the requirements of this section until deleted text begin six-monthdeleted text end renewal.
Sec. 30.
Minnesota Statutes 2006, section 256L.09, subdivision 4, is amended to read:
Subd. 4.
Eligibility as Minnesota resident.
(a) For purposes of this section, a
permanent Minnesota resident is a person who has demonstrated, through persuasive and
objective evidence, that the person is domiciled in the state and intends to live in the
state permanently.
(b) To be eligible as a permanent resident, an applicant must demonstrate the
requisite intent to live in the state permanently by:
(1) showing that the applicant maintains a residence at a verified address deleted text begin other than a
place of public accommodationdeleted text end , through the use of evidence of residence described in
section 256D.02, subdivision 12a, new text begin paragraph (b), new text end clause deleted text begin (1)deleted text end new text begin (2)new text end ;
(2) demonstrating that the applicant has been continuously domiciled in the state for
no less than 180 days immediately before the application; and
(3) signing an affidavit declaring that (A) the applicant currently resides in the state
and intends to reside in the state permanently; and (B) the applicant did not come to the
state for the primary purpose of obtaining medical coverage or treatment.
(c) A person who is temporarily absent from the state does not lose eligibility for
MinnesotaCare. "Temporarily absent from the state" means the person is out of the state
for a temporary purpose and intends to return when the purpose of the absence has been
accomplished. A person is not temporarily absent from the state if another state has
determined that the person is a resident for any purpose. If temporarily absent from the
state, the person must follow the requirements of the health plan in which the person is
enrolled to receive services.
Sec. 31.
Minnesota Statutes 2006, section 256L.11, subdivision 7, is amended to read:
Subd. 7.
Critical access dental providers.
Effective for dental services provided
to MinnesotaCare enrollees on or after January 1, 2007, the commissioner shall increase
payment rates to dentists and dental clinics deemed by the commissioner to be critical
access providers under section 256B.76, paragraph (c), by 50 percent above the payment
rate that would otherwise be paid to the provider. The commissioner shall deleted text begin adjust the rates
paid on or after January 1, 2007, todeleted text end new text begin pay the new text end prepaid health plans under contract with the
commissioner new text begin amounts sufficient new text end to reflect this rate increase. The prepaid health plan must
pass this rate increase to providers who have been identified by the commissioner as
critical access dental providers under section 256B.76, paragraph (c).
Sec. 32.
Minnesota Statutes 2006, section 256L.15, subdivision 1, is amended to read:
Subdivision 1.
Premium determination.
(a) Families with children and individuals
shall pay a premium determined according to subdivision 2.
(b) Pregnant women and children under age two are exempt from the provisions
of section 256L.06, subdivision 3, paragraph (b), clause (3), requiring disenrollment
for failure to pay premiums. For pregnant women, this exemption continues until the
first day of the month following the 60th day postpartum. Women who remain enrolled
during pregnancy or the postpartum period, despite nonpayment of premiums, shall be
disenrolled on the first of the month following the 60th day postpartum for the penalty
period that otherwise applies under section 256L.06, unless they begin paying premiums.
new text begin
(c) Members of the military and their families who meet the eligibility criteria
for MinnesotaCare upon eligibility approval made within 24 months following the end
of the member's tour of active duty shall have their premiums paid by the commissioner.
The effective date of coverage for an individual or family who meets the criteria of this
paragraph shall be the first day of the month following the month in which eligibility is
approved. This exemption applies for 12 months. This paragraph expires June 30, 2010.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2007, or upon federal
approval, whichever is later. The commissioner of human services shall notify the Office
of the Revisor of Statutes when federal approval is obtained.
new text end
Sec. 33.
Minnesota Statutes 2006, section 256L.15, subdivision 2, is amended to read:
Subd. 2.
Sliding fee scale; monthly gross individual or family income.
(a) The
commissioner shall establish a sliding fee scale to determine the percentage of monthly
gross individual or family income that households at different income levels must pay
to obtain coverage through the MinnesotaCare program. The sliding fee scale must be
based on the enrollee's monthly gross individual or family income. The sliding fee scale
must contain separate tables based on enrollment of one, two, or three or more persons.
The sliding fee scale begins with a premium of 1.5 percent of monthly gross individual or
family income for individuals or families with incomes below the limits for the medical
assistance program for families and children in effect on January 1, 1999, and proceeds
through the following evenly spaced steps: 1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 7.4, and 8.8 percent.
These percentages are matched to evenly spaced income steps ranging from the medical
assistance income limit for families and children in effect on January 1, 1999, to 275
percent of the federal poverty guidelines for the applicable family size, up to a family size
of five. The sliding fee scale for a family of five must be used for families of more than
five. deleted text begin Effective October 1, 2003, the commissioner shall increase each percentage by 0.5
percentage points for enrollees with income greater than 100 percent but not exceeding
200 percent of the federal poverty guidelines and shall increase each percentage by 1.0
percentage points for families and children with incomes greater than 200 percent of
the federal poverty guidelines.deleted text end The sliding fee scale and percentages are not subject to
the provisions of chapter 14. If a family or individual reports increased income after
enrollment, premiums shall be adjusted at the time the change in income is reported.
(b) deleted text begin Children indeleted text end Families whose gross income is above 275 percent of the federal
poverty guidelines shall pay the maximum premium. The maximum premium is defined
as a base charge for one, two, or three or more enrollees so that if all MinnesotaCare
cases paid the maximum premium, the total revenue would equal the total cost of
MinnesotaCare medical coverage and administration. In this calculation, administrative
costs shall be assumed to equal ten percent of the total. The costs of medical coverage
for pregnant women and children under age two and the enrollees in these groups shall
be excluded from the total. The maximum premium for two enrollees shall be twice the
maximum premium for one, and the maximum premium for three or more enrollees shall
be three times the maximum premium for one.
deleted text begin
(c) After calculating the percentage of premium each enrollee shall pay under
paragraph (a), eight percent shall be added to the premium.
deleted text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2007, or upon federal
approval, whichever is later.
new text end
Sec. 34.
Minnesota Statutes 2006, section 256L.15, subdivision 4, is amended to read:
Subd. 4.
Exception for transitioned adults.
County agencies shall pay premiums
for single adults and households with no children formerly enrolled in general assistance
medical care and enrolled in MinnesotaCare according to section 256D.03, subdivision 3,
until six-month renewal. The county agency has the option of continuing to pay premiums
for these enrollees deleted text begin past the first six-month renewal perioddeleted text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2007.
new text end
Sec. 35.
Minnesota Statutes 2006, section 256L.17, subdivision 2, is amended to read:
Subd. 2.
Limit on total assets.
(a) Effective July 1, 2002, or upon federal approval,
whichever is later, in order to be eligible for the MinnesotaCare program, a household of
two or more persons must not own more than $20,000 in total net assets, and a household
of one person must not own more than $10,000 in total net assets.
(b) For purposes of this subdivision, assets are determined according to section
256B.056, subdivision 3cnew text begin , except that workers' compensation settlements received due to
a work-related injury shall not be considerednew text end .
(c) State-funded MinnesotaCare is not available for applicants or enrollees who are
otherwise eligible for medical assistance but fail to verify assets. Enrollees who become
eligible for federally funded medical assistance shall be terminated from state-funded
MinnesotaCare and transferred to medical assistance.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2007, or upon federal
approval, whichever is later.
new text end
Sec. 36.
Minnesota Statutes 2006, section 256L.17, subdivision 7, is amended to read:
Subd. 7.
Exception for certain adults.
Single adults and households with
no children formerly enrolled in general assistance medical care and enrolled in
MinnesotaCare according to section 256D.03, subdivision 3, are exempt from the
requirements of this section until deleted text begin six-monthdeleted text end renewal.
Sec. 37. new text begin HENNEPIN COUNTY PILOT PROJECT.
new text end
new text begin
The commissioner of human services shall support a pilot project in Hennepin
County to demonstrate the effectiveness of alternative strategies to redetermine eligibility
for certain recipient populations in the medical assistance program. The target populations
for the demonstration are persons who are eligible based upon disability or age, who have
chronic medical conditions, and who are expected to experience minimal change in income
or assets from month to month. The commissioner and the county shall analyze the issues
and strategies employed and the outcomes to determine reasonable efforts to streamline
eligibility statewide. The duration of the pilot project shall be no more than two years.
The commissioner shall apply for any federal waivers needed to implement this section.
new text end
Sec. 38. new text begin PHARMACY REPORT ON DRA IMPACT.
new text end
new text begin Subdivision 1. new text end
new text begin Fiscal impact of deficit reduction act. new text end
new text begin
The commissioner of
human services shall report to the legislature by January 15, 2008, on the fiscal impact of
Deficit Reduction Act reforms on the Minnesota Medicaid pharmacy program, including
but not limited to:
new text end
new text begin
(1) overall cost reductions to the Minnesota Medicaid pharmacy program as a result
of the Deficit Reduction Act of 2005;
new text end
new text begin
(2) the impact of reforms on the federal upper limit on pharmacy reimbursement,
and the amount that the dispensing fee for multiple-source generic drugs would have to
be adjusted to offset any reductions resulting from federal upper limits implemented as a
result of the Deficit Reduction Act of 2005;
new text end
new text begin
(3) the change in federal rebates received from pharmaceutical manufacturers
as a result of Deficit Reduction Act reforms, and strategies that could be employed in
administering the Medicaid drug formulary to compensate for lost manufacturer rebates;
new text end
new text begin
(4) a comparison of published federal upper limits and state maximum allowable
cost (MAC) prices prior to and following implementation of the Deficit Reduction Act
federal upper limit reforms;
new text end
new text begin
(5) the number of participating pharmacies in the program as of January 1, 2007,
July 1, 2007, and November 1, 2007; and
new text end
new text begin
(6) the Minnesota Medicaid fee-for-service pharmacy program rate of generic
dispensing before and after state implementation of Deficit Reduction Act of 2005 generic
reimbursement reform.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 39. new text begin CHIROPRACTIC COVERAGE.
new text end
new text begin
The commissioner of human services, through the Health Services Policy
Committee established under Minnesota Statutes, section 256B.0625, subdivision 3c, and
using existing funding, shall study whether medical assistance coverage for chiropractic
services should be expanded to include initial and progress exams, and shall report
recommendations to the legislature by January 15, 2008.
new text end
Sec. 40. new text begin IMPLEMENTATION.
new text end
new text begin
The commissioner of human services shall implement the amendments to Minnesota
Statutes, sections 256.969, subdivision 9; 256.969, subdivision 27; and 256B.199, on the
earliest date for which the Centers for Medicare and Medicaid Services grants approval.
The commissioner may alter the reporting date for Hennepin County and Hennepin
County Medical Center in Minnesota Statutes, section 256.969, subdivision 9, paragraph
(f), clause (2), to reflect the approved effective date.
new text end
Sec. 41. new text begin REPEALER.
new text end
new text begin
(a) Minnesota Statutes 2006, sections 256B.0625, subdivisions 5a, 5b, 5c, 5d, 5e, 5f,
5g, 5h, 5i, 5j, and 5k; and 256L.07, subdivision 2a,
new text end
new text begin
are repealed effective July 1, 2007.
new text end
new text begin
(b) Minnesota Statutes 2006, sections 256.956,
new text end
new text begin
is repealed effective September
1, 2007.
new text end
new text begin
(c) Minnesota Statutes 2006, section 256L.035,
new text end
new text begin
is repealed effective January 1, 2008.
new text end
new text begin
(d) Minnesota Statutes 2006, section 256B.0631, subdivision 4,
new text end
new text begin
is repealed effective
January 1, 2009.
new text end
ARTICLE 6
CONTINUING CARE POLICY
Section 1.
Minnesota Statutes 2006, section 144A.351, is amended to read:
144A.351 BALANCING LONG-TERM CARE: REPORT REQUIRED.
The commissioners of health and human services, with the cooperation of counties
and regional entities, shall prepare a report to the legislature by deleted text begin Januarydeleted text end new text begin August new text end 15, 2004,
and biennially thereafter, regarding the status of the full range of long-term care services
for the elderly in Minnesota. The report shall address:
(1) demographics and need for long-term care in Minnesota;
(2) summary of county and regional reports on long-term care gaps, surpluses,
imbalances, and corrective action plans;
(3) status of long-term care services by county and region including:
(i) changes in availability of the range of long-term care services and housing
options;
(ii) access problems regarding long-term care; and
(iii) comparative measures of long-term care availability and progress over time; and
(4) recommendations regarding goals for the future of long-term care services,
policy changes, and resource needs.
Sec. 2.
Minnesota Statutes 2006, section 252.32, subdivision 3, is amended to read:
Subd. 3.
Amount of support grant; use.
Support grant amounts shall be
determined by the county social service agency. Services and items purchased with a
support grant must:
(1) be over and above the normal costs of caring for the dependent if the dependent
did not have a disability;
(2) be directly attributable to the dependent's disabling condition; and
(3) enable the family to delay or prevent the out-of-home placement of the dependent.
The design and delivery of services and items purchased under this section must
deleted text begin suit the dependent's chronological age anddeleted text end be provided in the least restrictive environment
possible, consistent with the needs identified in the individual service plan.
Items and services purchased with support grants must be those for which there
are no other public or private funds available to the family. Fees assessed to parents
for health or human services that are funded by federal, state, or county dollars are not
reimbursable through this program.
In approving or denying applications, the county shall consider the following factors:
(1) the extent and areas of the functional limitations of the disabled child;
(2) the degree of need in the home environment for additional support; and
(3) the potential effectiveness of the grant to maintain and support the person in
the family environment.
The maximum monthly grant amount shall be $250 per eligible dependent, or
$3,000 per eligible dependent per state fiscal year, within the limits of available fundsnew text begin and
as adjusted by any legislatively authorized cost of living adjustmentnew text end . The county social
service agency may consider the dependent's supplemental security income in determining
the amount of the support grant.
Any adjustments to their monthly grant amount must be based on the needs of the
family and funding availability.
Sec. 3.
Minnesota Statutes 2006, section 256.476, subdivision 1, is amended to read:
Subdivision 1.
Purpose and goals.
The commissioner of human services shall
establish a consumer support grant program for individuals with functional limitations and
their families who wish to purchase and secure their own supports. deleted text begin The commissioner and
local agencies shall jointly develop an implementation plan which must include a way to
resolve the issues related to county liability.deleted text end The program shall:
(1) make support grants available to individuals or families as an effective alternative
to the deleted text begin developmental disabilitydeleted text end family support program, personal care attendant services,
home health aide services, and private duty nursing services;
(2) provide consumers more control, flexibility, and responsibility over their services
and supports;
(3) promote local program management and decision making; and
(4) encourage the use of informal and typical community supports.
Sec. 4.
Minnesota Statutes 2006, section 256.476, subdivision 2, is amended to read:
Subd. 2.
Definitions.
For purposes of this section, the following terms have the
meanings given them:
(a) "County board" means the county board of commissioners for the county of
financial responsibility as defined in section 256G.02, subdivision 4, or its designated
representative. When a human services board has been established under sections 402.01
to 402.10, it shall be considered the county board for the purposes of this section.
(b) "Family" means the person's birth parents, adoptive parents or stepparents,
siblings or stepsiblings, children or stepchildren, grandparents, grandchildren, niece,
nephew, aunt, uncle, or spouse. For the purposes of this section, a family member is
at least 18 years of age.
(c) "Functional limitations" means the long-term inability to perform an activity or
task in one or more areas of major life activity, including self-care, understanding and use
of language, learning, mobility, self-direction, and capacity for independent living. For the
purpose of this section, the inability to perform an activity or task results from a mental,
emotional, psychological, sensory, or physical disability, condition, or illness.
(d) "Informed choice" means a voluntary decision made by the person deleted text begin ordeleted text end new text begin ,new text end
the person's legal representative, new text begin or other authorized representative new text end after becoming
familiarized with the alternatives to:
(1) select a preferred alternative from a number of feasible alternatives;
(2) select an alternative which may be developed in the future; and
(3) refuse any or all alternatives.
(e) "Local agency" means the local agency authorized by the county board or,
for counties not participating in the consumer grant program by July 1, 2002, the
commissioner, to carry out the provisions of this section.
(f) "Person" or "persons" means a person or persons meeting the eligibility criteria in
subdivision 3.
(g) "Authorized representative" means an individual designated by the person or
their legal representative to act on their behalf. This individual may be a family member,
guardian, representative payee, or other individual designated by the person or their legal
representative, if any, to assist in purchasing and arranging for supports. For the purposes
of this section, an authorized representative is at least 18 years of age.
(h) "Screening" means the screening of a person's service needs under sections
256B.0911 and 256B.092.
(i) "Supports" means services, care, aids, environmental modifications, or assistance
purchased by the person deleted text begin or the person's familydeleted text end new text begin , the person's legal representative, or other
authorized representativenew text end . Examples of supports include respite care, assistance with daily
living, and assistive technology. For the purpose of this section, notwithstanding the
provisions of section 144A.43, supports purchased under the consumer support program
are not considered home care services.
(j) "Program of origination" means the program the individual transferred from
when approved for the consumer support grant program.
Sec. 5.
Minnesota Statutes 2006, section 256.476, subdivision 3, is amended to read:
Subd. 3.
Eligibility to apply for grants.
(a) A person is eligible to apply for a
consumer support grant if the person meets all of the following criteria:
(1) the person is eligible for and has been approved to receive services under
medical assistance as determined under sections 256B.055 and 256B.056 or the person
has been approved to receive a grant under the deleted text begin developmental disabilitydeleted text end family support
program under section 252.32;
(2) the person is able to direct and purchase the person's own care and supports, or
the person has a family member, legal representative, or other authorized representative
who can purchase and arrange supports on the person's behalf;
(3) the person has functional limitations, requires ongoing supports to live in the
community, and is at risk of or would continue institutionalization without such supports;
and
(4) the person will live in a home. For the purpose of this section, "home" means the
person's own home or home of a person's family member. These homes are natural home
settings and are not licensed by the Department of Health or Human Services.
(b) Persons may not concurrently receive a consumer support grant if they are:
(1) receiving personal care attendant and home health aide services, or private duty
nursing under section 256B.0625; a deleted text begin developmental disabilitydeleted text end family support grant; or
alternative care services under section 256B.0913; or
(2) residing in an institutional or congregate care setting.
(c) A person or person's family receiving a consumer support grant shall not be
charged a fee or premium by a local agency for participating in the program.
(d) Individuals receiving home and community-based waivers under United States
Code, title 42, section 1396h(c), are not eligible for the consumer support grant, except
for individuals receiving consumer support grants before July 1, 2003, as long as other
eligibility criteria are met.
(e) The commissioner shall establish a budgeted appropriation each fiscal year
for the consumer support grant program. The number of individuals participating in
the program will be adjusted so the total amount allocated to counties does not exceed
the amount of the budgeted appropriation. The budgeted appropriation will be adjusted
annually to accommodate changes in demand for the consumer support grants.
Sec. 6.
Minnesota Statutes 2006, section 256.476, subdivision 4, is amended to read:
Subd. 4.
Support grants; criteria and limitations.
(a) A county board may
choose to participate in the consumer support grant program. If a county has not chosen
to participate by July 1, 2002, the commissioner shall contract with another county or
other entity to provide access to residents of the nonparticipating county who choose
the consumer support grant option. The commissioner shall notify the county board
in a county that has declined to participate of the commissioner's intent to enter into
a contract with another county or other entity at least 30 days in advance of entering
into the contract. The local agency shall establish written procedures and criteria to
determine the amount and use of support grants. These procedures must include, at least,
the availability of respite care, assistance with daily living, and adaptive aids. The local
agency may establish monthly or annual maximum amounts for grants and procedures
where exceptional resources may be required to meet the health and safety needs of the
person on a time-limited basis, however, the total amount awarded to each individual may
not exceed the limits established in subdivision 11.
(b) Support grants to a person deleted text begin or a person's familydeleted text end new text begin , a person's legal representative,
or other authorized representativenew text end will be provided through a monthly subsidy payment
and be in the form of cash, voucher, or direct county payment to vendor. Support grant
amounts must be determined by the local agency. Each service and item purchased with a
support grant must meet all of the following criteria:
(1) it must be over and above the normal cost of caring for the person if the person
did not have functional limitations;
(2) it must be directly attributable to the person's functional limitations;
(3) it must enable the person deleted text begin or the person's familydeleted text end new text begin , a person's legal representative,
or other authorized representativenew text end to delay or prevent out-of-home placement of the
person; and
(4) it must be consistent with the needs identified in the service agreement, when
applicable.
(c) Items and services purchased with support grants must be those for which there
are no other public or private funds available to the person deleted text begin or the person's familydeleted text end new text begin , a person's
legal representative, or other authorized representativenew text end . Fees assessed to the person or the
person's family for health and human services are not reimbursable through the grant.
(d) In approving or denying applications, the local agency shall consider the
following factors:
(1) the extent and areas of the person's functional limitations;
(2) the degree of need in the home environment for additional support; and
(3) the potential effectiveness of the grant to maintain and support the person in the
family environment or the person's own home.
(e) At the time of application to the program or screening for other services,
the person deleted text begin or the person's familydeleted text end new text begin , a person's legal representative, or other authorized
representativenew text end shall be provided sufficient information to ensure an informed choice
of alternatives by the person, the person's legal representative,new text begin or other authorized
representative,new text end if anydeleted text begin , or the person's familydeleted text end . The application shall be made to the local
agency and shall specify the needs of the person and family, the form and amount of
grant requested, the items and services to be reimbursed, and evidence of eligibility for
medical assistance.
(f) Upon approval of an application by the local agency and agreement on a support
plan for the person or person's family, the local agency shall make grants to the person or
the person's family. The grant shall be in an amount for the direct costs of the services or
supports outlined in the service agreement.
(g) Reimbursable costs shall not include costs for resources already available, such as
special education classes, day training and habilitation, case management, other services to
which the person is entitled, medical costs covered by insurance or other health programs,
or other resources usually available at no cost to the person or the person's family.
(h) The state of Minnesota, the county boards participating in the consumer
support grant program, or the agencies acting on behalf of the county boards in the
implementation and administration of the consumer support grant program shall not be
liable for damages, injuries, or liabilities sustained through the purchase of support by
the individual, the individual's family, or the authorized representative under this section
with funds received through the consumer support grant program. Liabilities include but
are not limited to: workers' compensation liability, the Federal Insurance Contributions
Act (FICA), or the Federal Unemployment Tax Act (FUTA). For purposes of this section,
participating county boards and agencies acting on behalf of county boards are exempt
from the provisions of section 268.04.
Sec. 7.
Minnesota Statutes 2006, section 256.476, subdivision 5, is amended to read:
Subd. 5.
Reimbursement, allocations, and reporting.
(a) For the purpose of
transferring persons to the consumer support grant program from the deleted text begin developmental
disabilitydeleted text end family support program and personal care assistant services, home health
aide services, or private duty nursing services, the amount of funds transferred by the
commissioner between the deleted text begin developmental disabilitydeleted text end family support program account, the
medical assistance account, or the consumer support grant account shall be based on each
county's participation in transferring persons to the consumer support grant program
from those programs and services.
(b) At the beginning of each fiscal year, county allocations for consumer support
grants shall be based on:
(1) the number of persons to whom the county board expects to provide consumer
supports grants;
(2) their eligibility for current program and services;
(3) the amount of nonfederal dollars allowed under subdivision 11; and
(4) projected dates when persons will start receiving grants. County allocations shall
be adjusted periodically by the commissioner based on the actual transfer of persons or
service openings, and the nonfederal dollars associated with those persons or service
openings, to the consumer support grant program.
(c) The amount of funds transferred by the commissioner from the medical
assistance account for an individual may be changed if it is determined by the county or its
agent that the individual's need for support has changed.
(d) The authority to utilize funds transferred to the consumer support grant account
for the purposes of implementing and administering the consumer support grant program
will not be limited or constrained by the spending authority provided to the program
of origination.
(e) The commissioner may use up to five percent of each county's allocation, as
adjusted, for payments for administrative expenses, to be paid as a proportionate addition
to reported direct service expenditures.
(f) The county allocation for each individual or individual's family cannot exceed
the amount allowed under subdivision 11.
(g) The commissioner may recover, suspend, or withhold payments if the county
board, local agency, or grantee does not comply with the requirements of this section.
(h) Grant funds unexpended by consumers shall return to the state once a year. The
annual return of unexpended grant funds shall occur in the quarter following the end of
the state fiscal year.
Sec. 8.
Minnesota Statutes 2006, section 256.476, subdivision 10, is amended to read:
Subd. 10.
Consumer responsibilities.
Persons receiving grants under this section
shall:
(1) spend the grant money in a manner consistent with their agreement with the
local agency;
(2) notify the local agency of any necessary changes in the grant or the items on
which it is spent;
(3) notify the local agency of any decision made by the person, deleted text begin thedeleted text end new text begin anew text end person's legal
representative, deleted text begin or the person's familydeleted text end new text begin or other authorized representativenew text end that would change
their eligibility for consumer support grants;
(4) arrange and pay for supports; and
(5) inform the local agency of areas where they have experienced difficulty securing
or maintaining supports.
Sec. 9.
Minnesota Statutes 2006, section 256.974, is amended to read:
256.974 OFFICE OF OMBUDSMAN FOR deleted text begin OLDER MINNESOTANSdeleted text end new text begin
LONG-TERM CAREnew text end ; LOCAL PROGRAMS.
The ombudsman for deleted text begin older Minnesotansdeleted text end new text begin long-term carenew text end serves in the classified service
under section 256.01, subdivision 7, in an office within the Minnesota Board on Aging that
incorporates the long-term care ombudsman program required by the Older Americans
Act, deleted text begin Public Law 100-75deleted text end new text begin as amendednew text end , United States Code, title 42, section 3027(a)deleted text begin (12)deleted text end new text begin
(9) and 3058g (a)new text end , and established within the Minnesota Board on Aging. The Minnesota
Board on Aging may make grants to and designate local programs for the provision of
ombudsman services to clients in county or multicounty areas. The local program may not
be an agency engaged in the provision of nursing home care, hospital care, or home care
services either directly or by contract, or have the responsibility for planning, coordinating,
funding, or administering nursing home care, hospital care, or home care services.
Sec. 10.
Minnesota Statutes 2006, section 256.9741, subdivision 1, is amended to read:
Subdivision 1.
Long-term care facility.
"Long-term care facility" means a nursing
home licensed under sections 144A.02 to 144A.10 deleted text begin ordeleted text end new text begin ; anew text end boarding care home licensed
under sections 144.50 to 144.56new text begin ; or a licensed or registered residential setting that provides
or arranges for the provision of home care servicesnew text end .
Sec. 11.
Minnesota Statutes 2006, section 256.9741, subdivision 3, is amended to read:
Subd. 3.
Client.
"Client" means an individual who requests, or on whose behalf a
request is made for, ombudsman services and is (a) a resident of a long-term care facility
or (b) a Medicare beneficiary who requests assistance relating to access, discharge, or
denial of inpatient or outpatient services, or (c) an individual reservingnew text begin , receiving,new text end or
requesting a home care service.
Sec. 12.
Minnesota Statutes 2006, section 256.9742, subdivision 3, is amended to read:
Subd. 3.
Posting.
Every long-term care facility and acute care facility shall post in a
conspicuous place the address and telephone number of the office. A home care service
provider shall provide all recipients, including those in deleted text begin elderlydeleted text end housing with services
under chapter 144D, with the address and telephone number of the office. Counties shall
provide clients receiving deleted text begin a consumer support grant or a service allowancedeleted text end new text begin long-term care
consultation services under section 256B.0911 or home and community-based services
through a state or federally funded program new text end with the name, address, and telephone number
of the office. The posting or notice is subject to approval by the ombudsman.
Sec. 13.
Minnesota Statutes 2006, section 256.9742, subdivision 4, is amended to read:
Subd. 4.
Access to long-term care and acute care facilities and clients.
The
ombudsman or designee may:
(1) enter any long-term care facility without notice at any time;
(2) enter any acute care facility without notice during normal business hours;
(3) enter any acute care facility without notice at any time to interview a patient or
observe services being provided to the patient as part of an investigation of a matter that is
within the scope of the ombudsman's authority, but only if the ombudsman's or designee's
presence does not intrude upon the privacy of another patient or interfere with routine
hospital services provided to any patient in the facility;
(4) communicate privately and without restriction with any client deleted text begin in accordance
with section 144.651deleted text end , as long as the ombudsman has the client's consent for such
communication;
(5) inspect records of a long-term care facility, home care service provider, or acute
care facility that pertain to the care of the client according to deleted text begin sectionsdeleted text end new text begin section new text end 144.335 deleted text begin and
144.651deleted text end ; and
(6) with the consent of a client or client's legal guardian, the ombudsman or
designated staff shall have access to review records pertaining to the care of the client
according to deleted text begin sectionsdeleted text end new text begin section new text end 144.335 deleted text begin and 144.651deleted text end . If a client cannot consent and has no
legal guardian, access to the records is authorized by this section.
A person who denies access to the ombudsman or designee in violation of this
subdivision or aids, abets, invites, compels, or coerces another to do so is guilty of a
misdemeanor.
Sec. 14.
Minnesota Statutes 2006, section 256.9742, subdivision 6, is amended to read:
Subd. 6.
Prohibition against discrimination or retaliation.
(a) No entity shall take
discriminatory, disciplinary, or retaliatory action against an employee or volunteer, or a
patient, resident, or guardian or family member of a patient, resident, or guardian for filing
in good faith a complaint with or providing information to the ombudsman or designee
including volunteers. A person who violates this subdivision or who aids, abets, invites,
compels, or coerces another to do so is guilty of a misdemeanor.
(b) There shall be a rebuttable presumption that any adverse action, as defined below,
within 90 days of report, is discriminatory, disciplinary, or retaliatory. For the purpose
of this clause, the term "adverse action" refers to action taken by the entity involved in a
report against the person making the report or the person with respect to whom the report
was made because of the report, and includes, but is not limited to:
(1) discharge or transfer from a facility;
(2) termination of service;
(3) restriction or prohibition of access to the facility or its residents;
(4) discharge from or termination of employment;
(5) demotion or reduction in remuneration for services; and
(6) any restriction of rights set forth in section 144.651 deleted text begin ordeleted text end new text begin ,new text end 144A.44new text begin , or 144A.751new text end .
Sec. 15.
Minnesota Statutes 2006, section 256.9744, subdivision 1, is amended to read:
Subdivision 1.
Classification.
Except as provided in this section, data maintained
by the office under sections 256.974 to 256.9744 are private data on individuals or
nonpublic data as defined in section 13.02, subdivision 9 or 12, and must be maintained
in accordance with the requirements of deleted text begin Public Law 100-75deleted text end new text begin the Older Americans Act, as
amendednew text end , United States Code, title 42, section deleted text begin 3027(a)(12)(D)deleted text end new text begin 3058g(d)new text end .
Sec. 16.
Minnesota Statutes 2006, section 256.975, is amended by adding a subdivision
to read:
new text begin Subd. 2a. new text end
new text begin Electronic meetings. new text end
new text begin
(a) Notwithstanding section 13D.01, the Minnesota
Board on Aging may conduct a meeting of its members by telephone or other electronic
means so long as the following conditions are met:
new text end
new text begin
(1) all members of the board participating in the meeting, wherever their physical
location, can hear one another and can hear all discussion and testimony;
new text end
new text begin
(2) members of the public present at the regular meeting location of the board can
hear all discussion and testimony and all votes of members of the board;
new text end
new text begin
(3) at least one member of the board is physically present at the regular meeting
location; and
new text end
new text begin
(4) all votes are conducted by roll call, so that each member's vote on each issue
can be identified and recorded.
new text end
new text begin
(b) Each member of the board participating in a meeting by telephone or other
electronic means is considered present at the meeting for purposes of determining a
quorum and participating in all proceedings.
new text end
new text begin
(c) If telephone or other electronic means is used to conduct a meeting, the board,
to the extent practical, shall allow a person to monitor the meeting electronically from
a remote location. The board may require the person making a connection to pay for
documented marginal costs that the board incurs as a result of the additional connection.
new text end
new text begin
(d) If telephone or other electronic means is used to conduct a regular, special, or
emergency meeting, the board shall provide notice of the regular meeting location, of the
fact that some members may participate by telephone or other electronic means, and of
the provisions of paragraph (c). The timing and method of providing notice is governed
by section 13D.04.
new text end
Sec. 17.
Minnesota Statutes 2006, section 256B.0621, subdivision 11, is amended to
read:
Subd. 11.
deleted text begin Data use agreement;deleted text end Notice of relocation assistance.
The commissioner
shall deleted text begin execute a data use agreement with the Centers for Medicare and Medicaid Services
to obtain the long-term care minimum data set data to assist residents of nursing facilities
who havedeleted text end new text begin establish a process with the Centers for Independent Living that allows a person
residing in a Minnesota nursing facility to receive needed information, consultation, and
assistance from one of the centers about the available community support options that may
enable the person to relocate to the community, if the person: (1) is under the age of 65,
(2) hasnew text end indicated a desire to live in the communitydeleted text begin . The commissioner shall in turn enter
into agreements with the Centers for Independent Living to provide information about
assistance for persons who want to move to the community. The commissioner shall work
with the Centers for Independent Living on both the content of the information to be
provided and privacy protections for the individual residentsdeleted text end new text begin , and (3) has signed a release
of information authorized by the person or the person's appointed legal representative.
The process established under this subdivision shall be coordinated with the long-term
care consultation service activities established in section 256B.0911new text end .
Sec. 18.
Minnesota Statutes 2006, section 256B.0625, subdivision 23, is amended to
read:
Subd. 23.
Day treatment services.
Medical assistance covers day treatment
services as specified in sections 245.462, subdivision 8, and 245.4871, subdivision 10, that
are provided under contract with the county board. Notwithstanding Minnesota Rules,
part 9505.0323, subpart 15, the commissioner may set authorization thresholds for day
treatment for adults according to section 256B.0625, subdivision 25. new text begin Notwithstanding
Minnesota Rules, part 9505.0323, subpart 15, new text end effective July 1, 2004, medical assistance
covers day treatment services for children as specified under section 256B.0943.
Sec. 19.
Minnesota Statutes 2006, section 256B.0655, subdivision 1f, is amended to
read:
Subd. 1f.
Personal care assistant.
new text begin (a) new text end "Personal care assistant" means a person who:
(1) is at least 18 years old, except for persons 16 to 18 years of age who participated
in a related school-based job training program or have completed a certified home health
aide competency evaluation;
(2) is able to effectively communicate with the recipient and personal care provider
organization;
(3) effective July 1, 1996, has completed one of the training requirements as
specified in deleted text begin Minnesota Rules, part 9505.0335, subpart 3, items A to Edeleted text end new text begin paragraph (b)new text end ;
(4) has the ability to, and provides covered personal care assistant services according
to the recipient's care plan, responds appropriately to recipient needs, and reports changes
in the recipient's condition to the supervising qualified professional or physician;
(5) is not a consumer of personal care assistant services;
(6) maintains daily written records detailing:
(i) the actual services provided to the recipient; and
(ii) the amount of time spent providing the services; and
(7) is subject to criminal background checks and procedures specified in chapter
245C.
new text begin
(b) Personal care assistant training must include successful completion of one or
more training requirements in:
new text end
new text begin
(1) a nursing assistant training program or its equivalent for which competency as a
nursing assistant is determined according to a test administered by the Minnesota State
Board of Technical Colleges;
new text end
new text begin
(2) a homemaker home health aide preservice training program using a curriculum
recommended by the Department of Health;
new text end
new text begin
(3) an accredited educational program for registered nurses or licensed practical
nurses;
new text end
new text begin
(4) a training program that provides the assistant with skills required to perform
personal care assistant services specified in subdivision 2; or
new text end
new text begin
(5) a determination by the personal care provider that the assistant has, through
training or experience, the skills required to perform the personal care services specified in
subdivision 2.
new text end
Sec. 20.
Minnesota Statutes 2006, section 256B.0655, is amended by adding a
subdivision to read:
new text begin Subd. 12. new text end
new text begin Personal care provider responsibilities. new text end
new text begin
The personal care provider
shall:
new text end
new text begin
(1) employ or contract with services staff to provide personal care services and to
train services staff as necessary;
new text end
new text begin
(2) supervise the personal care services as provided in subdivision 2, paragraph (f);
new text end
new text begin
(3) employ a personal care assistant that a qualified recipient brings to the personal
care provider as the recipient's choice of assistant and who meets the employment
qualifications of the provider, except that a personal care provider who must comply with
the requirements of a governmental personnel administration system is exempt from
this clause;
new text end
new text begin
(4) bill the medical assistance program for a personal care service by the personal
care assistant and a visit by the qualified professional supervising the personal care
assistant;
new text end
new text begin
(5) establish a grievance mechanism to resolve consumer complaints about personal
care services, including the personal care provider's decision whether to employ the
qualified recipient's choice of a personal care assistant;
new text end
new text begin
(6) keep records as required in Minnesota Rules, parts 9505.2160 to 9505.2195;
new text end
new text begin
(7) perform functions and provide services specified in the personal care provider's
contract;
new text end
new text begin
(8) comply with applicable rules and statutes; and
new text end
new text begin
(9) perform other functions as necessary to carry out the responsibilities in clauses
(1) to (8).
new text end
Sec. 21.
Minnesota Statutes 2006, section 256B.0655, is amended by adding a
subdivision to read:
new text begin Subd. 13. new text end
new text begin Personal care provider; employment prohibition. new text end
new text begin
A personal care
provider shall not employ a person to provide personal care service for a qualified
recipient if the person:
new text end
new text begin
(1) refuses to provide full disclosure of criminal history records as specified in
subdivision 1g, clause (1);
new text end
new text begin
(2) has been convicted of a crime that directly relates to the occupation of providing
personal care services to a qualified recipient;
new text end
new text begin
(3) has jeopardized the health or welfare of a vulnerable adult through physical
abuse, sexual abuse, or neglect as defined in section 626.557; or
new text end
new text begin
(4) is misusing or is dependent on mood-altering chemicals, including alcohol, to
the extent that the personal care provider knows or has reason to believe that the use of
chemicals has a negative effect on the person's ability to provide personal care services
or the use of chemicals is apparent during the hours the person is providing personal
care services.
new text end
Sec. 22.
Minnesota Statutes 2006, section 256B.0655, is amended by adding a
subdivision to read:
new text begin Subd. 14. new text end
new text begin Supervision of personal care services. new text end
new text begin
A personal care service to a
qualified recipient as described in subdivision 4 shall be under the supervision of a
qualified professional who shall have the following duties:
new text end
new text begin
(1) ensure that the personal care assistant is capable of providing the required
personal care services through direct observation of the assistant's work or through
consultation with the qualified recipient;
new text end
new text begin
(2) ensure that the personal care assistant is knowledgeable about the plan of
personal care services before the personal care assistant performs personal care services;
new text end
new text begin
(3) ensure that the personal care assistant is knowledgeable about essential
observations of the recipient's health, and about any conditions that should be immediately
brought to the attention of either the qualified professional or the attending physician;
new text end
new text begin
(4) evaluate the personal care services of a recipient through direct observation of
the personal care assistant's work or through consultation with the qualified recipient.
Evaluation shall be made:
new text end
new text begin
(i) within 14 days after the placement of a personal care assistant with the qualified
recipient;
new text end
new text begin
(ii) at least once every 30 days during the first 90 days after the qualified recipient
first receives personal care services according to the plan of personal care service; and
new text end
new text begin
(iii) at least once every 120 days following the period of evaluations in item (ii). The
qualified professional shall record in writing the results of the evaluation and actions taken
to correct any deficiencies in the work of the personal care assistant;
new text end
new text begin
(5) review, together with the recipient, and revise, as necessary, the plan of
personal care services at least once every 120 days after a plan of personal care services
is developed;
new text end
new text begin
(6) ensure that the personal care assistant and recipient are knowledgeable about a
change in the plan of personal care services;
new text end
new text begin
(7) ensure that records are kept, showing the services provided to the recipient
by the personal care assistant as described in subdivision 2, paragraph (f), and the time
spent providing the services;
new text end
new text begin
(8) determine that a qualified recipient is still capable of directing the recipient's
own care or has a responsible party; and
new text end
new text begin
(9) determine with a physician that a recipient is a qualified recipient.
new text end
Sec. 23.
Minnesota Statutes 2006, section 256B.0911, subdivision 3b, is amended to
read:
Subd. 3b.
Transition assistance.
(a) A long-term care consultation team shall
provide assistance to persons residing in a nursing facility, hospital, regional treatment
center, or intermediate care facility for persons with developmental disabilities who
request or are referred for assistance. Transition assistance must include assessment,
community support plan development, referrals to Minnesota health care programs,
and referrals to programs that provide assistance with housing.new text begin Transition assistance
must also include information about the Centers for Independent Living and about other
organizations that can provide assistance with relocation efforts, and information about
contacting these organizations to obtain their assistance and support.
new text end
(b) The county shall develop transition processes with institutional social workers
and discharge planners to ensure that:
(1) persons admitted to facilities receive information about transition assistance
that is available;
(2) the assessment is completed for persons within ten working days of the date of
request or recommendation for assessment; and
(3) there is a plan for transition and follow-up for the individual's return to the
community. The plan must require notification of other local agencies when a person
who may require assistance is screened by one county for admission to a facility located
in another county.
(c) If a person who is eligible for a Minnesota health care program is admitted to a
nursing facility, the nursing facility must include a consultation team member or the case
manager in the discharge planning process.
Sec. 24.
Minnesota Statutes 2006, section 256B.0911, subdivision 4b, is amended to
read:
Subd. 4b.
Exemptions and emergency admissions.
(a) Exemptions from the
federal screening requirements outlined in subdivision 4a, paragraphs (b) and (c), are
limited to:
(1) a person who, having entered an acute care facility from a certified nursing
facility, is returning to a certified nursing facility;
(2) a person transferring from one certified nursing facility in Minnesota to another
certified nursing facility in Minnesota; and
(3) a person, 21 years of age or older, who satisfies the following criteria, as specified
in Code of Federal Regulations, title 42, section 483.106(b)(2):
(i) the person is admitted to a nursing facility directly from a hospital after receiving
acute inpatient care at the hospital;
(ii) the person requires nursing facility services for the same condition for which
care was provided in the hospital; and
(iii) the attending physician has certified before the nursing facility admission that
the person is likely to receive less than 30 days of nursing facility services.
(b) Persons who are exempt from preadmission screening for purposes of level of
care determination include:
(1) persons described in paragraph (a);
(2) an individual who has a contractual right to have nursing facility care paid for
indefinitely by the veterans' administration;
(3) an individual enrolled in a demonstration project under section 256B.69,
subdivision 8, at the time of application to a nursing facility;new text begin andnew text end
(4) an individual currently being served under the alternative care program or under
a home and community-based services waiver authorized under section 1915(c) of the
federal Social Security Actdeleted text begin ; anddeleted text end new text begin .
new text end
deleted text begin
(5) individuals admitted to a certified nursing facility for a short-term stay, which
is expected to be 14 days or less in duration based upon a physician's certification, and
who have been assessed and approved for nursing facility admission within the previous
six months. This exemption applies only if the consultation team member determines at
the time of the initial assessment of the six-month period that it is appropriate to use the
nursing facility for short-term stays and that there is an adequate plan of care for return to
the home or community-based setting. If a stay exceeds 14 days, the individual must be
referred no later than the first county working day following the 14th resident day for a
screening, which must be completed within five working days of the referral. The payment
limitations in subdivision 7 apply to an individual found at screening to not meet the level
of care criteria for admission to a certified nursing facility.
deleted text end
(c) Persons admitted to a Medicaid-certified nursing facility from the community
on an emergency basis as described in paragraph (d) or from an acute care facility on a
nonworking day must be screened the first working day after admission.
(d) Emergency admission to a nursing facility prior to screening is permitted when
all of the following conditions are met:
(1) a person is admitted from the community to a certified nursing or certified
boarding care facility during county nonworking hours;
(2) a physician has determined that delaying admission until preadmission screening
is completed would adversely affect the person's health and safety;
(3) there is a recent precipitating event that precludes the client from living safely in
the community, such as sustaining an injury, sudden onset of acute illness, or a caregiver's
inability to continue to provide care;
(4) the attending physician has authorized the emergency placement and has
documented the reason that the emergency placement is recommended; and
(5) the county is contacted on the first working day following the emergency
admission.
Transfer of a patient from an acute care hospital to a nursing facility is not considered
an emergency except for a person who has received hospital services in the following
situations: hospital admission for observation, care in an emergency room without hospital
admission, or following hospital 24-hour bed care.
(e) A nursing facility must provide deleted text begin adeleted text end written deleted text begin notice to persons who satisfy the criteria
in paragraph (a), clause (3),deleted text end new text begin information to all persons admitted new text end regarding the person's
right to request and receive long-term care consultation services as defined in subdivision
1a. The deleted text begin noticedeleted text end new text begin information new text end must be provided prior to the person's discharge from the
facility and in a format specified by the commissioner.
Sec. 25.
Minnesota Statutes 2006, section 256B.0911, subdivision 4c, is amended to
read:
Subd. 4c.
Screening requirements.
(a) A person may be screened for nursing
facility admission by telephone or in a face-to-face screening interview. Consultation team
members shall identify each individual's needs using the following categories:
(1) the person needs no face-to-face screening interview to determine the need
for nursing facility level of care based on information obtained from other health care
professionals;
(2) the person needs an immediate face-to-face screening interview to determine the
need for nursing facility level of care and complete activities required under subdivision
4a; or
(3) the person may be exempt from screening requirements as outlined in subdivision
4b, but will need transitional assistance after admission or in-person follow-along after
a return home.
(b) Persons admitted on a nonemergency basis to a Medicaid-certified nursing
facility must be screened prior to admission.
deleted text begin
(c) The long-term care consultation team shall recommend a case mix classification
for persons admitted to a certified nursing facility when sufficient information is received
to make that classification. The nursing facility is authorized to conduct all case mix
assessments for persons who have been screened prior to admission for whom the county
did not recommend a case mix classification. The nursing facility is authorized to conduct
all case mix assessments for persons admitted to the facility prior to a preadmission
screening. The county retains the responsibility of distributing appropriate case mix
forms to the nursing facility.
deleted text end
deleted text begin (d)deleted text end new text begin (c)new text end The county screening or intake activity must include processes to identify
persons who may require transition assistance as described in subdivision 3b.
Sec. 26.
Minnesota Statutes 2006, section 256B.0911, subdivision 6, is amended to
read:
Subd. 6.
Payment for long-term care consultation services.
(a) The total payment
for each county must be paid monthly by certified nursing facilities in the county. The
monthly amount to be paid by each nursing facility for each fiscal year must be determined
by dividing the county's annual allocation for long-term care consultation services by 12
to determine the monthly payment and allocating the monthly payment to each nursing
facility based on the number of licensed beds in the nursing facility. Payments to counties
in which there is no certified nursing facility must be made by increasing the payment
rate of the two facilities located nearest to the county seat.
(b) The commissioner shall include the total annual payment determined under
paragraph (a) for each nursing facility reimbursed under section 256B.431 or 256B.434
according to section 256B.431, subdivision 2b, paragraph (g)deleted text begin , or 256B.435deleted text end .
(c) In the event of the layaway, delicensure and decertification, or removal from
layaway of 25 percent or more of the beds in a facility, the commissioner may adjust
the per diem payment amount in paragraph (b) and may adjust the monthly payment
amount in paragraph (a). The effective date of an adjustment made under this paragraph
shall be on or after the first day of the month following the effective date of the layaway,
delicensure and decertification, or removal from layaway.
(d) Payments for long-term care consultation services are available to the county
or counties to cover staff salaries and expenses to provide the services described in
subdivision 1a. The county shall employ, or contract with other agencies to employ, within
the limits of available funding, sufficient personnel to provide long-term care consultation
services while meeting the state's long-term care outcomes and objectives as defined in
section 256B.0917, subdivision 1. The county shall be accountable for meeting local
objectives as approved by the commissioner in the biennial home and community-based
services quality assurance plan on a form provided by the commissioner.
(e) Notwithstanding section 256B.0641, overpayments attributable to payment of the
screening costs under the medical assistance program may not be recovered from a facility.
(f) The commissioner of human services shall amend the Minnesota medical
assistance plan to include reimbursement for the local consultation teams.
(g) The county may bill, as case management services, assessments, support
planning, and follow-along provided to persons determined to be eligible for case
management under Minnesota health care programs. No individual or family member
shall be charged for an initial assessment or initial support plan development provided
under subdivision 3a or 3b.
Sec. 27.
Minnesota Statutes 2006, section 256B.0911, is amended by adding a
subdivision to read:
new text begin Subd. 6a. new text end
new text begin Withholding. new text end
new text begin
If any provider obligated to pay the long-term care
consultation amount as described in subdivision 6 is more than two months delinquent in
the timely payment of the monthly installment, the commissioner may withhold payments,
penalties, and interest in accordance with the methods outlined in section 256.9657,
subdivision 7a. Any amount withheld under this provision must be returned to the county
to whom the delinquent payments were due.
new text end
Sec. 28.
Minnesota Statutes 2006, section 256B.0911, subdivision 7, is amended to
read:
Subd. 7.
Reimbursement for certified nursing facilities.
(a) Medical assistance
reimbursement for nursing facilities shall be authorized for a medical assistance recipient
only if a preadmission screening has been conducted prior to admission or the county has
authorized an exemption. Medical assistance reimbursement for nursing facilities shall
not be provided for any recipient who the local screener has determined does not meet the
level of care criteria for nursing facility placement or, if indicated, has not had a level II
OBRA evaluation as required under the federal Omnibus Budget Reconciliation Act of
1987 completed unless an admission for a recipient with mental illness is approved by the
local mental health authority or an admission for a recipient with developmental disability
is approved by the state developmental disability authority.
(b) The nursing facility must not bill a person who is not a medical assistance
recipient for resident days that preceded the date of completion of screening activities as
required under subdivisions 4a, 4b, and 4c. The nursing facility must include unreimbursed
resident days in the nursing facility resident day totals reported to the commissioner.
deleted text begin
(c) The commissioner shall make a request to the Centers for Medicare and Medicaid
Services for a waiver allowing team approval of Medicaid payments for certified nursing
facility care. An individual has a choice and makes the final decision between nursing
facility placement and community placement after the screening team's recommendation,
except as provided in subdivision 4a, paragraph (c).
deleted text end
Sec. 29.
Minnesota Statutes 2006, section 256B.0913, subdivision 4, is amended to
read:
Subd. 4.
Eligibility for funding for services for nonmedical assistance recipients.
(a) Funding for services under the alternative care program is available to persons who
meet the following criteria:
(1) the person has been determined by a community assessment under section
256B.0911 to be a person who would require the level of care provided in a nursing
facility, but for the provision of services under the alternative care program;
(2) the person is age 65 or older;
(3) the person would be eligible for medical assistance within 135 days of admission
to a nursing facility;
(4) the person is not ineligible for thenew text begin payment of long-term care services by thenew text end
medical assistance program due to an asset transfer penaltynew text begin under section 256B.0595 or
equity interest in the home exceeding $500,000 as stated in section 256B.056new text end ;
(5) the person needsnew text begin long-term carenew text end services that are not funded through other state
or federal funding;
(6) the monthly cost of the alternative care services funded by the program for
this person does not exceed 75 percent of the monthly limit described under section
256B.0915, subdivision 3a. This monthly limit does not prohibit the alternative care client
from payment for additional services, but in no case may the cost of additional services
purchased under this section exceed the difference between the client's monthly service
limit defined under section 256B.0915, subdivision 3, and the alternative care program
monthly service limit defined in this paragraph. If deleted text begin medicaldeleted text end new text begin care-relatednew text end supplies and
equipment or environmental modificationsnew text begin and adaptationsnew text end are or will be purchased for
an alternative care services recipient, the costs may be prorated on a monthly basis for
up to 12 consecutive months beginning with the month of purchase. If the monthly cost
of a recipient's other alternative care services exceeds the monthly limit established in
this paragraph, the annual cost of the alternative care services shall be determined. In this
event, the annual cost of alternative care services shall not exceed 12 times the monthly
limit described in this paragraph; and
(7) the person is making timely payments of the assessed monthly fee.
A person is ineligible if payment of the fee is over 60 days past due, unless the person
agrees to:
(i) the appointment of a representative payee;
(ii) automatic payment from a financial account;
(iii) the establishment of greater family involvement in the financial management of
payments; or
(iv) another method acceptable to the deleted text begin countydeleted text end new text begin lead agencynew text end to ensure prompt fee
payments.
The deleted text begin county shalldeleted text end new text begin lead agency maynew text end extend the client's eligibility as necessary while
making arrangements to facilitate payment of past-due amounts and future premium
payments. Following disenrollment due to nonpayment of a monthly fee, eligibility shall
not be reinstated for a period of 30 days.
(b) Alternative care funding under this subdivision is not available for a person
who is a medical assistance recipient or who would be eligible for medical assistance
without a spenddown or waiver obligation. A person whose initial application for medical
assistance and the elderly waiver program is being processed may be served under the
alternative care program for a period up to 60 days. If the individual is found to be eligible
for medical assistance, medical assistance must be billed for services payable under the
federally approved elderly waiver plan and delivered from the date the individual was
found eligible for the federally approved elderly waiver plan. Notwithstanding this
provision, alternative care funds may not be used to pay for any service the cost of which:
(i) is payable by medical assistance; (ii) is used by a recipient to meet a waiver obligation;
or (iii) is used to pay a medical assistance income spenddown for a person who is eligible
to participate in the federally approved elderly waiver program under the special income
standard provision.
(c) Alternative care funding is not available for a person who resides in a licensed
nursing home, certified boarding care home, hospital, or intermediate care facility, except
for case management services which are provided in support of the discharge planning
process for a nursing home resident or certified boarding care home resident to assist with
a relocation process to a community-based setting.
(d) Alternative care funding is not available for a person whose income is greater
than the maintenance needs allowance under section 256B.0915, subdivision 1d, but equal
to or less than 120 percent of the federal poverty guideline effective July 1 in thenew text begin fiscalnew text end
year for which alternative care eligibility is determined, who would be eligible for the
elderly waiver with a waiver obligation.
Sec. 30.
Minnesota Statutes 2006, section 256B.0913, subdivision 5, is amended to
read:
Subd. 5.
Services covered under alternative care.
Alternative care funding may
be used for payment of costs of:
(1) adult day care;
(2) home health aide;
(3) homemaker services;
(4) personal care;
(5) case management;
(6) respite care;
(7) care-related supplies and equipment;
(8) meals delivered to the home;
(9) new text begin nonmedical new text end transportation;
(10) nursing services;
(11) chore services;
(12) companion services;
(13) nutrition services;
(14) training for direct informal caregivers;
(15) telehome care to provide services in their own homes in conjunction with
in-home visits;
(16) deleted text begin discretionary services, for which counties may make payment from their
alternative care program allocation or services not otherwise defined in this section
or section 256B.0625, following approval by the commissionerdeleted text end new text begin consumer-directed
community services under the alternative care programs which are available statewide and
limited to the average monthly expenditures representative of all alternative care program
participants for the same case mix resident class assigned in the most recent fiscal year for
which complete expenditure data is availablenew text end ;
(17) environmental modificationsnew text begin and adaptationsnew text end ; and
(18) deleted text begin direct cash payments for which counties may make payment from their
alternative care program allocation to clients for the purpose of purchasing services,
following approval by the commissioner, and subject to the provisions of subdivision 5h,
until approval and implementation of consumer-directed services through the federally
approved elderly waiver plan. Upon implementation, consumer-directed services under
the alternative care program are available statewide and limited to the average monthly
expenditures representative of all alternative care program participants for the same case
mix resident class assigned in the most recent fiscal year for which complete expenditure
data is availabledeleted text end new text begin discretionary services, for which lead agencies may make payment from
their alternative care program allocation for services not otherwise defined in this section
or section 256B.0625, following approval by the commissionernew text end .
Total annual payments for discretionary services deleted text begin and direct cash payments, until
the federally approved consumer-directed service option is implemented statewide,deleted text end for
all clients deleted text begin within a county maydeleted text end new text begin served by a lead agency mustnew text end not exceed 25 percent of
that deleted text begin county'sdeleted text end new text begin lead agency'snew text end annual alternative care program base allocation. deleted text begin Thereafter,
discretionary services are limited to 25 percent of the county's annual alternative care
program base allocation.
deleted text end
Sec. 31.
Minnesota Statutes 2006, section 256B.0913, subdivision 5a, is amended to
read:
Subd. 5a.
Services; service definitions; service standards.
(a) Unless specified in
statute, the services, service definitions, and standards for alternative care services shall
be the same as the services, service definitions, and standards specified in the federally
approved elderly waiver plan, except deleted text begin fordeleted text end new text begin alternative care does not cover new text end transitional
support services, assisted living services, adult foster care services, and residential care
deleted text begin servicesdeleted text end new text begin and benefits defined under section 256B.0625 that meet primary and acute
health care needsnew text end .
(b) The deleted text begin countydeleted text end new text begin leadnew text end agency must ensure that the funds are not used to supplant
new text begin or supplement new text end services available through other public assistance or services programsdeleted text begin .deleted text end new text begin ,
including supplementation of client co-pays, deductibles, premiums, or other cost-sharing
arrangements for health-related benefits and services or entitlement programs and services
that are available to the person, but in which they have elected not to enroll.new text end For a provider
of supplies and equipment when the monthly cost of the supplies and equipment is less
than $250, persons or agencies must be employed by or under a contract with the deleted text begin countydeleted text end new text begin
leadnew text end agency or the public health nursing agency of the local board of health in order to
receive funding under the alternative care program. Supplies and equipment may be
purchased from a vendor not certified to participate in the Medicaid program if the cost for
the item is less than that of a Medicaid vendor.
(c) Personal care services must meet the service standards defined in the federally
approved elderly waiver plan, except that a deleted text begin countydeleted text end new text begin leadnew text end agency may contract with a
client's relative who meets the relative hardship waiver requirements or a relative who
meets the criteria and is also the responsible party under an individual service plan that
ensures the client's health and safety and supervision of the personal care services by a
qualified professional as defined in section 256B.0625, subdivision 19c. Relative hardship
is established by the deleted text begin countydeleted text end new text begin lead agencynew text end when the client's care causes a relative caregiver
to do any of the following: resign from a paying job, reduce work hours resulting in lost
wages, obtain a leave of absence resulting in lost wages, incur substantial client-related
expenses, provide services to address authorized, unstaffed direct care time, or meet
special needs of the client unmet in the formal service plan.
Sec. 32.
Minnesota Statutes 2006, section 256B.0913, subdivision 8, is amended to
read:
Subd. 8.
Requirements for individual care plan.
(a) The case manager shall
implement the plan of care for each alternative care client and ensure that a client's
service needs and eligibility are reassessed at least every 12 months. The plan shall
include any services prescribed by the individual's attending physician as necessary to
allow the individual to remain in a community setting. In developing the individual's care
plan, the case manager should include the use of volunteers from families and neighbors,
religious organizations, social clubs, and civic and service organizations to support the
formal home care services. The deleted text begin countydeleted text end new text begin lead agencynew text end shall be held harmless for damages or
injuries sustained through the use of volunteers under this subdivision including workers'
compensation liability. The deleted text begin county of servicedeleted text end new text begin case managernew text end shall provide documentation
in each individual's plan of care and, if requested, to the commissioner that the most
cost-effective alternatives available have been offered to the individual and that the
individual was free to choose among available qualified providers, both public and private,
including qualified case management or service coordination providers other than those
employed by any county; however, the county or tribe maintains responsibility for prior
authorizing services in accordance with statutory and administrative requirements. The
case manager must give the individual a ten-day written notice of any denial, termination,
or reduction of alternative care services.
(b) The county of servicenew text begin or tribenew text end must provide access to and arrange for case
management services, including assuring implementation of the plan.new text begin "County of service"
has the meaning given it in Minnesota Rules, part 9505.0015, subpart 11.new text end The county of
service must notify the county of financial responsibility of the approved care plan and
the amount of encumbered funds.
Sec. 33.
Minnesota Statutes 2006, section 256B.0913, subdivision 9, is amended to
read:
Subd. 9.
Contracting provisions for providers.
Alternative care funds paid to
service providers are subject to audit by the commissioner for fiscal and utilization control.
The lead agency must select providers for contracts or agreements using the
following criteria and other criteria established by the deleted text begin countydeleted text end new text begin lead agencynew text end :
(1) the need for the particular services offered by the provider;
(2) the population to be served, including the number of clients, the length of time
services will be provided, and the medical condition of clients;
(3) the geographic area to be served;
(4) quality assurance methods, including appropriate licensure, certification, or
standards, and supervision of employees when needed;
(5) rates for each service and unit of service exclusive of deleted text begin countydeleted text end new text begin lead agencynew text end
administrative costs;
(6) evaluation of services previously delivered by the provider; and
(7) contract or agreement conditions, including billing requirements, cancellation,
and indemnification.
The deleted text begin countydeleted text end new text begin lead agencynew text end must evaluate its own agency services under the criteria
established for other providers.
Sec. 34.
Minnesota Statutes 2006, section 256B.0913, subdivision 10, is amended to
read:
Subd. 10.
Allocation formula.
(a) deleted text begin The alternative care appropriation for fiscal
years 1992 and beyond shall cover only alternative care eligible clients.deleted text end By July deleted text begin 1deleted text end new text begin 15new text end of
each year, the commissioner shall allocate to county agencies the state funds available for
alternative care for persons eligible under subdivision 2.
(b) The adjusted base for each deleted text begin countydeleted text end new text begin lead agencynew text end is the deleted text begin county'sdeleted text end new text begin lead agency'snew text end
current fiscal year base allocation plus any targeted funds approved during the current
fiscal year. Calculations for paragraphs (c) and (d) are to be made as follows: for each
deleted text begin countydeleted text end new text begin lead agencynew text end , the determination of alternative care program expenditures shall be
based on payments for services rendered from April 1 through March 31 in the base year,
to the extent that claims have been submitted and paid by June 1 of that year.
(c) If the alternative care program expenditures as defined in paragraph (b) are 95
percent or more of the deleted text begin county'sdeleted text end new text begin lead agency'snew text end adjusted base allocation, the allocation for
the next fiscal year is 100 percent of the adjusted base, plus inflation to the extent that
inflation is included in the state budget.
(d) If the alternative care program expenditures as defined in paragraph (b) are less
than 95 percent of the deleted text begin county'sdeleted text end new text begin lead agency'snew text end adjusted base allocation, the allocation
for the next fiscal year is the adjusted base allocation less the amount of unspent funds
below the 95 percent level.
(e) If the annual legislative appropriation for the alternative care program is
inadequate to fund the combined deleted text begin countydeleted text end new text begin lead agencynew text end allocations for a biennium, the
commissioner shall distribute to each deleted text begin countydeleted text end new text begin lead agencynew text end the entire annual appropriation
as that deleted text begin county'sdeleted text end new text begin lead agency'snew text end percentage of the computed base as calculated in paragraphs
(c) and (d).
(f) On agreement between the commissioner and the lead agency, the commissioner
may have discretion to reallocate alternative care base allocations distributed to lead
agencies in which the base amount exceeds program expenditures.
Sec. 35.
Minnesota Statutes 2006, section 256B.0913, subdivision 11, is amended to
read:
Subd. 11.
Targeted funding.
(a) The purpose of targeted funding is to make
additional money available to deleted text begin countiesdeleted text end new text begin lead agenciesnew text end with the greatest need. Targeted
funds are not intended to be distributed equitably among all deleted text begin countiesdeleted text end new text begin lead agenciesnew text end , but
rather, allocated to those with long-term care strategies that meet state goals.
(b) The funds available for targeted funding shall be the total appropriation for each
fiscal year minus deleted text begin countydeleted text end new text begin lead agencynew text end allocations determined under subdivision 10 as
adjusted for any inflation increases provided in appropriations for the biennium.
(c) The commissioner shall allocate targeted funds to deleted text begin countiesdeleted text end new text begin lead agenciesnew text end that
demonstrate to the satisfaction of the commissioner that they have developed feasible
plans to increase alternative care spending. In making targeted funding allocations, the
commissioner shall use the following priorities:
(1) deleted text begin countiesdeleted text end new text begin lead agenciesnew text end that received a lower allocation in fiscal year 1991 than in
fiscal year 1990. Counties remain in this priority until they have been restored to their
fiscal year 1990 level plus inflation;
(2) deleted text begin countiesdeleted text end new text begin lead agenciesnew text end that sustain a base allocation reduction for failure to spend
95 percent of the allocation if they demonstrate that the base reduction should be restored;
(3) deleted text begin countiesdeleted text end new text begin lead agenciesnew text end that propose projects to divert community residents from
nursing home placement or convert nursing home residents to community living; and
(4) deleted text begin countiesdeleted text end new text begin lead agenciesnew text end that can otherwise justify program growth by
demonstrating the existence of waiting lists, demographically justified needs, or other
unmet needs.
(d) deleted text begin Countiesdeleted text end new text begin Lead agenciesnew text end that would receive targeted funds according to
paragraph (c) must demonstrate to the commissioner's satisfaction that the funds
would be appropriately spent by showing how the funds would be used to further the
state's alternative care goals as described in subdivision 1, and that the county has the
administrative and service delivery capability to use them.
(e) The commissioner shall deleted text begin request applicationsdeleted text end new text begin make applications availablenew text end for
targeted funds by November 1 of each year. The deleted text begin countiesdeleted text end new text begin lead agenciesnew text end selected for
targeted funds shall be notified of the amount of their additional funding. Targeted funds
allocated to a deleted text begin countydeleted text end new text begin leadnew text end agency in one year shall be treated as part of the deleted text begin county'sdeleted text end new text begin lead
agency'snew text end base allocation for that year in determining allocations for subsequent years. No
reallocations between deleted text begin countiesdeleted text end new text begin lead agenciesnew text end shall be made.
Sec. 36.
Minnesota Statutes 2006, section 256B.0913, subdivision 12, is amended to
read:
Subd. 12.
Client fees.
(a) A fee is required for all alternative care eligible clients
to help pay for the cost of participating in the program. The amount of the fee for the
alternative care client shall be determined as follows:
(1) when the alternative care client's income less recurring and predictable medical
expenses is less than 100 percent of the federal poverty guideline effective on July 1 of
the state fiscal year in which the fee is being computed, and total assets are less than
$10,000, the fee is zero;
(2) when the alternative care client's income less recurring and predictable medical
expenses is equal to or greater than 100 percent but less than 150 percent of the federal
poverty guideline effective on July 1 of the state fiscal year in which the fee is being
computed, and total assets are less than $10,000, the fee is five percent of the cost of
alternative care services;
(3) when the alternative care client's income less recurring and predictable medical
expenses is equal to or greater than 150 percent but less than 200 percent of the federal
poverty guidelines effective on July 1 of the state fiscal year in which the fee is being
computed and assets are less than $10,000, the fee is 15 percent of the cost of alternative
care services;
(4) when the alternative care client's income less recurring and predictable medical
expenses is equal to or greater than 200 percent of the federal poverty guidelines effective
on July 1 of the state fiscal year in which the fee is being computed and assets are less than
$10,000, the fee is 30 percent of the cost of alternative care services; and
(5) when the alternative care client's assets are equal to or greater than $10,000, the
fee is 30 percent of the cost of alternative care services.
For married persons, total assets are defined as the total marital assets less the
estimated community spouse asset allowance, under section 256B.059, if applicable. For
married persons, total income is defined as the client's income less the monthly spousal
allotment, under section 256B.058.
All alternative care services shall be included in the estimated costs for the purpose
of determining the fee.
Fees are due and payable each month alternative care services are received unless the
actual cost of the services is less than the fee, in which case the fee is the lesser amount.
(b) The fee shall be waived by the commissioner when:
(1) a person deleted text begin whodeleted text end is residing in a nursing facility deleted text begin is receiving case management onlydeleted text end ;
(2) a married couple is requesting an asset assessment under the spousal
impoverishment provisions;
(3) a person is found eligible for alternative care, but is not yet receiving alternative
care servicesnew text begin including case management servicesnew text end ; or
(4) a person has chosen to participate in a consumer-directed service plan for which
the cost is no greater than the total cost of the person's alternative care service plan less
the monthly fee amount that would otherwise be assessed.
(c) The deleted text begin county agency must record in the state's receivable system the client's
assessed fee amount or the reason the fee has been waived. Thedeleted text end commissioner will bill
and collect the fee from the client. Money collected must be deposited in the general fund
and is appropriated to the commissioner for the alternative care program. The client must
supply the deleted text begin countydeleted text end new text begin lead agencynew text end with the client's Social Security number at the time of
application. The deleted text begin countydeleted text end new text begin lead agencynew text end shall supply the commissioner with the client's Social
Security number and other information the commissioner requires to collect the fee from
the client. The commissioner shall collect unpaid fees using the Revenue Recapture Act in
chapter 270A and other methods available to the commissioner. The commissioner may
require deleted text begin countiesdeleted text end new text begin lead agenciesnew text end to inform clients of the collection procedures that may be
used by the state if a fee is not paid. This paragraph does not apply to alternative care
pilot projects authorized in Laws 1993, First Special Session chapter 1, article 5, section
133, if a county operating under the pilot project reports the following dollar amounts
to the commissioner quarterly:
(1) total fees billed to clients;
(2) total collections of fees billed; and
(3) balance of fees owed by clients.
If a deleted text begin countydeleted text end new text begin lead agencynew text end does not adhere to these reporting requirements, the commissioner
may terminate the billing, collecting, and remitting portions of the pilot project and require
the deleted text begin countydeleted text end new text begin lead agencynew text end involved to operate under the procedures set forth in this paragraph.
Sec. 37.
Minnesota Statutes 2006, section 256B.0913, subdivision 13, is amended to
read:
Subd. 13.
deleted text begin Countydeleted text end new text begin Lead agencynew text end biennial plan.
The deleted text begin countydeleted text end new text begin lead agencynew text end biennial
plan for long-term care consultation services under section 256B.0911, the alternative
care program under this section, and waivers for the elderly under section 256B.0915,
shall be submitted by the lead agency as the home and community-based services quality
assurance plan on a form provided by the commissioner.
Sec. 38.
Minnesota Statutes 2006, section 256B.0913, subdivision 14, is amended to
read:
Subd. 14.
Provider requirements, payment, and rate adjustments.
(a) Unless
otherwise specified in statute, providers must be enrolled as Minnesota health care
program providers and abide by the requirements for provider participation according to
Minnesota Rules, part 9505.0195.
(b) Payment for provided alternative care services as approved by the client's
case manager shall occur through the invoice processing procedures of the department's
Medicaid Management Information System (MMIS). To receive payment, the deleted text begin countydeleted text end new text begin lead
agencynew text end or vendor must submit invoices within 12 months following the date of service.
The deleted text begin countydeleted text end new text begin leadnew text end agency and its vendors under contract shall not be reimbursed for services
which exceed the county allocation.
(c) The deleted text begin countydeleted text end new text begin lead agencynew text end shall negotiate individual rates with vendors and may
authorize service payment for actual costs up to the county's current approved rate.
Notwithstanding any other rule or statutory provision to the contrary, the commissioner
shall not be authorized to increase rates by an annual inflation factor, unless so authorized
by the legislature. To improve access to community services and eliminate payment
disparities between the alternative care program and the elderly waiver program, the
commissioner shall establish statewide maximum service rate limits and eliminate
county-specific service rate limits.
(1) Effective July 1, 2001, for service rate limits, except those in subdivision 5,
paragraphs (d) and (i), the rate limit for each service shall be the greater of the alternative
care statewide maximum rate or the elderly waiver statewide maximum rate.
(2) deleted text begin Countiesdeleted text end new text begin Lead agenciesnew text end may negotiate individual service rates with vendors for
actual costs up to the statewide maximum service rate limit.
Sec. 39.
Minnesota Statutes 2006, section 256B.0919, subdivision 3, is amended to
read:
Subd. 3.
County certification of persons providing adult foster care to related
persons.
A person exempt from licensure under section 245A.03, subdivision 2, who
provides adult foster care to a related individual age 65 and older, and who meets the
requirements in Minnesota Rules, parts 9555.5105 to 9555.6265, may be certified by the
county to provide adult foster care. A person certified by the county to provide adult foster
care may be reimbursed for services provided and eligible for funding under deleted text begin sections
256B.0913 anddeleted text end new text begin sectionnew text end 256B.0915, if the relative would suffer a financial hardship as
a result of providing care. For purposes of this subdivision, financial hardship refers
to a situation in which a relative incurs a substantial reduction in income as a result of
resigning from a full-time job or taking a leave of absence without pay from a full-time
job to care for the client.
Sec. 40.
Minnesota Statutes 2006, section 256B.27, subdivision 2a, is amended to read:
Subd. 2a.
deleted text begin On-sitedeleted text end new text begin Cost and statistical datanew text end audits.
deleted text begin Each yeardeleted text end The commissioner
shall provide for deleted text begin the on-sitedeleted text end new text begin an new text end audit of the cost deleted text begin reportsdeleted text end new text begin and statistical data new text end of nursing deleted text begin homesdeleted text end
new text begin facilities new text end participating as vendors of medical assistance. The commissioner shall select for
audit at least 15 percent of deleted text begin thesedeleted text end new text begin thenew text end nursing deleted text begin homesdeleted text end new text begin facilities' data reported new text end at random or
using factors including, but not limited to: new text begin data reported to the public as criteria for rating
nursing facilities; data used to set limits for other medical assistance programs or vendors
of services to nursing facilities;new text end change in ownership; frequent changes in administration
in excess of normal turnover rates; complaints to the commissioner of health about care,
safety, or rights; where previous inspections or reinspections under section 144A.10 have
resulted in correction orders related to care, safety, or rights; or where persons involved in
ownership or administration of the facility have been indicted for alleged criminal activity.
new text begin
The commissioner shall meet the 15 percent requirement by either conducting an
audit focused on an individual nursing facility, a group of facilities, or targeting specific
data categories in multiple nursing facilities. These audits may be conducted on site
at the nursing facility, at office space used by a nursing facility or a nursing facility's
parent organization, or at the commissioner's office. Data being audited may be collected
electronically, in person, or by any other means the commissioner finds acceptable.
new text end
Sec. 41.
Minnesota Statutes 2006, section 256B.431, subdivision 1, is amended to read:
Subdivision 1.
In general.
The commissioner shall determine prospective
payment rates for resident care costs. For rates established on or after July 1, 1985, the
commissioner shall develop procedures for determining operating cost payment rates that
take into account the mix of resident needs, geographic location, and other factors as
determined by the commissioner. The commissioner shall consider whether the fact that a
facility is attached to a hospital or has an average length of stay of 180 days or less should
be taken into account in determining rates. The commissioner shall consider the use of the
standard metropolitan statistical areas when developing groups by geographic location.
The commissioner shall provide notice to each nursing facility on or before deleted text begin May 1deleted text end new text begin August
15new text end of the rates effective for the following rate year except that if legislation is pending on
deleted text begin May 1deleted text end new text begin August 15new text end that may affect rates for nursing facilities, the commissioner shall set the
rates after the legislation is enacted and provide notice to each facility as soon as possible.
Compensation for top management personnel shall continue to be categorized as a
general and administrative cost and is subject to any limits imposed on that cost category.
Sec. 42.
Minnesota Statutes 2006, section 256B.431, subdivision 3f, is amended to
read:
Subd. 3f.
Property costs after July 1, 1988.
(a) Investment per bed limit. For the
rate year beginning July 1, 1988, the replacement-cost-new per bed limit must be $32,571
per licensed bed in multiple bedrooms and $48,857 per licensed bed in a single bedroom.
For the rate year beginning July 1, 1989, the replacement-cost-new per bed limit for a
single bedroom must be $49,907 adjusted according to Minnesota Rules, part 9549.0060,
subpart 4, item A, subitem (1). Beginning January 1, 1990, the replacement-cost-new per
bed limits must be adjusted annually as specified in Minnesota Rules, part 9549.0060,
subpart 4, item A, subitem (1). Beginning January 1, 1991, the replacement-cost-new per
bed limits will be adjusted annually as specified in Minnesota Rules, part 9549.0060,
subpart 4, item A, subitem (1), except that the index utilized will be the Bureau of deleted text begin the
Census: Composite fixed-weighted price index as published in the C30 Report, Value
of New Construction Put in Placedeleted text end new text begin Economic Analysis: Price Indexes for Private Fixed
Investments in Structures; Special Carenew text end .
(b) Rental factor. For the rate year beginning July 1, 1988, the commissioner shall
increase the rental factor as established in Minnesota Rules, part 9549.0060, subpart 8,
item A, by 6.2 percent rounded to the nearest 100th percent for the purpose of reimbursing
nursing facilities for soft costs and entrepreneurial profits not included in the cost valuation
services used by the state's contracted appraisers. For rate years beginning on or after July
1, 1989, the rental factor is the amount determined under this paragraph for the rate year
beginning July 1, 1988.
(c) Occupancy factor. For rate years beginning on or after July 1, 1988, in order
to determine property-related payment rates under Minnesota Rules, part 9549.0060,
for all nursing facilities except those whose average length of stay in a skilled level of
care within a nursing facility is 180 days or less, the commissioner shall use 95 percent
of capacity days. For a nursing facility whose average length of stay in a skilled level of
care within a nursing facility is 180 days or less, the commissioner shall use the greater of
resident days or 80 percent of capacity days but in no event shall the divisor exceed 95
percent of capacity days.
(d) Equipment allowance. For rate years beginning on July 1, 1988, and July 1,
1989, the commissioner shall add ten cents per resident per day to each nursing facility's
property-related payment rate. The ten-cent property-related payment rate increase is not
cumulative from rate year to rate year. For the rate year beginning July 1, 1990, the
commissioner shall increase each nursing facility's equipment allowance as established
in Minnesota Rules, part 9549.0060, subpart 10, by ten cents per resident per day. For
rate years beginning on or after July 1, 1991, the adjusted equipment allowance must be
adjusted annually for inflation as in Minnesota Rules, part 9549.0060, subpart 10, item E.
For the rate period beginning October 1, 1992, the equipment allowance for each nursing
facility shall be increased by 28 percent. For rate years beginning after June 30, 1993, the
allowance must be adjusted annually for inflation.
(e) Post chapter 199 related-organization debts and interest expense. For rate
years beginning on or after July 1, 1990, Minnesota Rules, part 9549.0060, subpart 5, item
E, shall not apply to outstanding related organization debt incurred prior to May 23, 1983,
provided that the debt was an allowable debt under Minnesota Rules, parts 9510.0010
to 9510.0480, the debt is subject to repayment through annual principal payments, and
the nursing facility demonstrates to the commissioner's satisfaction that the interest rate
on the debt was less than market interest rates for similar arm's-length transactions at
the time the debt was incurred. If the debt was incurred due to a sale between family
members, the nursing facility must also demonstrate that the seller no longer participates
in the management or operation of the nursing facility. Debts meeting the conditions of
this paragraph are subject to all other provisions of Minnesota Rules, parts 9549.0010
to 9549.0080.
(f) Building capital allowance for nursing facilities with operating leases. For
rate years beginning on or after July 1, 1990, a nursing facility with operating lease costs
incurred for the nursing facility's buildings shall receive its building capital allowance
computed in accordance with Minnesota Rules, part 9549.0060, subpart 8. If an operating
lease provides that the lessee's rent is adjusted to recognize improvements made by the
lessor and related debt, the costs for capital improvements and related debt shall be allowed
in the computation of the lessee's building capital allowance, provided that reimbursement
for these costs under an operating lease shall not exceed the rate otherwise paid.
Sec. 43.
Minnesota Statutes 2006, section 256B.431, subdivision 17e, is amended to
read:
Subd. 17e.
Replacement-costs-new per bed limit effective deleted text begin Julydeleted text end new text begin October new text end 1, deleted text begin 2001deleted text end new text begin
2007new text end .
Notwithstanding Minnesota Rules, part 9549.0060, subpart 11, item C, subitem
(2), for a total replacement, as defined in deleted text begin paragraph (f)deleted text end new text begin subdivision 17dnew text end , authorized
under section 144A.071 or 144A.073 after July 1, 1999, deleted text begin ordeleted text end any building project that is a
relocation, renovation, upgrading, or conversion completed on or after July 1, 2001, new text begin or
any building project eligible for reimbursement under section 256B.434, subdivision 4f,
new text end the replacement-costs-new per bed limit shall be $74,280 per licensed bed in multiple-bed
rooms, $92,850 per licensed bed in semiprivate rooms with a fixed partition separating
the resident beds, and $111,420 per licensed bed in single rooms. Minnesota Rules, part
9549.0060, subpart 11, item C, subitem (2), does not apply. These amounts must be
adjusted annually as specified in subdivision 3f, paragraph (a), beginning January 1, 2000.
Sec. 44.
Minnesota Statutes 2006, section 256B.431, subdivision 41, is amended to
read:
Subd. 41.
Rate increases for October 1, 2005, and October 1, 2006.
(a) For the
rate period beginning October 1, 2005, the commissioner shall make available to each
nursing facility reimbursed under this section or section 256B.434 an adjustment equal to
2.2553 percent of the total operating payment rate, and for the rate year beginning October
1, 2006, the commissioner shall make available to each nursing facility reimbursed
under this section or section 256B.434 an adjustment equal to 1.2553 percent of the total
operating payment rate.
(b) 75 percent of the money resulting from the rate adjustment under paragraph (a)
must be used to increase wages and benefits and pay associated costs for all employees,
except management fees, the administrator, and central office staff. Except as provided
in paragraph (c), 75 percent of the money received by a facility as a result of the rate
adjustment provided in paragraph (a) must be used only for wage, benefit, and staff
increases implemented on or after the effective date of the rate increase each year, and
must not be used for increases implemented prior to that date.
(c) With respect only to the October 1, 2005, rate increase, a nursing facility that
incurred costs for salary and employee benefit increases first provided after July 1, 2003,
may count those costs towards the amount required to be spent on salaries and benefits
under paragraph (b). These costs must be reported to the commissioner in the form and
manner specified by the commissioner.
(d) Nursing facilities may apply for the portion of the rate adjustment under
paragraph (a) for employee wages and benefits and associated costs. The application
must be made to the commissioner and contain a plan by which the nursing facility
will distribute the funds according to paragraph (b). For nursing facilities in which the
employees are represented by an exclusive bargaining representative, an agreement
negotiated and agreed to by the employer and the exclusive bargaining representative
constitutes the plan. A negotiated agreement may constitute the plan only if the agreement
is finalized after the date of enactment of all increases for the rate year and signed by both
parties prior to submission to the commissioner. The commissioner shall review the
plan to ensure that the rate adjustments are used as provided in paragraph (b). To be
eligible, a facility must submit its distribution plan by March 31, 2006, and March 31,
2007, respectively. The commissioner may approve distribution plans on or before June
30, 2006, and June 30, 2007, respectively. new text begin The commissioner may waive the deadlines in
this paragraph under extraordinary circumstances, either retroactively or prospectively, to
be determined at the sole discretion of the commissioner. new text end If a facility's distribution plan is
effective after the first day of the applicable rate period that the funds are available, the
rate adjustments are effective the same date as the facility's plan.
(e) A copy of the approved distribution plan must be made available to all employees
by giving each employee a copy or by posting a copy in an area of the nursing facility
to which all employees have access. If an employee does not receive the wage and
benefit adjustment described in the facility's approved plan and is unable to resolve the
problem with the facility's management or through the employee's union representative,
the employee may contact the commissioner at an address or telephone number provided
by the commissioner and included in the approved plan.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective upon enactment and is retroactive
from October 1, 2005.
new text end
Sec. 45.
Minnesota Statutes 2006, section 256B.49, subdivision 11, is amended to read:
Subd. 11.
Authority.
(a) The commissioner is authorized to apply for home and
community-based service waivers, as authorized under section 1915(c) of the Social
Security Act to serve persons under the age of 65 who are determined to require the level
of care provided in a nursing home and persons who require the level of care provided in a
hospital. The commissioner shall apply for the home and community-based waivers in
order to:
(i) promote the support of persons with disabilities in the most integrated settings;
(ii) expand the availability of services for persons who are eligible for medical
assistance;
(iii) promote cost-effective options to institutional care; and
(iv) obtain federal financial participation.
(b) The provision of waivered services to medical assistance recipients with
disabilities shall comply with the requirements outlined in the federally approved
applications for home and community-based services and subsequent amendments,
including provision of services according to a service plan designed to meet the needs of
the individual. For purposes of this section, the approved home and community-based
application is considered the necessary federal requirement.
(c) The commissioner shall provide interested persons serving on agency advisory
committees deleted text begin anddeleted text end new text begin ,new text end task forces, new text begin the Centers for Independent Living, new text end and others deleted text begin upondeleted text end new text begin whonew text end
requestdeleted text begin , withdeleted text end new text begin to be on a list to receive,new text end notice of, and an opportunity to comment on,
new text begin at least 30 days before any effective dates, (1) new text end any new text begin substantive changes to the state's
disability services program manual, or (2) new text end changes or amendments to the federally
approved applications for home and community-based waivers, prior to their submission
to the federal Centers for Medicare and Medicaid Services.
(d) The commissioner shall seek approval, as authorized under section 1915(c) of
the Social Security Act, to allow medical assistance eligibility under this section for
children under age 21 without deeming of parental income or assets.
(e) The commissioner shall seek approval, as authorized under section 1915(c) of
the Social Act, to allow medical assistance eligibility under this section for individuals
under age 65 without deeming the spouse's income or assets.
Sec. 46.
Laws 2000, chapter 340, section 19, is amended to read:
Sec. 19. ALTERNATIVE CARE PILOT PROJECTS.
(a) Expenditures for housing with services and adult foster care shall be excluded
when determining average monthly expenditures per client for alternative care pilot
projects authorized in Laws 1993, First Special Session chapter 1, article 5, section 133.
(b) Alternative care pilot projects shall not expire on June 30, 2001, but shall
continue until June 30, deleted text begin 2005deleted text end new text begin 2007new text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective retroactively from June 29, 2005, for
activities related to discontinuing pilot projects under this section.
new text end
Sec. 47. new text begin LICENSURE; SERVICES FOR YOUTH WITH DISABILITIES.
new text end
new text begin
(a) Notwithstanding the requirements of Minnesota Statutes, chapter 245A, upon
the recommendation of a county agency, the commissioner of human services shall
grant a license with any necessary variances to a nonresidential program for youth
that provides services to youth with disabilities under age 21 during nonschool hours
established to ensure health and safety, prevent out-of-home placement, and increase
community inclusion of youth with disabilities. The nonresidential youth program is
subject to the conditions of any variances granted and to consumer rights standards under
Minnesota Statutes, section 245B.04; consumer protection standards under Minnesota
Statutes, section 245B.05; service standards under Minnesota Statutes, section 245B.06;
management standards under Minnesota Statutes, section 245B.07; and fire marshal
inspections under Minnesota Statutes, section 245A.151, until the commissioner develops
other licensure requirements for this type of program.
new text end
new text begin
(b) By February 1, 2008, the commissioner shall recommend amendments to
licensure requirements in Minnesota Statutes, chapter 245A, to allow licensure of
appropriate services for school-age youth with disabilities under age 21 who need
supervision and services to develop skills necessary to maintain personal safety and
increase their independence, productivity, and participation in their communities during
nonschool hours. As part of developing the recommendations, the commissioner shall
survey county agencies to determine how the needs of youth with disabilities under age 21
who require supervision and support services are being met and the funding sources used.
The recommendations must be provided to the house and senate chairs of the committees
with jurisdiction over licensing of programs for youth with disabilities.
new text end
ARTICLE 7
CONTINUING CARE
Section 1.
Minnesota Statutes 2006, section 144A.073, subdivision 4, is amended to
read:
Subd. 4.
Criteria for review.
The following criteria shall be used in a consistent
manner to compare, evaluate, and rank all proposals submitted. Except for the criteria
specified in clause (3), the application of criteria listed under this subdivision shall not
reflect any distinction based on the geographic location of the proposed project:
(1) the extent to which the proposal furthers state long-term care goals, including
the goal of enhancing the availability and use of alternative care services and the goal of
reducing the number of long-term care resident rooms with more than two beds;
(2) the proposal's long-term effects on state costs including the cost estimate of the
project according to section 144A.071, subdivision 5a;
(3) the extent to which the proposal promotes equitable access to long-term care
services in nursing homes through redistribution of the nursing home bed supply, as
measured by the number of beds relative to the population 85 or older, projected to the
year 2000 by the state demographer, and according to items (i) to (iv):
(i) reduce beds in counties where the supply is high, relative to the statewide mean,
and increase beds in counties where the supply is low, relative to the statewide mean;
(ii) adjust the bed supply so as to create the greatest benefits in improving the
distribution of beds;
(iii) adjust the existing bed supply in counties so that the bed supply in a county
moves toward the statewide mean; and
(iv) adjust the existing bed supply so that the distribution of beds as projected for the
year 2020 would be consistent with projected need, based on the methodology outlined in
the Interagency Long-Term Care Committee's nursing home bed distribution study;
(4) the extent to which the project improves conditions that affect the health or
safety of residents, such as narrow corridors, narrow door frames, unenclosed fire exits,
and wood frame construction, and similar provisions contained in fire and life safety
codes and licensure and certification rules;
(5) the extent to which the project improves conditions that affect the comfort or
quality of life of residents in a facility or the ability of the facility to provide efficient
care, such as a relatively high number of residents in a room; inadequate lighting or
ventilation; poor access to bathing or toilet facilities; a lack of available ancillary space for
dining rooms, day rooms, or rooms used for other activities; problems relating to heating,
cooling, or energy efficiency; inefficient location of nursing stations; narrow corridors; or
other provisions contained in the licensure and certification rules;
(6) the extent to which the applicant demonstrates the delivery of quality care, as
defined in state and federal statutes and rules, to residents as evidenced by the two most
recent state agency certification surveys and the applicants' response to those surveys;
(7) the extent to which the project removes the need for waivers or variances
previously granted by either the licensing agency, certifying agency, fire marshal, or
local government entity;
(8) the extent to which the project increases the number of private or single bed
rooms; deleted text begin and
deleted text end
(9) new text begin the extent to which the applicant demonstrates the continuing need for nursing
facility care in the community and adjacent communities; and
new text end
new text begin (10) new text end other factors that may be developed in permanent rule by the commissioner of
health that evaluate and assess how the proposed project will further promote or protect
the health, safety, comfort, treatment, or well-being of the facility's residents.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2007.
new text end
Sec. 2.
Minnesota Statutes 2006, section 252.27, subdivision 2a, is amended to read:
Subd. 2a.
Contribution amount.
(a) The natural or adoptive parents of a minor
child, including a child determined eligible for medical assistance without consideration of
parental income, must contribute to the cost of services used by making monthly payments
on a sliding scale based on income, unless the child is married or has been married,
parental rights have been terminated, or the child's adoption is subsidized according to
section 259.67 or through title IV-E of the Social Security Act. new text begin The parental contribution
is a partial or full payment for medical services provided for diagnostic, therapeutic,
curing, treating, mitigating, rehabilitation, maintenance, and personal care services as
defined in United States Code, title 26, section 213, needed by the child with a chronic
illness or disability.
new text end
(b) For households with adjusted gross income equal to or greater than 100 percent
of federal poverty guidelines, the parental contribution shall be computed by applying the
following schedule of rates to the adjusted gross income of the natural or adoptive parents:
(1) if the adjusted gross income is equal to or greater than 100 percent of federal
poverty guidelines and less than 175 percent of federal poverty guidelines, the parental
contribution is $4 per month;
(2) if the adjusted gross income is equal to or greater than 175 percent of federal
poverty guidelines and less than or equal to 545 percent of federal poverty guidelines,
the parental contribution shall be determined using a sliding fee scale established by the
commissioner of human services which begins at one percent of adjusted gross income
at 175 percent of federal poverty guidelines and increases to 7.5 percent of adjusted
gross income for those with adjusted gross income up to 545 percent of federal poverty
guidelines;
(3) if the adjusted gross income is greater than 545 percent of federal poverty
guidelines and less than 675 percent of federal poverty guidelines, the parental
contribution shall be 7.5 percent of adjusted gross income;
(4) if the adjusted gross income is equal to or greater than 675 percent of federal
poverty guidelines and less than 975 percent of federal poverty guidelines, the parental
contribution shall be determined using a sliding fee scale established by the commissioner
of human services which begins at 7.5 percent of adjusted gross income at 675 percent of
federal poverty guidelines and increases to ten percent of adjusted gross income for those
with adjusted gross income up to 975 percent of federal poverty guidelines; and
(5) if the adjusted gross income is equal to or greater than 975 percent of federal
poverty guidelines, the parental contribution shall be 12.5 percent of adjusted gross
income.
If the child lives with the parent, the annual adjusted gross income is reduced by
$2,400 prior to calculating the parental contribution. If the child resides in an institution
specified in section 256B.35, the parent is responsible for the personal needs allowance
specified under that section in addition to the parental contribution determined under this
section. The parental contribution is reduced by any amount required to be paid directly to
the child pursuant to a court order, but only if actually paid.
(c) The household size to be used in determining the amount of contribution under
paragraph (b) includes natural and adoptive parents and their dependents, including the
child receiving services. Adjustments in the contribution amount due to annual changes
in the federal poverty guidelines shall be implemented on the first day of July following
publication of the changes.
(d) For purposes of paragraph (b), "income" means the adjusted gross income of the
natural or adoptive parents determined according to the previous year's federal tax form,
except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds
have been used to purchase a home shall not be counted as income.
(e) The contribution shall be explained in writing to the parents at the time eligibility
for services is being determined. The contribution shall be made on a monthly basis
effective with the first month in which the child receives services. Annually upon
redetermination or at termination of eligibility, if the contribution exceeded the cost of
services provided, the local agency or the state shall reimburse that excess amount to
the parents, either by direct reimbursement if the parent is no longer required to pay
a contribution, or by a reduction in or waiver of parental fees until the excess amount
is exhausted.
(f) The monthly contribution amount must be reviewed at least every 12 months;
when there is a change in household size; and when there is a loss of or gain in income
from one month to another in excess of ten percent. The local agency shall mail a written
notice 30 days in advance of the effective date of a change in the contribution amount.
A decrease in the contribution amount is effective in the month that the parent verifies a
reduction in income or change in household size.
(g) Parents of a minor child who do not live with each other shall each pay the
contribution required under paragraph (a). An amount equal to the annual court-ordered
child support payment actually paid on behalf of the child receiving services shall be
deducted from the adjusted gross income of the parent making the payment prior to
calculating the parental contribution under paragraph (b).
(h) The contribution under paragraph (b) shall be increased by an additional five
percent if the local agency determines that insurance coverage is available but not
obtained for the child. For purposes of this section, "available" means the insurance is a
benefit of employment for a family member at an annual cost of no more than five percent
of the family's annual income. For purposes of this section, "insurance" means health
and accident insurance coverage, enrollment in a nonprofit health service plan, health
maintenance organization, self-insured plan, or preferred provider organization.
Parents who have more than one child receiving services shall not be required
to pay more than the amount for the child with the highest expenditures. There shall
be no resource contribution from the parents. The parent shall not be required to pay
a contribution in excess of the cost of the services provided to the child, not counting
payments made to school districts for education-related services. Notice of an increase in
fee payment must be given at least 30 days before the increased fee is due.
(i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if,
in the 12 months prior to July 1:
(1) the parent applied for insurance for the child;
(2) the insurer denied insurance;
(3) the parents submitted a complaint or appeal, in writing to the insurer, submitted
a complaint or appeal, in writing, to the commissioner of health or the commissioner of
commerce, or litigated the complaint or appeal; and
(4) as a result of the dispute, the insurer reversed its decision and granted insurance.
For purposes of this section, "insurance" has the meaning given in paragraph (h).
A parent who has requested a reduction in the contribution amount under this
paragraph shall submit proof in the form and manner prescribed by the commissioner or
county agency, including, but not limited to, the insurer's denial of insurance, the written
letter or complaint of the parents, court documents, and the written response of the insurer
approving insurance. The determinations of the commissioner or county agency under this
paragraph are not rules subject to chapter 14.
Sec. 3.
new text begin
[252.295] LICENSING EXCEPTION.
new text end
new text begin
(a) Notwithstanding section 252.294, the commissioner may license two six-bed,
level B intermediate care facilities for persons with developmental disabilities (ICF's/MR)
to replace a 15-bed level A facility in Minneapolis that is not accessible to persons with
disabilities. The new facilities must be accessible to persons with disabilities and must
be located on a different site or sites in Hennepin County. Notwithstanding section
256B.5012, the payment rate at the new facilities is $200.47 plus any rate adjustments for
ICF's/MR effective on or after July 1, 2007.
new text end
new text begin
(b) Notwithstanding section 252.294, the commissioner may license one six-bed
level B intermediate care facility for persons with developmental disabilities to replace
a downsized 21-bed facility attached to a day training and habilitation program in
Chisholm. Notwithstanding section 256B.5012, the facility must serve persons who
require substantial nursing care and are able to leave the facility to receive day training
and habilitation services. The payment rate at this facility is $274.50.
new text end
new text begin
(c) Notwithstanding section 256B.5012, the payment rate of a six-bed level B
intermediate care facility for persons with developmental disabilities in Hibbing, with a
per diem rate of $164.13 as of March 1, 2007, for persons who require substantial nursing
care and are able to leave the facility to receive day training and habilitation services shall
be increased to $250.84.
new text end
new text begin
(d) The payment rates in paragraphs (b) and (c) are effective October 1, 2009.
new text end
Sec. 4.
Minnesota Statutes 2006, section 256.01, is amended by adding a subdivision
to read:
new text begin Subd. 24. new text end
new text begin Disability linkage line. new text end
new text begin
The commissioner shall establish the disability
linkage line, a statewide consumer information, referral, and assistance system for people
with disabilities and chronic illnesses that:
new text end
new text begin
(1) provides information about state and federal eligibility requirements, benefits,
and service options;
new text end
new text begin
(2) makes referrals to appropriate support entities;
new text end
new text begin
(3) delivers information and assistance based on national and state standards;
new text end
new text begin
(4) assists people to make well-informed decisions; and
new text end
new text begin
(5) supports the timely resolution of service access and benefit issues.
new text end
Sec. 5.
Minnesota Statutes 2006, section 256.975, subdivision 7, is amended to read:
Subd. 7.
Consumer information and assistance; senior linkage.
(a) The
Minnesota Board on Aging shall operate a statewide information and assistance service
to aid older Minnesotans and their families in making informed choices about long-term
care options and health care benefits. Language services to persons with limited English
language skills may be made available. The service, known as Senior LinkAge Line, must
be available during business hours through a statewide toll-free number and must also
be available through the Internet.
(b) The service must assist older adults, caregivers, and providers in accessing
information about choices in long-term care services that are purchased through private
providers or available through public options. The service must:
(1) develop a comprehensive database that includes detailed listings in both
consumer- and provider-oriented formats;
(2) make the database accessible on the Internet and through other telecommunication
and media-related tools;
(3) link callers to interactive long-term care screening tools and make these tools
available through the Internet by integrating the tools with the database;
(4) develop community education materials with a focus on planning for long-term
care and evaluating independent living, housing, and service options;
(5) conduct an outreach campaign to assist older adults and their caregivers in
finding information on the Internet and through other means of communication;
(6) implement a messaging system for overflow callers and respond to these callers
by the next business day;
(7) link callers with county human services and other providers to receive more
in-depth assistance and consultation related to long-term care options; deleted text begin and
deleted text end
(8) link callers with quality profiles for nursing facilities and other providers
developed by the commissioner of healthdeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(9) incorporate information about housing with services and consumer rights
within the MinnesotaHelp.info network long-term care database to facilitate consumer
comparison of services and costs among housing with services establishments and with
other in-home services and to support financial self-sufficiency as long as possible.
Housing with services establishments and their arranged home care providers shall provide
information to the commissioner of human services that is consistent with information
required by the commissioner of health under section 144G.06, the Uniform Consumer
Information Guide. The commissioner of human services shall provide the data to the
Minnesota Board on Aging for inclusion in the MinnesotaHelp.info network long-term
care database.
new text end
(c) The Minnesota Board on Aging shall conduct an evaluation of the effectiveness
of the statewide information and assistance, and submit this evaluation to the legislature
by December 1, 2002. The evaluation must include an analysis of funding adequacy, gaps
in service delivery, continuity in information between the service and identified linkages,
and potential use of private funding to enhance the service.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 6.
Minnesota Statutes 2006, section 256B.0625, subdivision 18a, is amended to
read:
Subd. 18a.
Access to medical services.
(a) Medical assistance reimbursement for
meals for persons traveling to receive medical care may not exceed $5.50 for breakfast,
$6.50 for lunch, or $8 for dinner.
(b) Medical assistance reimbursement for lodging for persons traveling to receive
medical care may not exceed $50 per day unless prior authorized by the local agency.
(c) Medical assistance direct mileage reimbursement to the eligible person or the
eligible person's driver may not exceed 20 cents per mile.
(d)new text begin Regardless of the number of employees that an enrolled health care provider
may have,new text end medical assistance coversnew text begin sign andnew text end oral language interpreter services when
provided by an enrolled health care provider during the course of providing a direct,
person-to-person covered health care service to an enrolled recipient with limited English
proficiencynew text begin or who has a hearing loss and uses interpreting servicesnew text end .
Sec. 7.
Minnesota Statutes 2006, section 256B.0625, is amended by adding a
subdivision to read:
new text begin Subd. 49. new text end
new text begin Self-directed supports option. new text end
new text begin
Upon federal approval, medical
assistance covers the self-directed supports option as defined under section 256B.0657 and
section 6087 of the Federal Deficit Reduction Act of 2005, Public Law 109-171.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective upon federal approval of the state
Medicaid plan amendment. The commissioner of human services shall inform the Office
of the Revisor of Statutes when approval is obtained.
new text end
Sec. 8.
Minnesota Statutes 2006, section 256B.0651, subdivision 7, is amended to read:
Subd. 7.
Prior authorization; time limits.
The commissioner or the commissioner's
designee shall determine the time period for which a prior authorization shall be effective
and, if flexible use has been requested, whether to allow the flexible use option. If
the recipient continues to require home care services beyond the duration of the prior
authorization, the home care provider must request a new prior authorization. new text begin A personal
care provider agency must request a new personal care assistant services assessment, or
service update if allowed, at least 60 days prior to the end of the current prior authorization
time period. The request for the assessment must be made on a form approved by the
commissioner. new text end Under no circumstances, other than the exceptions in subdivision 4, shall a
prior authorization be valid prior to the date the commissioner receives the request or for
more than 12 months. A recipient who appeals a reduction in previously authorized home
care services may continue previously authorized services, other than temporary services
under subdivision 8, pending an appeal under section 256.045. The commissioner must
provide a detailed explanation of why the authorized services are reduced in amount from
those requested by the home care provider.
Sec. 9.
Minnesota Statutes 2006, section 256B.0655, subdivision 1b, is amended to
read:
Subd. 1b.
Assessment.
"Assessment" means a review and evaluation of a recipient's
need for home care services conducted in person. Assessments for personal care assistant
services shall be conducted by the county public health nurse or a certified public
health nurse under contract with the county. A face-to-face assessment must include:
documentation of health status, determination of need, evaluation of service effectiveness,
identification of appropriate services, service plan development or modification,
coordination of services, referrals and follow-up to appropriate payers and community
resources, completion of required reports, recommendation of service authorization, and
consumer education. Once the need for personal care assistant services is determined
under this section or sections 256B.0651, 256B.0653, 256B.0654, and 256B.0656, the
county public health nurse or certified public health nurse under contract with the county
is responsible for communicating this recommendation to the commissioner and the
recipient. A face-to-face assessment for personal care assistant services is conducted
on those recipients who have never had a county public health nurse assessment. A
face-to-face assessment must occur at least annually or when there is a significant change
in the recipient's condition or when there is a change in the need for personal care assistant
services. A service update may substitute for the annual face-to-face assessment when
there is not a significant change in recipient condition or a change in the need for personal
care assistant service. new text begin A service update may be completed by telephone, used when there
is no need for an increase in personal care assistant services, and used for two consecutive
assessments if followed by a face-to-face assessment. A service update must be completed
on a form approved by the commissioner. new text end A service update or review for temporary
increase includes a review of initial baseline data, evaluation of service effectiveness,
redetermination of service need, modification of service plan and appropriate referrals,
update of initial forms, obtaining service authorization, and on going consumer education.
Assessments must be completed on forms provided by the commissioner within 30 days
of a request for home care services by a recipient or responsible partynew text begin or personal care
provider agencynew text end .
Sec. 10.
Minnesota Statutes 2006, section 256B.0655, subdivision 3, is amended to
read:
Subd. 3.
Assessment and service plan.
Assessments under subdivision 1b
and sections 256B.0651, subdivision 1, paragraph (b), and 256B.0654, subdivision 1,
paragraph (a), shall be conducted initially, and at least annually thereafter, in person
with the recipient and result in a completed service plan using forms specified by
the commissioner. new text begin A personal care provider agency must use a form approved by
the commissioner to request a county public health nurse to conduct a personal care
assistant services assessment. When requesting a reassessment, the personal care provider
agency must notify the county and the recipient at least 60 days prior to the end of the
current prior authorization for personal care assistant services. The recipient notice
shall include information on the recipient's appeal rights. new text end Within 30 days of recipient
or responsible party new text begin or personal care assistant provider agency new text end request for home care
services, the assessment, the service plan, and other information necessary to determine
medical necessity such as diagnostic or testing information, social or medical histories,
and hospital or facility discharge summaries shall be submitted to the commissioner.
Notwithstanding the provisions of subdivision 8, the commissioner shall maximize
federal financial participation to pay for public health nurse assessments for personal care
services. For personal care assistant services:
(1) The amount and type of service authorized based upon the assessment and
service plan will follow the recipient if the recipient chooses to change providers.
(2) If the recipient's need changes, the recipient's provider may assess the need for
a change in service authorization and request the change from the county public health
nurse. new text begin The request must be made on a form approved by the commissioner. new text end Within 30
days of the request, the public health nurse will determine whether to request the change
in services based upon the provider assessment, or conduct a home visit to assess the need
and determine whether the change is appropriate. If the change in service need is due to
a change in medical condition, a new physician's statement of need required by section
256B.0625, subdivision 19c, must be obtained.
(3) To continue to receive personal care assistant services after the first year,
the recipient or the responsible party, in conjunction with the public health nurse,
may complete a service update on forms developed by the commissioner according to
criteria and procedures in subdivisions 1a to 1i and sections 256B.0651, subdivision 1;
256B.0653, subdivision 1; and 256B.0654, subdivision 1.
Sec. 11.
Minnesota Statutes 2006, section 256B.0655, subdivision 8, is amended to
read:
Subd. 8.
Public health nurse assessment rate.
(a) The reimbursement rates for
public health nurse visits that relate to the provision of personal care services under this
section and section 256B.0625, subdivision 19a, are:
(i) $210.50 for a face-to-face assessment visit;
(ii) $105.25 for each service update; and
(iii) $105.25 for each request for a temporary service increase.
(b) The rates specified in paragraph (a) must be adjusted to reflect provider rate
increases for personal care assistant services that are approved by the legislature for the
fiscal year ending June 30, 2000, and subsequent fiscal years. Any requirements applied
by the legislature to provider rate increases for personal care assistant services also apply
to adjustments under this paragraph.
new text begin
(c) Effective July 1, 2008, the payment rate for an assessment under this section and
section 256B.0651 shall be reduced by 25 percent when the assessment is not completed
on time or the service agreement documentation is not submitted in time to continue
services. The commissioner shall recoup these amounts on a retroactive basis.
new text end
Sec. 12.
new text begin
[256B.0657] SELF-DIRECTED SUPPORTS OPTION.
new text end
new text begin Subdivision 1. new text end
new text begin Definition. new text end
new text begin
"Self-directed supports option" means personal
assistance, supports, items, and related services purchased under an approved budget
plan and budget by a recipient.
new text end
new text begin Subd. 2. new text end
new text begin Eligibility. new text end
new text begin
(a) The self-directed supports option is available to a person
who:
new text end
new text begin
(1) is a recipient of medical assistance as determined under sections 256B.055,
256B.056, and 256B.057, subdivision 9;
new text end
new text begin
(2) is eligible for personal care assistant services under section 256B.0655;
new text end
new text begin
(3) lives in the person's own apartment or home, which is not owned, operated, or
controlled by a provider of services not related by blood or marriage;
new text end
new text begin
(4) has the ability to hire, fire, supervise, establish staff compensation for, and
manage the individuals providing services, and to choose and obtain items, related
services, and supports as described in the participant's plan. If the recipient is not able to
carry out these functions but has a legal guardian or parent to carry them out, the guardian
or parent may fulfill these functions on behalf of the recipient; and
new text end
new text begin
(5) has not been excluded or disenrolled by the commissioner.
new text end
new text begin
(b) The commissioner may disenroll or exclude recipients, including guardians and
parents, under the following circumstances:
new text end
new text begin
(1) recipients who have been restricted by the Primary Care Utilization Review
Committee may be excluded for a specified time period;
new text end
new text begin
(2) recipients who exit the self-directed supports option during the recipient's
service plan year shall not access the self-directed supports option for the remainder of
that service plan year; and
new text end
new text begin
(3) when the department determines that the recipient cannot manage recipient
responsibilities under the program.
new text end
new text begin Subd. 3. new text end
new text begin Eligibility for other services. new text end
new text begin
Selection of the self-directed supports
option by a recipient shall not restrict access to other medically necessary care and
services furnished under the state plan medical assistance benefit, including home care
targeted case management, except that a person receiving home and community-based
waiver services, a family support grant or a consumer support grant is not eligible for
funding under the self-directed supports option.
new text end
new text begin Subd. 4. new text end
new text begin Assessment requirements. new text end
new text begin
(a) The self-directed supports option
assessment must meet the following requirements:
new text end
new text begin
(1) it shall be conducted by the county public health nurse or a certified public
health nurse under contract with the county;
new text end
new text begin
(2) it shall be conducted face-to-face in the recipient's home initially, and at least
annually thereafter; when there is a significant change in the recipient's condition; and
when there is a change in the need for personal care assistant services. A recipient who is
residing in a facility may be assessed for the self-directed support option for the purpose
of returning to the community using this option; and
new text end
new text begin
(3) it shall be completed using the format established by the commissioner.
new text end
new text begin
(b) The results of the assessment and recommendations shall be communicated to
the commissioner and the recipient by the county public health nurse or certified public
health nurse under contract with the county.
new text end
new text begin Subd. 5. new text end
new text begin Self-directed supports option plan requirements. new text end
new text begin
(a) The plan for the
self-directed supports option must meet the following requirements:
new text end
new text begin
(1) the plan must be completed using a person-centered process that:
new text end
new text begin
(i) builds upon the recipient's capacity to engage in activities that promote
community life;
new text end
new text begin
(ii) respects the recipient's preferences, choices, and abilities;
new text end
new text begin
(iii) involves families, friends, and professionals in the planning or delivery of
services or supports as desired or required by the recipient; and
new text end
new text begin
(iv) addresses the need for personal care assistant services identified in the recipient's
self-directed supports option assessment;
new text end
new text begin
(2) the plan shall be developed by the recipient or by the guardian of an adult
recipient or by a parent or guardian of a minor child, with the assistance of an enrolled
medical assistance home care targeted case manager provider who meets the requirements
established for using a person-centered planning process and shall be reviewed at least
annually upon reassessment or when there is a significant change in the recipient's
condition; and
new text end
new text begin
(3) the plan must include the total budget amount available divided into monthly
amounts that cover the number of months of personal care assistant services authorization
included in the budget. The amount used each month may vary, but additional funds shall
not be provided above the annual personal care assistant services authorized amount
unless a change in condition is documented.
new text end
new text begin
(b) The commissioner shall:
new text end
new text begin
(1) establish the format and criteria for the plan as well as the requirements for
providers who assist with plan development;
new text end
new text begin
(2) review the assessment and plan and, within 30 days after receiving the
assessment and plan, make a decision on approval of the plan;
new text end
new text begin
(3) notify the recipient, parent, or guardian of approval or denial of the plan and
provide notice of the right to appeal under section 256.045; and
new text end
new text begin
(4) provide a copy of the plan to the fiscal support entity selected by the recipient.
new text end
new text begin Subd. 6. new text end
new text begin Services covered. new text end
new text begin
(a) Services covered under the self-directed supports
option include:
new text end
new text begin
(1) personal care assistant services under section 256B.0655; and
new text end
new text begin
(2) items, related services, and supports, including assistive technology, that increase
independence or substitute for human assistance to the extent expenditures would
otherwise be used for human assistance.
new text end
new text begin
(b) Items, supports, and related services purchased under this option shall not be
considered home care services for the purposes of section 144A.43.
new text end
new text begin Subd. 7. new text end
new text begin Noncovered services. new text end
new text begin
Services or supports that are not eligible for
payment under the self-directed supports option include:
new text end
new text begin
(1) services, goods, or supports that do not benefit the recipient;
new text end
new text begin
(2) any fees incurred by the recipient, such as Minnesota health care program fees
and co-pays, legal fees, or costs related to advocate agencies;
new text end
new text begin
(3) insurance, except for insurance costs related to employee coverage or fiscal
support entity payments;
new text end
new text begin
(4) room and board and personal items that are not related to the disability, except
that medically prescribed specialized diet items may be covered if they reduce the need for
human assistance;
new text end
new text begin
(5) home modifications that add square footage;
new text end
new text begin
(6) home modifications for a residence other than the primary residence of the
recipient, or in the event of a minor with parents not living together, the primary residences
of the parents;
new text end
new text begin
(7) expenses for travel, lodging, or meals related to training the recipient, the parent
or guardian of an adult recipient, or the parent or guardian of a minor child, or paid or
unpaid caregivers that exceed $500 in a 12-month period;
new text end
new text begin
(8) experimental treatment;
new text end
new text begin
(9) any service or item covered by other medical assistance state plan services,
including prescription and over-the-counter medications, compounds, and solutions and
related fees, including premiums and co-payments;
new text end
new text begin
(10) membership dues or costs, except when the service is necessary and appropriate
to treat a physical condition or to improve or maintain the recipient's physical condition.
The condition must be identified in the recipient's plan of care and monitored by a
Minnesota health care program enrolled physician;
new text end
new text begin
(11) vacation expenses other than the cost of direct services;
new text end
new text begin
(12) vehicle maintenance or modifications not related to the disability;
new text end
new text begin
(13) tickets and related costs to attend sporting or other recreational events; and
new text end
new text begin
(14) costs related to Internet access, except when necessary for operation of assistive
technology, to increase independence, or to substitute for human assistance.
new text end
new text begin Subd. 8. new text end
new text begin Self-directed budget requirements. new text end
new text begin
The budget for the provision of the
self-directed service option shall be equal to the greater of either:
new text end
new text begin
(1) the annual amount of personal care assistant services under section 256B.0655
that the recipient has used in the most recent 12-month period; or
new text end
new text begin
(2) the amount determined using the consumer support grant methodology under
section 256.476, subdivision 11, except that the budget amount shall include the federal
and nonfederal share of the average service costs.
new text end
new text begin Subd. 9. new text end
new text begin Quality assurance and risk management. new text end
new text begin
(a) The commissioner
shall establish quality assurance and risk management measures for use in developing
and implementing self-directed plans and budgets that (1) recognize the roles and
responsibilities involved in obtaining services in a self-directed manner, and (2) assure
the appropriateness of such plans and budgets based upon a recipient's resources and
capabilities. These measures must include (i) background studies, and (ii) backup and
emergency plans, including disaster planning.
new text end
new text begin
(b) The commissioner shall provide ongoing technical assistance and resource and
educational materials for families and recipients selecting the self-directed option.
new text end
new text begin
(c) Performance assessments measures, such as of a recipient's satisfaction with the
services and supports, and ongoing monitoring of health and well-being shall be identified
in consultation with the stakeholder group.
new text end
new text begin Subd. 10. new text end
new text begin Fiscal support entity. new text end
new text begin
(a) Each recipient shall choose a fiscal support
entity provider certified by the commissioner to make payments for services, items,
supports, and administrative costs related to managing a self-directed service plan
authorized for payment in the approved plan and budget. Recipients shall also choose
the payroll, agency with choice, or the fiscal conduit model of financial and service
management.
new text end
new text begin
(b) The fiscal support entity:
new text end
new text begin
(1) may not limit or restrict the recipient's choice of service or support providers,
including use of the payroll, agency with choice, or fiscal conduit model of financial
and service management;
new text end
new text begin
(2) must have a written agreement with the recipient or the recipient's representative
that identifies the duties and responsibilities to be performed and the specific related
charges;
new text end
new text begin
(3) must provide the recipient and the home care targeted case manager with a
monthly written summary of the self-directed supports option services that were billed,
including charges from the fiscal support entity;
new text end
new text begin
(4) must be knowledgeable of and comply with Internal Revenue Service
requirements necessary to process employer and employee deductions, provide appropriate
and timely submission of employer tax liabilities, and maintain documentation to support
medical assistance claims;
new text end
new text begin
(5) must have current and adequate liability insurance and bonding and sufficient
cash flow and have on staff or under contract a certified public accountant or an individual
with a baccalaureate degree in accounting; and
new text end
new text begin
(6) must maintain records to track all self-directed supports option services
expenditures, including time records of persons paid to provide supports and receipts for
any goods purchased. The records must be maintained for a minimum of five years from
the claim date and be available for audit or review upon request. Claims submitted by
the fiscal support entity must correspond with services, amounts, and time periods as
authorized in the recipient's self-directed supports option plan.
new text end
new text begin
(c) The commissioner shall have authority to:
new text end
new text begin
(1) set or negotiate rates with fiscal support entities;
new text end
new text begin
(2) limit the number of fiscal support entities;
new text end
new text begin
(3) identify a process to certify and recertify fiscal support entities and assure fiscal
support entities are available to recipients throughout the state; and
new text end
new text begin
(4) establish a uniform format and protocol to be used by eligible fiscal support
entities.
new text end
new text begin Subd. 11. new text end
new text begin Stakeholder consultation. new text end
new text begin
The commissioner shall consult with a
statewide consumer-directed services stakeholder group, including representatives of
all types of consumer-directed service users, advocacy organizations, counties, and
consumer-directed service providers. The commissioner shall seek recommendations
from this stakeholder group in developing:
new text end
new text begin
(1) the self-directed plan format;
new text end
new text begin
(2) requirements and guidelines for the person-centered plan assessment and
planning process;
new text end
new text begin
(3) implementation of the option and the quality assurance and risk management
techniques; and
new text end
new text begin
(4) standards and requirements, including rates for the personal support plan
development provider and the fiscal support entity; policies; training; and implementation.
The stakeholder group shall provide recommendations on the repeal of the personal care
assistant choice option, transition issues, and whether the consumer support grant program
under section 256.476 should be modified. The stakeholder group shall meet at least
three times each year to provide advice on policy, implementation, and other aspects of
consumer and self-directed services.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
Subdivisions 1 to 10 are effective upon federal approval of
the state Medicaid plan amendment. The commissioner of human services shall inform
the Office of the Revisor of Statutes when federal approval is obtained. Subdivision 11
is effective July 1, 2007.
new text end
Sec. 13.
Minnesota Statutes 2006, section 256B.0911, subdivision 3a, is amended to
read:
Subd. 3a.
Assessment and support planning.
(a) Persons requesting assessment,
services planning, or other assistance intended to support community-based livingnew text begin ,
including persons who need assessment in order to determine waiver or alternative care
program eligibility,new text end must be visited by a long-term care consultation team within ten
working days after the date on which an assessment was requested or recommended.
Assessments must be conducted according to paragraphs (b) to deleted text begin (g)deleted text end new text begin (i)new text end .
(b) The county may utilize a team of either the social worker or public health nurse,
or both, to conduct the assessment in a face-to-face interview. The consultation team
members must confer regarding the most appropriate care for each individual screened or
assessed.
(c) The long-term care consultation team must assess the health and social needs of
the person, using an assessment form provided by the commissioner.
(d) The team must conduct the assessment in a face-to-face interview with the
person being assessed and the person's legal representative, if applicable.
(e) The team must provide the person, or the person's legal representative, with
written recommendations for facility- or community-based services. The team must
document that the most cost-effective alternatives available were offered to the individual.
For purposes of this requirement, "cost-effective alternatives" means community services
and living arrangements that cost the same as or less than nursing facility care.
(f) If the person chooses to use community-based services, the team must provide
the person or the person's legal representative with a written community support plan,
regardless of whether the individual is eligible for Minnesota health care programs.
The person may request assistance in developing a community support plan without
participating in a complete assessment.
(g) new text begin The person has the right to make the final decision between nursing facility
placement and community placement after the screening team's recommendation, except
as provided in subdivision 4a, paragraph (c).
new text end
new text begin (h) new text end The team must give the person receiving assessment or support planning, or
the person's legal representative, materialsnew text begin , and forms new text end supplied by the commissioner
containing the following information:
(1) the new text begin need for and new text end purpose of preadmission screening deleted text begin and assessmentdeleted text end new text begin if the person
selects nursing facility placementnew text end ;
new text begin
(2) the role of the long-term care consultation assessment and support planning in
waiver and alternative care program eligibility determination;
new text end
deleted text begin (2)deleted text end new text begin (3)new text end information about Minnesota health care programs;
deleted text begin (3)deleted text end new text begin (4)new text end the person's freedom to accept or reject the recommendations of the team;
deleted text begin (4)deleted text end new text begin (5)new text end the person's right to confidentiality under the Minnesota Government Data
Practices Act, chapter 13; and
new text begin
(6) the long-term care consultant's decision regarding the person's need for nursing
facility level of care;
new text end
deleted text begin (5)deleted text end new text begin (7)new text end the person's right to appeal the decision regarding the need for nursing facility
level of care or the county's final decisions regarding public programs eligibility according
to section 256.045, subdivision 3.
new text begin
(i) Face-to-face assessment completed as part of eligibility determination for
the alternative care, elderly waiver, community alternatives for disabled individuals,
community alternative care, and traumatic brain injury waiver programs under sections
256B.0915, 256B.0917, and 256B.49 is valid to establish service eligibility for no more
than 60 calendar days after the date of assessment. The effective eligibility start date
for these programs can never be prior to the date of assessment. If an assessment was
completed more than 60 days before the effective waiver or alternative care program
eligibility start date, assessment and support plan information must be updated in a
face-to-face visit and documented in the department's Medicaid Management Information
System (MMIS). The effective date of program eligibility in this case cannot be prior to
the date the updated assessment is completed.
new text end
Sec. 14.
Minnesota Statutes 2006, section 256B.0911, is amended by adding a
subdivision to read:
new text begin Subd. 3c. new text end
new text begin Transition to housing with services. new text end
new text begin
(a) Housing with services
establishments offering or providing assisted living under chapter 144G shall inform
all prospective residents of the availability of and contact information for transitional
consultation services under this subdivision prior to executing a lease or contract with the
prospective resident. The purpose of transitional long-term care consultation is to support
persons with current or anticipated long-term care needs in making informed choices
among options that include the most cost-effective and least restrictive settings, and to
delay spenddown to eligibility for publicly funded programs by connecting people to
alternative services in their homes before transition to housing with services. Regardless
of the consultation, prospective residents maintain the right to choose housing with
services or assisted living if that option is their preference.
new text end
new text begin
(b) Transitional consultation services are provided as determined by the
commissioner of human services in partnership with county long-term care consultation
units, and the Area Agencies on Aging, and are a combination of telephone-based
and in-person assistance provided under models developed by the commissioner. The
consultation shall be performed in a manner that provides objective and complete
information. Transitional consultation must be provided within five working days of the
request of the prospective resident as follows:
new text end
new text begin
(1) the consultation must be provided by a qualified professional as determined by
the commissioner;
new text end
new text begin
(2) the consultation must include a review of the prospective resident's reasons for
considering assisted living, the prospective resident's personal goals, a discussion of the
prospective resident's immediate and projected long-term care needs, and alternative
community services or assisted living settings that may meet the prospective resident's
needs; and
new text end
new text begin
(3) the prospective resident shall be informed of the availability of long-term care
consultation services described in subdivision 3a that are available at no charge to the
prospective resident to assist the prospective resident in assessment and planning to meet
the prospective resident's long-term care needs.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective October 1, 2008.
new text end
Sec. 15.
Minnesota Statutes 2006, section 256B.0915, is amended to read:
256B.0915 MEDICAID WAIVER FOR ELDERLY SERVICES.
Subdivision 1.
Authority.
The commissioner is authorized to apply for a home
and community-based services waiver for the elderly, authorized under section 1915(c)
of the Social Security Act, in order to obtain federal financial participation to expand
the availability of services for persons who are eligible for medical assistance. The
commissioner may apply for additional waivers or pursue other federal financial
participation which is advantageous to the state for funding home care services for the
frail elderly who are eligible for medical assistance. The provision of waivered services
to elderly and disabled medical assistance recipients must comply with the criteria new text begin for
service definitions and provider standards new text end approved in the waiver.
Subd. 1a.
Elderly waiver case management services.
(a) Elderly case management
services under the home and community-based services waiver for elderly individuals are
available from providers meeting qualification requirements and the standards specified
in subdivision 1b. Eligible recipients may choose any qualified provider of elderly case
management services.
new text begin
Case management services assist individuals who receive waiver services in gaining
access to needed waiver and other state plan services, as well as needed medical, social,
educational, and other services regardless of the funding source for the services to which
access is gained.
new text end
new text begin
A case aide shall provide assistance to the case manager in carrying out
administrative activities of the case management function. The case aide may not assume
responsibilities that require professional judgment including assessments, reassessments,
and care plan development. The case manager is responsible for providing oversight of
the case aide.
new text end
new text begin
Case managers shall be responsible for ongoing monitoring of the provision of
services included in the individual's plan of care. Case managers shall initiate and oversee
the process of assessment and reassessment of the individual's care and review plan of
care at intervals specified in the federally approved waiver plan.
new text end
(b) The county of service or tribe must provide access to and arrange for case
management services.new text begin County of service has the meaning given it in Minnesota Rules,
part 9505.0015, subpart 11.
new text end
Subd. 1b.
Provider qualifications and standards.
The commissioner must
enroll qualified providers of elderly case management services under the home
and community-based waiver for the elderly under section 1915(c) of the Social
Security Act. The enrollment process shall ensure the provider's ability to meet the
qualification requirements and standards in this subdivision and other federal and state
requirements of this service. An elderly case management provider is an enrolled medical
assistance provider who is determined by the commissioner to have all of the following
characteristics:
(1) the demonstrated capacity and experience to provide the components of
case management to coordinate and link community resources needed by the eligible
population;
(2) administrative capacity and experience in serving the target population for
whom it will provide services and in ensuring quality of services under state and federal
requirements;
(3) a financial management system that provides accurate documentation of services
and costs under state and federal requirements;
(4) the capacity to document and maintain individual case records under state and
federal requirements; and
(5) the deleted text begin countydeleted text end new text begin lead agency new text end may allow a case manager employed by the deleted text begin countydeleted text end new text begin lead
agency new text end to delegate certain aspects of the case management activity to another individual
employed by the deleted text begin countydeleted text end new text begin lead agency new text end provided there is oversight of the individual by
the case manager. The case manager may not delegate those aspects which require
professional judgment including assessments, reassessments, and care plan development.new text begin
Lead agencies include counties, health plans, and federally recognized tribes who
authorize services under this section.
new text end
deleted text begin Subd. 1c. deleted text end
deleted text begin Case management activities under the state plan. deleted text end
deleted text begin
The commissioner
shall seek an amendment to the home and community-based services waiver for the
elderly to implement the provisions of subdivisions 1a and 1b. If the commissioner
is unable to secure the approval of the secretary of health and human services for the
requested waiver amendment by December 31, 1993, the commissioner shall amend
the medical assistance state plan to provide that case management provided under the
home and community-based services waiver for the elderly is performed by counties
as an administrative function for the proper and effective administration of the state
medical assistance plan. The state shall reimburse counties for the nonfederal share of
costs for case management performed as an administrative function under the home and
community-based services waiver for the elderly.
deleted text end
Subd. 1d.
Posteligibility treatment of income and resources for elderly waiver.
Notwithstanding the provisions of section 256B.056, the commissioner shall make the
following amendment to the medical assistance elderly waiver program effective July 1,
1999, or upon federal approval, whichever is later.
A recipient's maintenance needs will be an amount equal to the Minnesota
supplemental aid equivalent rate as defined in section 256I.03, subdivision 5, plus the
medical assistance personal needs allowance as defined in section 256B.35, subdivision
1, paragraph (a), when applying posteligibility treatment of income rules to the gross
income of elderly waiver recipients, except for individuals whose income is in excess of
the special income standard according to Code of Federal Regulations, title 42, section
435.236. Recipient maintenance needs shall be adjusted under this provision each July 1.
Subd. 2.
Spousal impoverishment policies.
The commissioner shall deleted text begin seek to amend
the federal waiver and the medical assistance state plan to allowdeleted text end new text begin apply:
new text end
new text begin (1) the new text end spousal impoverishment criteria as authorized under United States Code, title
42, section 1396r-5, and as implemented in sections 256B.0575, 256B.058, and 256B.059deleted text begin ,
except that the amendment shall seek to add todeleted text end new text begin ;
new text end
new text begin (2) new text end the personal needs allowance permitted in section 256B.0575deleted text begin ,deleted text end new text begin ; andnew text end
new text begin (3) new text end an amount equivalent to the group residential housing rate as set by section
256I.03, subdivision 5new text begin , and according to the approved federal waiver and medical
assistance state plannew text end .
Subd. 3.
Limits of cases.
The number of medical assistance waiver recipients that
a deleted text begin countydeleted text end new text begin lead agency new text end may serve must be allocated according to the number of medical
assistance waiver cases open on July 1 of each fiscal year. Additional recipients may be
served with the approval of the commissioner.
Subd. 3a.
Elderly waiver cost limits.
(a) The monthly limit for the cost of waivered
services to an individual elderly waiver client shall be the weighted average monthly
nursing facility rate of the case mix resident class to which the elderly waiver client would
be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, less the recipient's
maintenance needs allowance as described in subdivision 1d, paragraph (a), until the first
day of the state fiscal year in which the resident assessment system as described in section
256B.437 for nursing home rate determination is implemented. Effective on the first day
of the state fiscal year in which the resident assessment system as described in section
256B.437 for nursing home rate determination is implemented and the first day of each
subsequent state fiscal year, the monthly limit for the cost of waivered services to an
individual elderly waiver client shall be the rate of the case mix resident class to which the
waiver client would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059,
in effect on the last day of the previous state fiscal year, adjusted by the greater of any
legislatively adopted home and community-based services percentage rate increase or the
average statewide percentage increase in nursing facility payment rates.
(b) If extended medical supplies and equipment or environmental modifications are
or will be purchased for an elderly waiver client, the costs may be prorated for up to
12 consecutive months beginning with the month of purchase. If the monthly cost of a
recipient's waivered services exceeds the monthly limit established in paragraph (a), the
annual cost of all waivered services shall be determined. In this event, the annual cost of
all waivered services shall not exceed 12 times the monthly limit of waivered services as
described in paragraph (a).
Subd. 3b.
Cost limits for elderly waiver applicants who reside in a nursing
facility.
(a) For a person who is a nursing facility resident at the time of requesting a
determination of eligibility for elderly waivered services, a monthly conversion limit
for the cost of elderly waivered services may be requested. The monthly conversion
limit for the cost of elderly waiver services shall be the resident class assigned under
Minnesota Rules, parts 9549.0050 to 9549.0059, for that resident in the nursing facility
where the resident currently resides until July 1 of the state fiscal year in which the
resident assessment system as described in section deleted text begin 256B.437deleted text end new text begin 256B.438 new text end for nursing home
rate determination is implemented. Effective on July 1 of the state fiscal year in which
the resident assessment system as described in section new text begin 256B.438 new text end for nursing
home rate determination is implemented, the monthly conversion limit for the cost of
elderly waiver services shall be the per diem nursing facility rate as determined by the
resident assessment system as described in section new text begin 256B.438 new text end for that resident in
the nursing facility where the resident currently resides multiplied by 365 and divided
by 12, less the recipient's maintenance needs allowance as described in subdivision 1d.
The initially approved conversion rate may be adjusted by the greater of any subsequent
legislatively adopted home and community-based services percentage rate increase or
the average statewide percentage increase in nursing facility payment rates. The limit
under this subdivision only applies to persons discharged from a nursing facility after a
minimum 30-day stay and found eligible for waivered services on or after July 1, 1997.
new text begin For conversions from the nursing home to the elderly waiver with consumer directed
community support services, the conversion rate limit is equal to the nursing facility rate
reduced by a percentage equal to the percentage difference between the consumer directed
services budget limit that would be assigned according to the federally approved waiver
plan and the corresponding community case mix cap, but not to exceed 50 percent.
new text end
(b) The following costs must be included in determining the total monthly costs
for the waiver client:
(1) cost of all waivered services, including extended medical supplies and equipment
and environmental modificationsnew text begin and adaptationsnew text end ; and
(2) cost of skilled nursing, home health aide, and personal care services reimbursable
by medical assistance.
Subd. 3c.
Service approval and contracting provisions.
(a) Medical assistance
funding for skilled nursing services, private duty nursing, home health aide, and personal
care services for waiver recipients must be approved by the case manager and included in
the individual care plan.
(b) A deleted text begin countydeleted text end new text begin lead agency new text end is not required to contract with a provider of supplies and
equipment if the monthly cost of the supplies and equipment is less than $250.
Subd. 3d.
Adult foster care rate.
The adult foster care rate shall be considered
a difficulty of care payment and shall not include room and board. The adult foster
care service rate shall be negotiated between the deleted text begin countydeleted text end new text begin lead new text end agency and the foster care
provider. The elderly waiver payment for the foster care service in combination with
the payment for all other elderly waiver services, including case management, must not
exceed the limit specified in subdivision 3a, paragraph (a).
Subd. 3e.
deleted text begin Assisted livingdeleted text end new text begin Customized living new text end service rate.
(a) Payment for deleted text begin assisted
living servicedeleted text end new text begin customized living services new text end shall be a monthly rate negotiated and authorized
by the deleted text begin county agency based on an individualized service plan for each resident and may
not cover direct rent or food costs.deleted text end new text begin lead agency within the parameters established by
the commissioner. The payment agreement must delineate the services that have been
customized for each recipient and specify the amount of each service to be provided. The
lead agency shall ensure that there is a documented need for all services authorized.
Customized living services must not include rent or raw food costs. The negotiated
payment rate must be based on services to be provided. Negotiated rates must not exceed
payment rates for comparable elderly waiver or medical assistance services and must
reflect economies of scale.
new text end
(b) The individualized monthly negotiated payment for deleted text begin assisted livingdeleted text end new text begin customized
living new text end services deleted text begin as described in section 256B.0913, subdivisions 5d to 5f, and residential
care services as described in section 256B.0913, subdivision 5c,deleted text end shall not exceed the
nonfederal share, in effect on July 1 of the state fiscal year for which the rate limit
is being calculated, of the greater of either the statewide or any of the geographic
groups' weighted average monthly nursing facility rate of the case mix resident class
to which the elderly waiver eligible client would be assigned under Minnesota Rules,
parts 9549.0050 to 9549.0059, less the maintenance needs allowance as described in
subdivision 1d, paragraph (a), until the July 1 of the state fiscal year in which the resident
assessment system as described in section 256B.437 for nursing home rate determination
is implemented. Effective on July 1 of the state fiscal year in which the resident
assessment system as described in section 256B.437 for nursing home rate determination
is implemented and July 1 of each subsequent state fiscal year, the individualized monthly
negotiated payment for the services described in this clause shall not exceed the limit
described in this clause which was in effect on June 30 of the previous state fiscal year
and which has been adjusted by the greater of any legislatively adopted home and
community-based services cost-of-living percentage increase or any legislatively adopted
statewide percent rate increase for nursing facilities.
(c) deleted text begin The individualized monthly negotiated payment for assisteddeleted text end new text begin Customizednew text end living
services deleted text begin described in section 144A.4605 anddeleted text end new text begin arenew text end delivered by a provider licensed by the
Department of Health as a class Anew text begin or class Fnew text end home care provider deleted text begin or an assisted living
home care providerdeleted text end and provided in a building that is registered as a housing with services
establishment under chapter 144D deleted text begin and that provides 24-hour supervision in combination
with the payment for other elderly waiver services, including case management, must not
exceed the limit specified in subdivision 3adeleted text end .
Subd. 3f.
Individual service rates; expenditure forecasts.
(a) The deleted text begin countydeleted text end new text begin lead
agency new text end shall negotiate individual service rates with vendors and may authorize payment
for actual costs up to the deleted text begin county'sdeleted text end new text begin lead agency's new text end current approved rate. Persons or agencies
must be employed by or under a contract with the deleted text begin countydeleted text end new text begin lead new text end agency or the public health
nursing agency of the local board of health in order to receive funding under the elderly
waiver program, except as a provider of supplies and equipment when the monthly cost of
the supplies and equipment is less than $250.
(b) Reimbursement for the medical assistance recipients under the approved waiver
shall be made from the medical assistance account through the invoice processing
procedures of the department's Medicaid Management Information System (MMIS),
only with the approval of the client's case manager. The budget for the state share of the
Medicaid expenditures shall be forecasted with the medical assistance budget, and shall
be consistent with the approved waiver.
Subd. 3g.
Service rate limits; state assumption of costs.
(a) To improve access
to community services and eliminate payment disparities between the alternative care
program and the elderly waiver, the commissioner shall establish statewide maximum
service rate limits and eliminate deleted text begin county-specificdeleted text end new text begin lead agency-specific new text end service rate limits.
(b) Effective July 1, 2001, for service rate limits, except those described or defined in
subdivisions 3d and 3e, the rate limit for each service shall be the greater of the alternative
care statewide maximum rate or the elderly waiver statewide maximum rate.
(c) deleted text begin Countiesdeleted text end new text begin Lead agencies new text end may negotiate individual service rates with vendors for
actual costs up to the statewide maximum service rate limit.
new text begin Subd. 3h. new text end
new text begin Service rate limits; 24-hour customized living services. new text end
new text begin
The payment
rates for 24-hour customized living services is a monthly rate negotiated and authorized by
the lead agency within the parameters established by the commissioner of human services.
The payment agreement must delineate the services that have been customized for each
recipient and specify the amount of each service to be provided. The lead agency shall
ensure that there is a documented need for all services authorized. The lead agency shall
not authorize 24-hour customized living services unless there is a documented need for
24-hour supervision. For purposes of this section, "24-hour supervision" means that the
recipient requires assistance due to needs related to one or more of the following:
new text end
new text begin
(1) intermittent assistance with toileting or transferring;
new text end
new text begin
(2) cognitive or behavioral issues;
new text end
new text begin
(3) a medical condition that requires clinical monitoring; or
new text end
new text begin
(4) other conditions or needs as defined by the commissioner of human services.
The lead agency shall ensure that the frequency and mode of supervision of the recipient
and the qualifications of staff providing supervision are described and meet the needs
of the recipient. Customized living services must not include rent or raw food costs.
The negotiated payment rate for 24-hour customized living services must be based on
services to be provided. Negotiated rates must not exceed payment rates for comparable
elderly waiver or medical assistance services and must reflect economies of scale. The
individually negotiated 24-hour customized living payments, in combination with the
payment for other elderly waiver services, including case management, must not exceed
the recipient's community budget cap specified in subdivision 3a.
new text end
Subd. 4.
Termination notice.
The case manager must give the individual a ten-day
written notice of any denial, reduction, or termination of waivered services.
Subd. 5.
Assessments and reassessments for waiver clients.
Each client shall
receive an initial assessment of strengths, informal supports, and need for services in
accordance with section 256B.0911, subdivisions 3, 3a, and 3b. A reassessment of a
client served under the elderly waiver must be conducted at least every 12 months and
at other times when the case manager determines that there has been significant change
in the client's functioning. This may include instances where the client is discharged
from the hospital.
Subd. 6.
Implementation of care plan.
Each elderly waiver client shall be provided
a copy of a written care plan that meets the requirements outlined in section 256B.0913,
subdivision 8. The care plan must be implemented by the county deleted text begin administering waivered
servicesdeleted text end new text begin of service new text end when it is different than the county of financial responsibility. The
county new text begin of service new text end administering waivered services must notify the county of financial
responsibility of the approved care plan.
Subd. 7.
Prepaid elderly waiver services.
An individual for whom a prepaid health
plan is liable for nursing home services or elderly waiver services according to section
256B.69, subdivision 6a, is not eligible to new text begin also new text end receive county-administered elderly waiver
services deleted text begin under this sectiondeleted text end .
Subd. 8.
Services and supports.
(a) Services and supports shall meet the
requirements set out in United States Code, title 42, section 1396n.
(b) Services and supports shall promote consumer choice and be arranged and
provided consistent with individualized, written care plans.
(c) The state of Minnesota, county, new text begin managed care organization, new text end or tribal government
under contract to administer the elderly waiver shall not be liable for damages, injuries,
or liabilities sustained through the purchase of direct supports or goods by the person,
the person's family, or the authorized representatives with funds received through
consumer-directed community support services under the federally approved waiver plan.
Liabilities include, but are not limited to, workers' compensation liability, the Federal
Insurance Contributions Act (FICA), or the Federal Unemployment Tax Act (FUTA).
Subd. 9.
Tribal management of elderly waiver.
Notwithstanding contrary
provisions of this section, or those in other state laws or rules, the commissioner may
develop a model for tribal management of the elderly waiver program and implement this
model through a contract between the state and any of the state's federally recognized tribal
governments. The model shall include the provision of tribal waiver case management,
assessment for personal care assistance, and administrative requirements otherwise carried
out by deleted text begin countiesdeleted text end new text begin lead agencies new text end but shall not include tribal financial eligibility determination
for medical assistance.
new text begin EFFECTIVE DATE. new text end
new text begin
Subdivision 3h is effective the day following final enactment.
new text end
Sec. 16.
Minnesota Statutes 2006, section 256B.095, is amended to read:
256B.095 QUALITY ASSURANCE SYSTEM ESTABLISHED.
(a) Effective July 1, 1998, a quality assurance system for persons with developmental
disabilities, which includes an alternative quality assurance licensing system for programs,
is established in Dodge, Fillmore, Freeborn, Goodhue, Houston, Mower, Olmsted, Rice,
Steele, Wabasha, and Winona Counties for the purpose of improving the quality of
services provided to persons with developmental disabilities. A county, at its option, may
choose to have all programs for persons with developmental disabilities located within
the county licensed under chapter 245A using standards determined under the alternative
quality assurance licensing system or may continue regulation of these programs under
the licensing system operated by the commissioner. The project expires on June 30,
deleted text begin 2009deleted text end new text begin 2014new text end .
(b) Effective July 1, 2003, a county not listed in paragraph (a) may apply to
participate in the quality assurance system established under paragraph (a). The
commission established under section 256B.0951 may, at its option, allow additional
counties to participate in the system.
(c) Effective July 1, 2003, any county or group of counties not listed in paragraph (a)
may establish a quality assurance system under this section. A new system established
under this section shall have the same rights and duties as the system established
under paragraph (a). A new system shall be governed by a commission under section
256B.0951. The commissioner shall appoint the initial commission members based
on recommendations from advocates, families, service providers, and counties in the
geographic area included in the new system. Counties that choose to participate in a
new system shall have the duties assigned under section 256B.0952. The new system
shall establish a quality assurance process under section 256B.0953. The provisions of
section 256B.0954 shall apply to a new system established under this paragraph. The
commissioner shall delegate authority to a new system established under this paragraph
according to section 256B.0955.
new text begin
(d) Effective July 1, 2007, the quality assurance system may be expanded to include
programs for persons with disabilities and older adults.
new text end
Sec. 17.
Minnesota Statutes 2006, section 256B.0951, subdivision 1, is amended to
read:
Subdivision 1.
Membership.
The Quality Assurance Commission is established.
The commission consists of at least 14 but not more than 21 members as follows: at
least three but not more than five members representing advocacy organizations; at
least three but not more than five members representing consumers, families, and their
legal representatives; at least three but not more than five members representing service
providers; at least three but not more than five members representing counties; and the
commissioner of human services or the commissioner's designee. The first commission
shall establish membership guidelines for the transition and recruitment of membership for
the commission's ongoing existence. Members of the commission who do not receive a
salary or wages from an employer for time spent on commission duties may receive a per
diem payment when performing commission duties and functions. All members may be
reimbursed for expenses related to commission activities. Notwithstanding the provisions
of section 15.059, subdivision 5, the commission expires on June 30, deleted text begin 2009deleted text end new text begin 2014new text end .
Sec. 18.
new text begin
[256B.096] QUALITY MANAGEMENT, ASSURANCE, AND
IMPROVEMENT SYSTEM FOR MINNESOTANS RECEIVING DISABILITY
SERVICES.
new text end
new text begin Subdivision 1. new text end
new text begin Scope. new text end
new text begin
In order to improve the quality of services provided to
Minnesotans with disabilities and to meet the requirements of the federally approved home
and community-based waivers under section 1915c of the Social Security Act, a statewide
quality assurance and improvement system for Minnesotans receiving disability services
shall be developed. The disability services included are the home and community-based
services waiver programs for persons with developmental disabilities under section
256B.092, subdivision 4, and for persons with disabilities under section 256B.49.
new text end
new text begin Subd. 2. new text end
new text begin Stakeholder advisory group. new text end
new text begin
The commissioner shall consult with a
stakeholder advisory group on the development and implementation of the state quality
management, assurance, and improvement system, including representatives of disability
service recipients, disability service providers, disability advocacy groups, county human
service agencies, and state agency staff from the Departments of Human Services and
Health, and the ombudsman for mental health and developmental disabilities on the
development of a statewide quality assurance and improvement system.
new text end
new text begin Subd. 3. new text end
new text begin Annual survey of service recipients. new text end
new text begin
The commissioner, in consultation
with the stakeholder advisory group, shall develop an annual independent random
statewide survey of between five and ten percent of service recipients to determine the
effectiveness and quality of disability services. The survey shall be consistent with the
system performance expectations of the Centers for Medicare and Medicaid Services
quality management requirements and framework. The survey shall analyze whether
desired outcomes have been achieved for persons with different demographic, diagnostic,
health, and functional needs receiving different types of services, in different settings,
with different costs. The survey shall be field tested during 2008. The biennial report
established in subdivision 5 shall include recommendations on statewide and regional
reports of the survey results that, if published, would be useful to regions, counties, and
providers to plan and measure the impact of quality improvement activities.
new text end
new text begin Subd. 4. new text end
new text begin
Improvements for incident reporting, investigation, analysis, and
follow-up.
new text end
new text begin
In consultation with the stakeholder advisory group, the commissioner shall
identify the information, data sources, and technology needed to improve the system
of incident reporting, including:
new text end
new text begin
(1) reports made under the Maltreatment of Minors and Vulnerable Adults Acts; and
new text end
new text begin
(2) investigation, analysis, and follow-up for disability services.
new text end
new text begin
The commissioner must ensure that the federal home and community-based waiver
requirements are met and that incidents that may have jeopardized safety and health or
violated service-related assurances, civil and human rights, and other protections designed
to prevent abuse, neglect, and exploitation, are reviewed, investigated, and acted upon
in a timely manner.
new text end
new text begin Subd. 5. new text end
new text begin Biennial report. new text end
new text begin
The commissioner shall provide a biennial report to the
chairs of the legislative committees with jurisdiction over health and human services
policy and funding beginning January 15, 2009, on the development and activities of the
quality management, assurance, and improvement system designed to meet the federal
requirements under the home and community-based services waiver programs for persons
with disabilities. By January 15, 2008, the commissioner shall provide a preliminary
report on priorities for meeting the federal requirements, progress on development and
field testing of the annual survey, appropriations necessary to implement an annual survey
of service recipients once field testing is completed, recommendations for improvements
in the incident reporting system, and a plan for incorporating quality assurance efforts
under section 256B.095 and other regional efforts into the statewide system.
new text end
Sec. 19.
Minnesota Statutes 2006, section 256B.431, subdivision 2e, is amended to
read:
Subd. 2e.
Contracts for services for ventilator-dependent persons.
new text begin (a)
new text end The commissioner may negotiate with a nursing facility eligible to receive medical
assistance payments to provide services to a ventilator-dependent person identified by the
commissioner according to criteria developed by the commissioner, including:
(1) nursing facility care has been recommended for the person by a preadmission
screening team;
(2) the person has been hospitalized and no longer requires inpatient acute care
hospital services; and
(3) the commissioner has determined that necessary services for the person cannot
be provided under existing nursing facility rates.
The commissioner may negotiate an adjustment to the operating cost payment
rate for a nursing facility with a resident who is ventilator-dependent, for that resident.
The negotiated adjustment must reflect only the actual additional cost of meeting the
specialized care needs of a ventilator-dependent person identified by the commissioner
for whom necessary services cannot be provided under existing nursing facility rates and
which are not otherwise covered under Minnesota Rules, parts 9549.0010 to 9549.0080 or
9505.0170 to 9505.0475. For persons who are initially admitted to a nursing facility before
July 1, 2001, and have their payment rate under this subdivision negotiated after July 1,
2001, the negotiated payment rate must not exceed 200 percent of the highest multiple
bedroom payment rate for the facility, as initially established by the commissioner for the
rate year for case mix classification K; or, upon implementation of the RUG's-based case
mix system, 200 percent of the highest RUG's rate. For persons initially admitted to a
nursing facility on or after July 1, 2001, the negotiated payment rate must not exceed 300
percent of the facility's multiple bedroom payment rate for case mix classification K; or,
upon implementation of the RUG's-based case mix system, 300 percent of the highest
RUG's rate. The negotiated adjustment shall not affect the payment rate charged to private
paying residents under the provisions of section 256B.48, subdivision 1.
new text begin
(b) Effective July 1, 2007, or upon opening a unit of at least ten beds dedicated to
care of ventilator-dependent persons in partnership with Mayo Health Systems, whichever
is later, the operating payment rates for residents determined eligible under paragraph (a)
of a nursing facility in Waseca County that on February 1, 2007, was licensed for 70 beds
and reimbursed under this section, section 256B.434, or section 256B.441, shall be 300
percent of the facility's highest RUG rate.
new text end
Sec. 20.
Minnesota Statutes 2006, section 256B.431, subdivision 17a, is amended to
read:
Subd. 17a.
Allowable interest expense.
(a) Notwithstanding Minnesota Rules, part
9549.0060, subparts 5, item A, subitems (1) and (3), and 7, item D, allowable interest
expense on debt shall include:
(1) interest expense on debt related to the cost of purchasing or replacing depreciable
equipment, excluding vehicles, not to exceed deleted text begin sixdeleted text end new text begin tennew text end percent of the total historical cost
of the project; and
(2) interest expense on debt related to financing or refinancing costs, including costs
related to points, loan origination fees, financing charges, legal fees, and title searches; and
issuance costs including bond discounts, bond counsel, underwriter's counsel, corporate
counsel, printing, and financial forecasts. Allowable debt related to items in this clause
shall not exceed seven percent of the total historical cost of the project. To the extent
these costs are financed, the straight-line amortization of the costs in this clause is not an
allowable cost; and
(3) interest on debt incurred for the establishment of a debt reserve fund, net of the
interest earned on the debt reserve fund.
(b) Debt incurred for costs under paragraph (a) is not subject to Minnesota Rules,
part 9549.0060, subpart 5, item A, subitem (5) or (6).
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective October 1, 2007.
new text end
Sec. 21.
Minnesota Statutes 2006, section 256B.434, subdivision 4, is amended to read:
Subd. 4.
Alternate rates for nursing facilities.
(a) For nursing facilities which
have their payment rates determined under this section rather than section 256B.431, the
commissioner shall establish a rate under this subdivision. The nursing facility must enter
into a written contract with the commissioner.
(b) A nursing facility's case mix payment rate for the first rate year of a facility's
contract under this section is the payment rate the facility would have received under
section 256B.431.
(c) A nursing facility's case mix payment rates for the second and subsequent years
of a facility's contract under this section are the previous rate year's contract payment
rates plus an inflation adjustment and, for facilities reimbursed under this section or
section 256B.431, an adjustment to include the cost of any increase in Health Department
licensing fees for the facility taking effect on or after July 1, 2001. The index for the
inflation adjustment must be based on the change in the Consumer Price Index-All Items
(United States City average) (CPI-U) forecasted by the commissioner of finance's national
economic consultant, as forecasted in the fourth quarter of the calendar year preceding
the rate year. The inflation adjustment must be based on the 12-month period from the
midpoint of the previous rate year to the midpoint of the rate year for which the rate is
being determined. For the rate years beginning on July 1, 1999, July 1, 2000, July 1,
2001, July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006, July 1, 2007,
deleted text begin anddeleted text end July 1, 2008, new text begin October 1, 2009, and October 1, 2010,new text end this paragraph shall apply only
to the property-related payment rate, except that adjustments to include the cost of any
increase in Health Department licensing fees taking effect on or after July 1, 2001, shall
be provided. Beginning in 2005, adjustment to the property payment rate under this
section and section 256B.431 shall be effective on October 1. In determining the amount
of the property-related payment rate adjustment under this paragraph, the commissioner
shall determine the proportion of the facility's rates that are property-related based on the
facility's most recent cost report.
(d) The commissioner shall develop additional incentive-based payments of up to
five percent above a facility's operating payment rate for achieving outcomes specified
in a contract. The commissioner may solicit contract amendments and implement those
which, on a competitive basis, best meet the state's policy objectives. The commissioner
shall limit the amount of any incentive payment and the number of contract amendments
under this paragraph to operate the incentive payments within funds appropriated for this
purpose. The contract amendments may specify various levels of payment for various
levels of performance. Incentive payments to facilities under this paragraph may be in the
form of time-limited rate adjustments or onetime supplemental payments. In establishing
the specified outcomes and related criteria, the commissioner shall consider the following
state policy objectives:
(1) successful diversion or discharge of residents to the residents' prior home or other
community-based alternatives;
(2) adoption of new technology to improve quality or efficiency;
(3) improved quality as measured in the Nursing Home Report Card;
(4) reduced acute care costs; and
(5) any additional outcomes proposed by a nursing facility that the commissioner
finds desirable.
new text begin
(e) Notwithstanding the threshold in section 256B.431, subdivision 16, facilities that
take action to come into compliance with existing or pending requirements of the life
safety code provisions or federal regulations governing sprinkler systems must receive
reimbursement for the costs associated with compliance if all of the following conditions
are met:
new text end
new text begin
(1) the expenses associated with compliance occurred on or after January 1, 2005,
and before December 31, 2008;
new text end
new text begin
(2) the costs were not otherwise reimbursed under subdivision 4f or section
144A.071 or 144A.073; and
new text end
new text begin
(3) the total allowable costs reported under this paragraph are less than the minimum
threshold established under section 256B.431, subdivision 15, paragraph (e), and
subdivision 16.
new text end
new text begin
The commissioner shall use money appropriated for this purpose to provide to qualifying
nursing facilities a rate adjustment beginning October 1, 2007, and ending September 30,
2008. Nursing facilities that have spent money or anticipate the need to spend money
to satisfy the most recent life safety code requirements by (1) installing a sprinkler
system or (2) replacing all or portions of an existing sprinkler system may submit to the
commissioner by June 30, 2007, on a form provided by the commissioner the actual
costs of a completed project or the estimated costs, based on a project bid, of a planned
project. The commissioner shall calculate a rate adjustment equal to the allowable
costs of the project divided by the resident days reported for the report year ending
September 30, 2006. If the costs from all projects exceed the appropriation for this
purpose, the commissioner shall allocate the money appropriated on a pro rata basis to the
qualifying facilities by reducing the rate adjustment determined for each facility by an
equal percentage. Facilities that used estimated costs when requesting the rate adjustment
shall report to the commissioner by January 31, 2009, on the use of this money on a
form provided by the commissioner. If the nursing facility fails to provide the report, the
commissioner shall recoup the money paid to the facility for this purpose. If the facility
reports expenditures allowable under this subdivision that are less than the amount received
in the facility's annualized rate adjustment, the commissioner shall recoup the difference.
new text end
Sec. 22.
Minnesota Statutes 2006, section 256B.434, is amended by adding a
subdivision to read:
new text begin Subd. 19. new text end
new text begin Nursing facility rate increases beginning October 1, 2007. new text end
new text begin
(a) For the
rate year beginning October 1, 2007, the commissioner shall make available to each
nursing facility reimbursed under this section operating payment rate adjustments equal to
1.87 percent of the operating payment rates in effect on September 30, 2007.
new text end
new text begin
(b) Seventy-five percent of the money resulting from the rate adjustment under
paragraph (a) must be used for increases in compensation-related costs for employees
directly employed by the nursing facility on or after the effective date of the rate
adjustment, except:
new text end
new text begin
(1) the administrator;
new text end
new text begin
(2) persons employed in the central office of a corporation that has an ownership
interest in the nursing facility or exercises control over the nursing facility; and
new text end
new text begin
(3) persons paid by the nursing facility under a management contract.
new text end
new text begin
(c) Two-thirds of the money available under paragraph (b) must be used for wage
increases for all employees directly employed by the nursing facility on or after the
effective date of the rate adjustment, except those listed in paragraph (b), clauses (1) to
(3). The wage adjustment that employees receive under this paragraph must be paid as
an equal hourly percentage wage increase for all eligible employees. All wage increases
under this paragraph must be effective on the same date. Only costs associated with the
portion of the equal hourly percentage wage increase that goes to all employees shall
qualify under this paragraph. Costs associated with wage increases in excess of the
amount of the equal hourly percentage wage increase provided to all employees shall be
allowed only for meeting the requirements in paragraph (b). This paragraph shall not
apply to employees covered by a collective bargaining agreement.
new text end
new text begin
(d) The commissioner shall allow as compensation-related costs all costs for:
new text end
new text begin
(1) wages and salaries;
new text end
new text begin
(2) FICA taxes, Medicare taxes, state and federal unemployment taxes, and workers'
compensation;
new text end
new text begin
(3) the employer's share of health and dental insurance, life insurance, disability
insurance, long-term care insurance, uniform allowance, and pensions; and
new text end
new text begin
(4) other benefits provided, subject to the approval of the commissioner.
new text end
new text begin
(e) The portion of the rate adjustment under paragraph (a) that is not subject to the
requirements in paragraphs (b) and (c) shall be provided to nursing facilities effective
October 1, 2007.
new text end
new text begin
(f) Nursing facilities may apply for the portion of the rate adjustment under
paragraph (a) that is subject to the requirements in paragraphs (b) and (c). The application
must be submitted to the commissioner within six months of the effective date of the
rate adjustment, and the nursing facility must provide additional information required
by the commissioner within nine months of the effective date of the rate adjustment.
The commissioner must respond to all applications within three weeks of receipt.
The commissioner may waive the deadlines in this paragraph under extraordinary
circumstances, to be determined at the sole discretion of the commissioner. The
application must contain:
new text end
new text begin
(1) an estimate of the amounts of money that must be used as specified in paragraphs
(b) and (c);
new text end
new text begin
(2) a detailed distribution plan specifying the allowable compensation-related and
wage increases the nursing facility will implement to use the funds available in clause (1);
new text end
new text begin
(3) a description of how the nursing facility will notify eligible employees of
the contents of the approved application, which must provide for giving each eligible
employee a copy of the approved application, excluding the information required in clause
(1), or posting a copy of the approved application, excluding the information required in
clause (1), for a period of at least six weeks in an area of the nursing facility to which all
eligible employees have access; and
new text end
new text begin
(4) instructions for employees who believe they have not received the
compensation-related or wage increases specified in clause (2), as approved by the
commissioner, and which must include a mailing address, e-mail address, and the
telephone number that may be used by the employee to contact the commissioner or the
commissioner's representative.
new text end
new text begin
(g) The commissioner shall ensure that cost increases in distribution plans under
paragraph (f), clause (2), that may be included in approved applications, comply with the
following requirements:
new text end
new text begin
(1) costs to be incurred during the applicable rate year resulting from wage and
salary increases effective after October 1, 2006, and prior to the first day of the nursing
facility's payroll period that includes October 1, 2007, shall be allowed if they were not
used in the prior year's application;
new text end
new text begin
(2) a portion of the costs resulting from tenure-related wage or salary increases
may be considered to be allowable wage increases, according to formulas that the
commissioner shall provide, where employee retention is above the average statewide
rate of retention of direct care employees;
new text end
new text begin
(3) the annualized amount of increases in costs for the employer's share of health
and dental insurance, life insurance, disability insurance, and workers' compensation
shall be allowable compensation-related increases if they are effective on or after April
1, 2007, and prior to April 1, 2008; and
new text end
new text begin
(4) for nursing facilities in which employees are represented by an exclusive
bargaining representative, the commissioner shall approve the application only upon
receipt of a letter of acceptance of the distribution plan, in regard to members of the
bargaining unit, signed by the exclusive bargaining agent and dated after enactment of
this subdivision. Upon receipt of the letter of acceptance, the commissioner shall deem
all requirements of this section as having been met in regard to the members of the
bargaining unit.
new text end
new text begin
(h) The commissioner shall review applications received under paragraph (f) and
shall provide the portion of the rate adjustment under paragraphs (b) and (c) if the
requirements of this subdivision have been met. The rate adjustment shall be effective
October 1. Notwithstanding paragraph (a), if the approved application distributes less
money than is available, the amount of the rate adjustment shall be reduced so that the
amount of money made available is equal to the amount to be distributed.
new text end
Sec. 23.
Minnesota Statutes 2006, section 256B.434, is amended by adding a
subdivision to read:
new text begin Subd. 20. new text end
new text begin Payment of Public Employees Retirement Association costs. new text end
new text begin
Nursing
facilities that participate in the Public Employees Retirement Association (PERA) shall
have the component of their payment rate associated with the costs of PERA determined
for each rate year. Effective for rate years beginning on and after October 1, 2007, the
commissioner shall determine the portion of the payment rate in effect on September 30
each year and shall subtract that amount from the payment rate to be effective on the
following October 1. The portion that shall be deemed to be included in the September 30,
2007, rate that is associated with PERA costs shall be the allowed costs in the facility's
base for determining rates under this section, divided by the resident days reported for that
year. The commissioner shall add to the payment rate to be effective on October 1 each
year an amount equal to the reported costs associated with PERA, for the year ended on
the most recent September 30 for which data is available, divided by total resident days
for that year, as reported by the facility and audited under section 256B.441.
new text end
Sec. 24.
Minnesota Statutes 2006, section 256B.437, is amended by adding a
subdivision to read:
new text begin Subd. 10. new text end
new text begin Big Stone County rate adjustment. new text end
new text begin
Notwithstanding the requirements
of this section, the commissioner shall approve a planned closure rate adjustment in Big
Stone County for an eight-bed facility in Clinton for reassignment to a 50-bed facility in
Graceville. The adjustment shall be calculated according to subdivisions 3 and 6.
new text end
Sec. 25.
Minnesota Statutes 2006, section 256B.441, subdivision 1, is amended to read:
Subdivision 1.
deleted text begin Rate determinationdeleted text end new text begin Rebasing of nursing facility operating cost
payment ratesnew text end .
(a) deleted text begin The commissioner shall establish a value-based nursing facility
reimbursement system which will provide facility-specific, prospective rates for nursing
facilities participating in the medical assistance program. The rates shall be determined
using an annual statistical and cost report filed by each nursing facility. The total payment
rate shall be composed of four rate components: direct care services, support services,
external fixed, and property-related rate components. The payment rate shall be derived
from statistical measures of actual costs incurred in facility operation of nursing facilities.
From this cost basis, the components of the total payment rate shall be adjusted for quality
of services provided, recognition of staffing levels, geographic variation in labor costs, and
resident acuity.deleted text end new text begin The commissioner shall rebase nursing facility operating cost payment
rates to align payments to facilities with the cost of providing care. The rebased operating
cost payment rates shall be calculated using the statistical and cost report filed by each
nursing facility for the report period ending one year prior to the rate year.
new text end
(b) deleted text begin Rates shall be rebased annually.deleted text end new text begin The new operating cost payment rates based on
this section shall take effect beginning with the rate year beginning October 1, 2008, and
shall be phased in over eight rate years through October 1, 2015.
new text end
new text begin (c) Operating cost payment rates shall be rebased on October 1, 2016, and every
two years after that date.new text end
new text begin (d) new text end Each cost reporting year shall begin on October 1 and end on the following
September 30. Beginning in 2006, a statistical and cost report shall be filed by each
nursing facility by January 15. Notice of rates shall be distributed by August 15 and the
rates shall go into effect on October 1 for one year.
deleted text begin
(c) The commissioner shall begin to phase in the new reimbursement system
beginning October 1, 2007. Full phase-in shall be completed by October 1, 2011.
deleted text end
new text begin
(e) Effective October 1, 2014, property rates shall be rebased in accordance with
section 256B.431 and Minnesota Rules, chapter 9549. The commissioner shall determine
what the property payment rate for a nursing facility would be had the facility not had its
property rate determined under section 256B.434. The commissioner shall allow nursing
facilities to provide information affecting this rate determination that would have been
filed annually under Minnesota Rules, chapter 9549, and nursing facilities shall report
information necessary to determine allowable debt. The commissioner shall use this
information to determine the property payment rate.
new text end
Sec. 26.
Minnesota Statutes 2006, section 256B.441, subdivision 2, is amended to read:
Subd. 2.
Definitions.
For purposes of this section, the terms in subdivisions 3 to
deleted text begin 42deleted text end new text begin 42a new text end have the meanings given unless otherwise provided for in this section.
Sec. 27.
Minnesota Statutes 2006, section 256B.441, subdivision 5, is amended to read:
Subd. 5.
Administrative costs.
"Administrative costs" means the direct costs for
administering the overall activities of the nursing home. These costs include salaries and
wages of the administrator, assistant administrator, business office employees, security
guards, and associated fringe benefits and payroll taxes, fees, contracts, or purchases
related to business office functions, licenses, and permits except as provided in the
external fixed costs category, employee recognition, travel including meals and lodging,
training, voice and data communication or transmission, office supplies, liability insurance
and other forms of insurance not designated to other areas, personnel recruitment, legal
services, accounting services, management or business consultants, data processing,
new text begin information technology, Web site, new text end central or home office costs, business meetings and
seminars, postage, fees for professional organizations, subscriptions, security services,
advertising, board of director's fees, working capital interest expense, and bad debts and
bad debt collection fees.
Sec. 28.
Minnesota Statutes 2006, section 256B.441, subdivision 6, is amended to read:
Subd. 6.
Allowed costs.
"Allowed costs" means the amounts reported by the
facility which are necessary for the operation of the facility and the care of residents
and which are reviewed by the department for accuracydeleted text begin ,deleted text end new text begin ;new text end reasonableness, new text begin in accordance
with the requirements set forth in Title XVIII of the federal Social Security Act and the
interpretations in the provider reimbursement manual; new text end and compliance with this section
and generally accepted accounting principles.new text begin All references to costs in this section shall
be assumed to refer to allowed costs.
new text end
Sec. 29.
Minnesota Statutes 2006, section 256B.441, subdivision 10, is amended to
read:
Subd. 10.
Dietary costs.
"Dietary costs" means the costs for the salaries and wages
of the dietary supervisor, dietitians, chefs, cooks, dishwashers, and other employees
assigned to the kitchen and dining room, and associated fringe benefits and payroll
taxes. Dietary costs also includes the salaries or fees of dietary consultants, deleted text begin direct costs
of raw food (both normal and special diet food),deleted text end dietary supplies, and food preparation
and serving. deleted text begin Also included are special dietary supplements used for tube feeding or oral
feeding, such as elemental high nitrogen diet, even if written as a prescription item by a
physician.
deleted text end
Sec. 30.
Minnesota Statutes 2006, section 256B.441, subdivision 11, is amended to
read:
Subd. 11.
Direct care costs deleted text begin categorydeleted text end .
deleted text begin "Direct care costs category"deleted text end new text begin "Direct care
costs"new text end means costs for deleted text begin nursing services, activities, and social servicesdeleted text end new text begin the wages of nursing
administration, staff education, direct care registered nurses, licensed practical nurses,
certified nursing assistants, trained medication aides, and associated fringe benefits and
payroll taxes; services from a supplemental nursing services agency; supplies that are
stocked at nursing stations or on the floor and distributed or used individually, including,
but not limited to: alcohol, applicators, cotton balls, incontinence pads, disposable ice
bags, dressings, bandages, water pitchers, tongue depressors, disposable gloves, enemas,
enema equipment, soap, medication cups, diapers, plastic waste bags, sanitary products,
thermometers, hypodermic needles and syringes, clinical reagents or similar diagnostic
agents, drugs that are not paid on a separate fee schedule by the medical assistance
program or any other payer, and technology related to the provision of nursing care to
residents, such as electronic charting systemsnew text end .
Sec. 31.
Minnesota Statutes 2006, section 256B.441, subdivision 13, is amended to
read:
Subd. 13.
External fixed costs deleted text begin categorydeleted text end .
deleted text begin "External fixed costs category"deleted text end new text begin "External
fixed costs" new text end means costs related to the nursing home surcharge under section 256.9657,
subdivision 1; licensure fees under section 144.122; long-term care consultation fees
under section 256B.0911, subdivision 6; family advisory council fee under section
144A.33; scholarships under section 256B.431, subdivision 36; planned closure rate
adjustments under sectionnew text begin 256B.436 ornew text end 256B.437; new text begin or single bed room incentives under
section 256B.431, subdivision 42; new text end property taxes and property insurance; and PERA.
Sec. 32.
Minnesota Statutes 2006, section 256B.441, subdivision 14, is amended to
read:
Subd. 14.
Facility average case mix index.
"Facility average case mix index" or
"CMI" means a numerical value score that describes the relative resource use for all
residents within the groups under the resource utilization group (RUG-III) classification
system prescribed by the commissioner based on an assessment of each resident. The
facility average CMI shall be computed as the standardized days divided by total days for
all residents in the facility.new text begin The RUG's weights used in this section shall be as follows
for each RUG's class: SE3 1.605; SE2 1.247; SE1 1.081; RAD 1.509; RAC 1.259; RAB
1.109; RAA 0.957; SSC 1.453; SSB 1.224; SSA 1.047; CC2 1.292; CC1 1.200; CB2
1.086; CB1 1.017; CA2 0.908; CA1 0.834; IB2 0.877; IB1 0.817; IA2 0.720; IA1 0.676;
BB2 0.956; BB1 0.885; BA2 0.716; BA1 0.673; PE2 1.199; PE1 1.104; PD2 1.023;
PD1 0.948; PC2 0.926; PC1 0.860; PB2 0.786; PB1 0.734; PA2 0.691; PA1 0.651; BC1
0.651; and DDF 1.000.
new text end
Sec. 33.
Minnesota Statutes 2006, section 256B.441, is amended by adding a
subdivision to read:
new text begin Subd. 14a. new text end
new text begin Facility type groups. new text end
new text begin
Facilities shall be classified into two groups,
called "facility type groups," which shall consist of:
new text end
new text begin
(1) C&NC/R80: facilities that are hospital-attached, or are licensed under Minnesota
Rules, parts 9570.2000 to 9570.3400; and
new text end
new text begin
(2) freestanding: all other facilities.
new text end
Sec. 34.
Minnesota Statutes 2006, section 256B.441, subdivision 17, is amended to
read:
Subd. 17.
Fringe benefit costs.
"Fringe benefit costs" means the costs for group
life, health, dental, workers' compensation, and other employee insurances and pension,
profit-sharing, and retirement plans for which the employer pays all or a portion of the
costs deleted text begin and that are available to at least all employees who work at least 20 hours per weekdeleted text end .
Sec. 35.
Minnesota Statutes 2006, section 256B.441, subdivision 20, is amended to
read:
Subd. 20.
Housekeeping costs.
"Housekeeping costs" means the costs for the
salaries and wages of the housekeeping supervisor, housekeepers, and other cleaning
employees and associated fringe benefits and payroll taxes. It also includes the cost of
housekeeping supplies, includingnew text begin , but not limited to, new text end cleaning and lavatory supplies and
contract services.
Sec. 36.
Minnesota Statutes 2006, section 256B.441, subdivision 24, is amended to
read:
Subd. 24.
Maintenance and plant operations costs.
"Maintenance and plant
operations costs" means the costs for the salaries and wages of the maintenance supervisor,
engineers, heating-plant employees, and other maintenance employees and associated
fringe benefits and payroll taxes. It also includes direct costs for maintenance and
operation of the building and grounds, includingnew text begin , but not limited to, new text end fuel, electricity,
medical waste and garbage removal, water, sewer, supplies, tools, and repairs.
Sec. 37.
Minnesota Statutes 2006, section 256B.441, is amended by adding a
subdivision to read:
new text begin Subd. 28a. new text end
new text begin Other direct care costs. new text end
new text begin
"Other direct care costs" means the costs
for the salaries and wages and associated fringe benefits and payroll taxes of mental
health workers, religious personnel, and other direct care employees not specified in
the definition of direct care costs.
new text end
Sec. 38.
Minnesota Statutes 2006, section 256B.441, subdivision 30, is amended to
read:
Subd. 30.
Peer groups.
Facilities shall be classified into three groupsdeleted text begin , called "peer
groups," whichdeleted text end new text begin by county. The groups new text end shall consist of:
(1) deleted text begin C&NC/Short Stay/R80 - facilities that have three or more admissions per bed
per year, are hospital-attached, or are licensed under Minnesota Rules, parts 9570.2000
to 9570.3600deleted text end new text begin group one: facilities in Anoka, Benton, Carlton, Carver, Chisago, Dakota,
Dodge, Goodhue, Hennepin, Isanti, Mille Lacs, Morrison, Olmsted, Ramsey, Rice, Scott,
Sherburne, St. Louis, Stearns, Steele, Wabasha, Washington, Winona, or Wright Countynew text end ;
(2)deleted text begin boarding care homes - facilities that have more than 50 percent of their beds
licensed as boarding care homesdeleted text end new text begin group two: facilities in Aitkin, Beltrami, Blue Earth,
Brown, Cass, Clay, Cook, Crow Wing, Faribault, Fillmore, Freeborn, Houston, Hubbard,
Itasca, Kanabec, Koochiching, Lake, Lake of the Woods, Le Sueur, Martin, McLeod,
Meeker, Mower, Nicollet, Norman, Pine, Roseau, Sibley, Todd, Wadena, Waseca,
Watonwan, or Wilkin Countynew text end ; and
(3) deleted text begin standard - all other facilitiesdeleted text end new text begin group three: facilities in all other countiesnew text end .
Sec. 39.
Minnesota Statutes 2006, section 256B.441, subdivision 31, is amended to
read:
Subd. 31.
Prior deleted text begin rate-setting methoddeleted text end new text begin system operating cost payment ratenew text end .
deleted text begin "Prior
rate-setting method"deleted text end new text begin "Prior system operating cost payment rate" new text end means the new text begin operating cost
payment new text end rate deleted text begin determination processdeleted text end in effect deleted text begin prior to October 1, 2006deleted text end new text begin on September 30,
2008new text end , under Minnesota Rules and Minnesota Statutesnew text begin , not including planned closure rate
adjustments under section 256B.436 or 256B.437, or single bed room incentives under
section 256B.431, subdivision 42new text end .
Sec. 40.
Minnesota Statutes 2006, section 256B.441, is amended by adding a
subdivision to read:
new text begin Subd. 33a. new text end
new text begin Raw food costs. new text end
new text begin
"Raw food costs" means the cost of food provided to
nursing facility residents. Also included are special dietary supplements used for tube
feeding or oral feeding, such as elemental high nitrogen diet.
new text end
Sec. 41.
Minnesota Statutes 2006, section 256B.441, subdivision 34, is amended to
read:
Subd. 34.
Related organization.
"Related organization" means a person that
furnishes goods or services to a nursing facility and that is a close relative of a nursing
facility, an affiliate of a nursing facility, a close relative of an affiliate of a nursing facility,
or an affiliate of a close relative of an affiliate of a nursing facility. As used in this
subdivision, paragraphs (a) to (d) apply:
(a) "Affiliate" means a person that directly, or indirectly through one or more
intermediaries, controls or is controlled by, or is under common control with another
person.
(b) "Person" means an individual, a corporation, a partnership, an association, a
trust, an unincorporated organization, or a government or political subdivision.
(c) "Close relative of an affiliate of a nursing facility" means an individual whose
relationship by blood, marriage, or adoption to an individual who is an affiliate of a
nursing facility is no more remote than first cousin.
(d) "Control" including the terms "controlling," "controlled by," and "under common
control with" means the possession, direct or indirect, of the power to direct or cause the
direction of the management, operations, or policies of a person, whether through the
ownership of voting securities, by contract, or otherwisedeleted text begin , or to influence in any manner
other than through an arms length, legal transactiondeleted text end .
Sec. 42.
Minnesota Statutes 2006, section 256B.441, subdivision 38, is amended to
read:
Subd. 38.
Social services costs.
"Social services costs" means the costs for the
salaries and wages of the supervisor and other social work employees, associated fringe
benefits and payroll taxes, supplies, services, and consultants.new text begin This category includes the
cost of those employees who manage and process admission to the nursing facility.
new text end
Sec. 43.
Minnesota Statutes 2006, section 256B.441, is amended by adding a
subdivision to read:
new text begin Subd. 42a. new text end
new text begin Therapy costs. new text end
new text begin
"Therapy costs" means any costs related to medical
assistance therapy services provided to residents that are not billed separately from the
daily operating rate.
new text end
Sec. 44.
Minnesota Statutes 2006, section 256B.441, is amended by adding a
subdivision to read:
new text begin Subd. 46a. new text end
new text begin
Calculation of quality add-on for the rate year beginning October
1, 2007.
new text end
new text begin
(a) The payment rate for the rate year beginning October 1, 2007, for the
quality add-on, is a variable amount based on each facility's quality score. For the rate
year, the maximum quality add-on is .3 percent of the operating payment rate in effect
on September 30, 2007. The commissioner shall determine the quality add-on for each
facility according to paragraphs (b) to (d).
new text end
new text begin
(b) For each facility, the commissioner shall determine the operating payment rate
in effect on September 30, 2007.
new text end
new text begin
(c) For each facility, the commissioner shall determine a ratio of the quality score of
the facility determined in subdivision 44, subtract 40, and then divide by 60. If this value
is less than zero, the commissioner shall use the value zero.
new text end
new text begin
(d) For each facility, the quality add-on is the value determined in paragraph (b),
multiplied by the value determined in paragraph (c), multiplied by .3 percent.
new text end
Sec. 45.
Minnesota Statutes 2006, section 256B.441, is amended by adding a
subdivision to read:
new text begin Subd. 48. new text end
new text begin Calculation of operating per diems. new text end
new text begin
The direct care per diem for
each facility shall be the facility's direct care costs divided by its standardized days.
The other care-related per diem shall be the sum of the facility's activities costs, other
direct care costs, raw food costs, therapy costs, and social services costs, divided by the
facility's resident days. The other operating per diem shall be the sum of the facility's
administrative costs, dietary costs, housekeeping costs, laundry costs, and maintenance
and plant operations costs divided by the facility's resident days.
new text end
Sec. 46.
Minnesota Statutes 2006, section 256B.441, is amended by adding a
subdivision to read:
new text begin Subd. 49. new text end
new text begin Determination of total care-related per diem. new text end
new text begin
The total care-related
per diem for each facility shall be the sum of the direct care per diem and the other
care-related per diem.
new text end
Sec. 47.
Minnesota Statutes 2006, section 256B.441, is amended by adding a
subdivision to read:
new text begin Subd. 50. new text end
new text begin Determination of total care-related limit. new text end
new text begin
(a) The limit on the total
care-related per diem shall be determined for each peer group and facility type group
combination. A facility's total care-related per diems shall be limited to 120 percent of the
median for the facility's peer and facility type group. The facility-specific direct care costs
used in making this comparison and in the calculation of the median shall be based on a
RUG's weight of 1.00. A facility that is above that limit shall have its total care-related per
diem reduced to the limit. If a reduction of the total care-related per diem is necessary
because of this limit, the reduction shall be made proportionally to both the direct care per
diem and the other care-related per diem.
new text end
new text begin
(b) Beginning with rates determined for October 1, 2016, the total care-related limit
shall be a variable amount based on each facility's quality score, as determined under
section 256B.441, subdivision 44, in accordance with clauses (1) to (4):
new text end
new text begin
(1) for each facility, the commissioner shall determine the quality score, subtract 40,
divide by 40, and convert to a percentage;
new text end
new text begin
(2) if the value determined in clause (1) is less than zero, the total care-related limit
shall be 105 percent of the median for the facility's peer and facility type group;
new text end
new text begin
(3) if the value determined in clause (1) is greater than 100 percent, the total
care-related limit shall be 125 percent of the median for the facility's peer and facility
type group; and
new text end
new text begin
(4) if the value determined in clause (1) is greater than zero and less than 100
percent, the total care-related limit shall be 105 percent of the median for the facility's peer
and facility type group plus one-fifth of the percentage determined in clause (1).
new text end
Sec. 48.
Minnesota Statutes 2006, section 256B.441, is amended by adding a
subdivision to read:
new text begin Subd. 50a. new text end
new text begin Determination of proximity adjustments. new text end
new text begin
For a nursing facility
located in close proximity to another nursing facility of the same facility group type but in
a different peer group and that has higher limits for care-related or other operating costs,
the commissioner shall adjust the limits in accordance with clauses (1) to (4):
new text end
new text begin
(1) determine the difference between the limits;
new text end
new text begin
(2) determine the distance between the two facilities, by the shortest driving route. If
the distance exceeds 20 miles, no adjustment shall be made;
new text end
new text begin
(3) subtract the value in clause (2) from 20 miles, divide by 20, and convert to a
percentage; and
new text end
new text begin
(4) increase the limits for the nursing facility with the lower limits by the value
determined in clause (1) multiplied by the value determined in clause (3).
new text end
Sec. 49.
Minnesota Statutes 2006, section 256B.441, is amended by adding a
subdivision to read:
new text begin Subd. 51. new text end
new text begin Determination of other operating limit. new text end
new text begin
The limit on the other operating
per diem shall be determined for each peer group. A facility's other operating per diem
shall be limited to 105 percent of the median for its peer group. A facility that is above
that limit shall have its other operating per diem reduced to the limit.
new text end
Sec. 50.
Minnesota Statutes 2006, section 256B.441, is amended by adding a
subdivision to read:
new text begin Subd. 51a. new text end
new text begin Exception allowing contracting for specialized care. new text end
new text begin
(a) For rate years
beginning on or after October 1, 2016, the commissioner may negotiate increases to
the care-related limit for nursing facilities that provide specialized care, at a cost to the
general fund not to exceed $600,000 per year. The commissioner shall publish a request
for proposals annually, and may negotiate increases to the limits that shall apply for either
one or two years before the increase shall be subject to a new proposal and negotiation.
The care-related limit may be increased by up to 50 percent.
new text end
new text begin
(b) In selecting facilities with which to negotiate, the commissioner shall consider:
new text end
new text begin
(1) the diagnoses or other circumstances of residents in the specialized program that
require care that costs substantially more than the RUG's rates associated with those
residents;
new text end
new text begin
(2) the nature of the specialized program or programs offered to meet the needs
of these individuals; and
new text end
new text begin
(3) outcomes achieved by the specialized program.
new text end
Sec. 51.
Minnesota Statutes 2006, section 256B.441, is amended by adding a
subdivision to read:
new text begin Subd. 52. new text end
new text begin Determination of efficiency incentive. new text end
new text begin
Each facility shall be eligible
for an efficiency incentive based on its other operating per diem. A facility with an other
operating per diem that exceeds the limit in subdivision 51 shall receive no efficiency
incentive. All other facilities shall receive an incentive calculated as 50 percent times the
difference between the facility's other operating per diem and its other operating per diem
limit, up to a maximum incentive of $3.
new text end
Sec. 52.
Minnesota Statutes 2006, section 256B.441, is amended by adding a
subdivision to read:
new text begin Subd. 53. new text end
new text begin Calculation of payment rate for external fixed costs. new text end
new text begin
The commissioner
shall calculate a payment rate for external fixed costs.
new text end
new text begin
(a) For a facility licensed as a nursing home, the portion related to section 256.9657
shall be equal to $8.86. For a facility licensed as both a nursing home and a boarding care
home, the portion related to section 256.9657 shall be equal to $8.86 multiplied by the
result of its number of nursing home beds divided by its total number of licensed beds.
new text end
new text begin
(b) The portion related to the licensure fee under section 144.122, paragraph (d),
shall be the amount of the fee divided by actual resident days.
new text end
new text begin
(c) The portion related to scholarships shall be determined under section 256B.431,
subdivision 36.
new text end
new text begin
(d) The portion related to long-term care consultation shall be determined according
to section 256B.0911, subdivision 6.
new text end
new text begin
(e) The portion related to development and education of resident and family advisory
councils under section 144A.33 shall be $5 divided by 365.
new text end
new text begin
(f) The portion related to planned closure rate adjustments shall be as determined
under sections 256B.436 and 256B.437, subdivision 6. Planned closure rate adjustments
that take effect before October 1, 2014, shall no longer be included in the payment rate
for external fixed costs beginning October 1, 2016. Planned closure rate adjustments that
take effect on or after October 1, 2014, shall no longer be included in the payment rate
for external fixed costs beginning on October 1 of the first year not less than two years
after their effective date.
new text end
new text begin
(g) The portions related to property insurance, real estate taxes, special assessments,
and payments made in lieu of real estate taxes directly identified or allocated to the nursing
facility shall be the actual amounts divided by actual resident days.
new text end
new text begin
(h) The portion related to the Public Employees Retirement Association shall be
actual costs divided by resident days.
new text end
new text begin
(i) The single bed room incentives shall be as determined under section 256B.431,
subdivision 42. Single bed room incentives that take effect before October 1, 2014, shall
no longer be included in the payment rate for external fixed costs beginning October 1,
2016. Single bed room incentives that take effect on or after October 1, 2014, shall no
longer be included in the payment rate for external fixed costs beginning on October 1 of
the first year not less than two years after their effective date.
new text end
new text begin
(j) The payment rate for external fixed costs shall be the sum of the amounts in
paragraphs (a) to (i).
new text end
Sec. 53.
Minnesota Statutes 2006, section 256B.441, is amended by adding a
subdivision to read:
new text begin Subd. 54. new text end
new text begin Determination of total payment rates. new text end
new text begin
In rate years when rates are
rebased, the total payment rate for a RUG's weight of 1.00 shall be the sum of the total
care-related payment rate, other operating payment rate, efficiency incentive, external
fixed cost rate, and the property rate determined under section 256B.434. To determine
a total payment rate for each RUG's level, the total care-related payment rate shall be
divided into the direct care payment rate and the other care-related payment rate, and the
direct care payment rate multiplied by the RUG's weight for each RUG's level using the
weights in subdivision 14.
new text end
Sec. 54.
Minnesota Statutes 2006, section 256B.441, is amended by adding a
subdivision to read:
new text begin Subd. 55. new text end
new text begin Phase-in of rebased operating cost payment rates. new text end
new text begin
(a) For the rate years
beginning October 1, 2008, to October 1, 2012, the operating cost payment rate calculated
under this section shall be phased in by blending the operating cost rate with the operating
cost payment rate determined under section 256B.434. For the rate year beginning
October 1, 2008, the operating cost payment rate for each facility shall be 13 percent of
the operating cost payment rate from this section, and 87 percent of the operating cost
payment rate from section 256B.434. For the rate year beginning October 1, 2009, the
operating cost payment rate for each facility shall be 14 percent of the operating cost
payment rate from this section, and 86 percent of the operating cost payment rate from
section 256B.434. For the rate year beginning October 1, 2010, the operating cost payment
rate for each facility shall be 14 percent of the operating cost payment rate from this
section, and 86 percent of the operating cost payment rate from section 256B.434. For the
rate year beginning October 1, 2011, the operating cost payment rate for each facility shall
be 31 percent of the operating cost payment rate from this section, and 69 percent of the
operating cost payment rate from section 256B.434. For the rate year beginning October 1,
2012, the operating cost payment rate for each facility shall be 48 percent of the operating
cost payment rate from this section, and 52 percent of the operating cost payment rate
from section 256B.434. For the rate year beginning October 1, 2013, the operating cost
payment rate for each facility shall be 65 percent of the operating cost payment rate from
this section, and 35 percent of the operating cost payment rate from section 256B.434. For
the rate year beginning October 1, 2014, the operating cost payment rate for each facility
shall be 82 percent of the operating cost payment rate from this section, and 18 percent
of the operating cost payment rate from section 256B.434. For the rate year beginning
October 1, 2015, the operating cost payment rate for each facility shall be the operating
cost payment rate determined under this section. The blending of operating cost payment
rates under this section shall be performed separately for each RUG's class.
new text end
new text begin
(b) A portion of the funds received under this subdivision that are in excess of
operating cost payment rates that a facility would have received under section 256B.434,
as determined in accordance with clauses (1) to (3), shall be subject to the requirements in
section 256B.434, subdivision 19, paragraphs (b) to (h).
new text end
new text begin
(1) Determine the amount of additional funding available to a facility, which shall be
equal to total medical assistance resident days from the most recent reporting year times
the difference between the blended rate determined in paragraph (a) for the rate year being
computed and the blended rate for the prior year.
new text end
new text begin
(2) Determine the portion of all operating costs, for the most recent reporting year,
that are compensation related. If this value exceeds 75 percent, use 75 percent.
new text end
new text begin
(3) Subtract the amount determined in clause (2) from 75 percent.
new text end
new text begin
(4) The portion of the fund received under this subdivision that shall be subject to
the requirements in section 256B.434, subdivision 19, paragraphs (b) to (h), shall equal
the amount determined in clause (1) times the amount determined in clause (3).
new text end
Sec. 55.
Minnesota Statutes 2006, section 256B.441, is amended by adding a
subdivision to read:
new text begin Subd. 56. new text end
new text begin Hold harmless. new text end
new text begin
For the rate years beginning October 1, 2008, to October
1, 2016, no nursing facility shall receive an operating cost payment rate less than its
operating cost payment rate under section 256B.434. The comparison of operating cost
payment rates under this section shall be made for a RUG's rate with a weight of 1.00.
new text end
Sec. 56.
Minnesota Statutes 2006, section 256B.441, is amended by adding a
subdivision to read:
new text begin Subd. 57. new text end
new text begin Appeals. new text end
new text begin
Nursing facilities may appeal, as described under section
256B.50, the determination of a payment rate established under this chapter.
new text end
Sec. 57.
Minnesota Statutes 2006, section 256B.441, is amended by adding a
subdivision to read:
new text begin Subd. 58. new text end
new text begin Implementation delay. new text end
new text begin
Within six months prior to the effective date of
(1) rebasing of property payment rates under subdivision 1; (2) quality-based rate limits
under subdivision 50; and (3) the removal of planned closure rate adjustments and single
bed room incentives from external fixed costs under subdivision 53, the commissioner
shall compare the average operating cost for all facilities combined from the most recent
cost reports to the average medical assistance operating payment rates for all facilities
combined from the same time period. Each provision shall not go into effect until the
average medical assistance operating payment rate is at least 92 percent of the average
operating cost.
new text end
Sec. 58.
Minnesota Statutes 2006, section 256B.49, is amended by adding a
subdivision to read:
new text begin Subd. 16a. new text end
new text begin Medical assistance reimbursement. new text end
new text begin
(a) The commissioner shall
seek federal approval for medical assistance reimbursement of independent living skills
services, foster care waiver service, supported employment, prevocational service,
structured day service, and adult day care under the home and community-based waiver
for persons with a traumatic brain injury, the community alternatives for disabled
individuals waivers, and the community alternative care waivers.
new text end
new text begin
(b) Medical reimbursement shall be made only when the provider demonstrates
evidence of its capacity to meet basic health, safety, and protection standards through
one of the methods in paragraphs (c) to (e).
new text end
new text begin
(c) The provider is licensed to provide services under chapter 245B and agrees to
apply these standards to services funded through the traumatic brain injury, community
alternatives for disabled, or community alternative care home and community-based
waivers.
new text end
new text begin
(d) The local agency contracting for the services certifies on a form provided by the
commissioner that the provider has the capacity to meet the individual needs as identified
in each person's individual service plan. When certifying that the service provider meets
the necessary provider qualifications, the local agency shall verify that the provider has
policies and procedures governing the following:
new text end
new text begin
(1) protection of the consumer's rights and privacy;
new text end
new text begin
(2) risk assessment and planning;
new text end
new text begin
(3) record keeping and reporting of incidents and emergencies with documentation
of corrective action if needed;
new text end
new text begin
(4) service outcomes, regular reviews of progress, and periodic reports;
new text end
new text begin
(5) complaint and grievance procedures;
new text end
new text begin
(6) service termination or suspension;
new text end
new text begin
(7) necessary training and supervision of direct care staff that includes:
new text end
new text begin
(i) documentation in personnel files of 20 hours of orientation training in providing
training related to service provision;
new text end
new text begin
(ii) training in recognizing the symptoms and effects of certain disabilities, health
conditions, and positive behavioral supports and interventions; and
new text end
new text begin
(iii) a minimum of five hours of related training annually; and
new text end
new text begin
(iv) when applicable:
new text end
new text begin
(A) safe medication administration;
new text end
new text begin
(B) proper handling of consumer funds; and
new text end
new text begin
(C) compliance with prohibitions and standards developed by the commissioner to
satisfy federal requirements regarding the use of restraints and restrictive interventions.
The local agency shall review at least annually each service provider's continued
compliance with the standards governing basic health, safety, and protection of rights.
new text end
new text begin
(h) The commissioner shall seek federal approval for Medicaid reimbursement
of foster care services under the home and community-based waiver for persons with
a traumatic brain injury, the community alternatives for disabled individuals waiver,
and community alternative care waiver when the provider demonstrates evidence of its
capacity to meet basic health, safety, and protection standards. The local agency shall
verify that the provider is licensed under Minnesota Rules, parts 9555.5105 to 9555.6265,
and certify that the provider has policies and procedures that govern:
new text end
new text begin
(1) compliance with prohibitions and standards developed by the commissioner to
meet federal requirements regarding the use of restraints and restrictive interventions; and
new text end
new text begin
(2) documentation of service needs and outcomes, regular reviews of progress,
and periodic reports.
new text end
new text begin
The local agency shall review at least annually each service provider's continued
compliance with the standards governing basic health, safety, and protection of rights
standards.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 59.
Minnesota Statutes 2006, section 256B.5012, is amended by adding a
subdivision to read:
new text begin Subd. 7. new text end
new text begin
ICF/MR rate increases effective October 1, 2007, and October 1, 2008.
new text end
new text begin
(a) For the rate year beginning October 1, 2007, the commissioner shall make available to
each facility reimbursed under this section operating payment rate adjustments equal to 2.0
percent of the operating payment rates in effect on September 30, 2007. For the rate year
beginning July 1, 2008, the commissioner shall make available to each facility reimbursed
under this section operating payment rate adjustments equal to 2.0 percent of the operating
payment rates in effect on June 30, 2008. For each facility, the commissioner shall make
available an adjustment, based on occupied beds, using the percentage specified in this
paragraph multiplied by the total payment rate, including the variable rate but excluding
the property-related payment rate, in effect on the preceding day. The total payment rate
shall include the adjustment provided in section 256B.501, subdivision 12. A facility
whose payment rates are governed by closure agreements, receivership agreements, or
Minnesota Rules, part 9553.0075, is not eligible for an adjustment otherwise granted
under this subdivision.
new text end
new text begin
(b) Seventy-five percent of the money resulting from the rate adjustments under
paragraph (a) must be used for increases in compensation-related costs for employees
directly employed by the facility on or after the effective date of the rate adjustments,
except:
new text end
new text begin
(1) the administrator;
new text end
new text begin
(2) persons employed in the central office of a corporation that has an ownership
interest in the facility or exercises control over the facility; and
new text end
new text begin
(3) persons paid by the facility under a management contract.
new text end
new text begin
(c) Two-thirds of the money available under paragraph (b) must be used for wage
increases for all employees directly employed by the facility on or after the effective
date of the rate adjustments, except those listed in paragraph (b), clauses (1) to (3). The
wage adjustment that employees receive under this paragraph must be paid as an equal
hourly percentage wage increase for all eligible employees. All wage increases under this
paragraph must be effective on the same date. Only costs associated with the portion of
the equal hourly percentage wage increase that goes to all employees shall qualify under
this paragraph. Costs associated with wage increases in excess of the amount of the equal
hourly percentage wage increase provided to all employees shall be allowed only for
meeting the requirements in paragraph (b). This paragraph shall not apply to employees
covered by a collective bargaining agreement.
new text end
new text begin
(d) The commissioner shall allow as compensation-related costs all costs for:
new text end
new text begin
(1) wages and salaries;
new text end
new text begin
(2) FICA taxes, Medicare taxes, state and federal unemployment taxes, and workers'
compensation;
new text end
new text begin
(3) the employer's share of health and dental insurance, life insurance, disability
insurance, long-term care insurance, uniform allowance, and pensions; and
new text end
new text begin
(4) other benefits provided, subject to the approval of the commissioner.
new text end
new text begin
(e) The portion of the rate adjustments under paragraph (a) that is not subject to the
requirements in paragraphs (b) and (c) shall be provided to facilities effective October
1 of each year.
new text end
new text begin
(f) Facilities may apply for the portion of the rate adjustments under paragraph
(a) that is subject to the requirements in paragraphs (b) and (c). The application
must be submitted to the commissioner within six months of the effective date of the
rate adjustments, and the facility must provide additional information required by
the commissioner within nine months of the effective date of the rate adjustments.
The commissioner must respond to all applications within three weeks of receipt.
The commissioner may waive the deadlines in this paragraph under extraordinary
circumstances, to be determined at the sole discretion of the commissioner. The
application must contain:
new text end
new text begin
(1) an estimate of the amounts of money that must be used as specified in paragraphs
(b) and (c);
new text end
new text begin
(2) a detailed distribution plan specifying the allowable compensation-related and
wage increases the facility will implement to use the funds available in clause (1);
new text end
new text begin
(3) a description of how the facility will notify eligible employees of the contents of
the approved application, which must provide for giving each eligible employee a copy of
the approved application, excluding the information required in clause (1), or posting a
copy of the approved application, excluding the information required in clause (1), for
a period of at least six weeks in an area of the facility to which all eligible employees
have access; and
new text end
new text begin
(4) instructions for employees who believe they have not received the
compensation-related or wage increases specified in clause (2), as approved by the
commissioner, and which must include a mailing address, e-mail address, and the
telephone number that may be used by the employee to contact the commissioner or the
commissioner's representative.
new text end
new text begin
(g) The commissioner shall ensure that cost increases in distribution plans under
paragraph (f), clause (2), that may be included in approved applications, comply with
requirements in clauses (1) to (4):
new text end
new text begin
(1) costs to be incurred during the applicable rate year resulting from wage and
salary increases effective after October 1, 2006, and prior to the first day of the facility's
payroll period that includes October 1 of each year shall be allowed if they were not used
in the prior year's application and they meet the requirements of paragraphs (b) and (c);
new text end
new text begin
(2) a portion of the costs resulting from tenure-related wage or salary increases
may be considered to be allowable wage increases, according to formulas that the
commissioner shall provide, where employee retention is above the average statewide
rate of retention of direct care employees;
new text end
new text begin
(3) the annualized amount of increases in costs for the employer's share of health
and dental insurance, life insurance, disability insurance, and workers' compensation shall
be allowable compensation-related increases if they are effective on or after April 1 of
the year in which the rate adjustments are effective and prior to April 1 of the following
year; and
new text end
new text begin
(4) for facilities in which employees are represented by an exclusive bargaining
representative, the commissioner shall approve the application only upon receipt of a letter
of acceptance of the distribution plan, as regards members of the bargaining unit, signed
by the exclusive bargaining agent and dated after enactment of this subdivision. Upon
receipt of the letter of acceptance, the commissioner shall deem all requirements of this
section as having been met in regard to the members of the bargaining unit.
new text end
new text begin
(h) The commissioner shall review applications received under paragraph (f) and
shall provide the portion of the rate adjustments under paragraphs (b) and (c) if the
requirements of this subdivision have been met. The rate adjustments shall be effective
October 1 of each year. Notwithstanding paragraph (a), if the approved application
distributes less money than is available, the amount of the rate adjustment shall be reduced
so that the amount of money made available is equal to the amount to be distributed.
new text end
Sec. 60.
Minnesota Statutes 2006, section 256B.69, subdivision 23, is amended to read:
Subd. 23.
Alternative services; elderly and disabled persons.
(a) The
commissioner may implement demonstration projects to create alternative integrated
delivery systems for acute and long-term care services to elderly persons and persons
with disabilities as defined in section 256B.77, subdivision 7a, that provide increased
coordination, improve access to quality services, and mitigate future cost increases.
The commissioner may seek federal authority to combine Medicare and Medicaid
capitation payments for the purpose of such demonstrations and may contract with
Medicare-approved special needs plans to provide Medicaid services. Medicare funds and
services shall be administered according to the terms and conditions of the federal contract
and demonstration provisions. For the purpose of administering medical assistance funds,
demonstrations under this subdivision are subject to subdivisions 1 to 22. The provisions
of Minnesota Rules, parts 9500.1450 to 9500.1464, apply to these demonstrations,
with the exceptions of parts 9500.1452, subpart 2, item B; and 9500.1457, subpart 1,
items B and C, which do not apply to persons enrolling in demonstrations under this
section. An initial open enrollment period may be provided. Persons who disenroll from
demonstrations under this subdivision remain subject to Minnesota Rules, parts 9500.1450
to 9500.1464. When a person is enrolled in a health plan under these demonstrations and
the health plan's participation is subsequently terminated for any reason, the person shall
be provided an opportunity to select a new health plan and shall have the right to change
health plans within the first 60 days of enrollment in the second health plan. Persons
required to participate in health plans under this section who fail to make a choice of
health plan shall not be randomly assigned to health plans under these demonstrations.
Notwithstanding section 256L.12, subdivision 5, and Minnesota Rules, part 9505.5220,
subpart 1, item A, if adopted, for the purpose of demonstrations under this subdivision,
the commissioner may contract with managed care organizations, including counties, to
serve only elderly persons eligible for medical assistance, elderly and disabled persons, or
disabled persons only. For persons with a primary diagnosis of developmental disability,
serious and persistent mental illness, or serious emotional disturbance, the commissioner
must ensure that the county authority has approved the demonstration and contracting
design. Enrollment in these projects for persons with disabilities shall be voluntary. The
commissioner shall not implement any demonstration project under this subdivision for
persons with a primary diagnosis of developmental disabilities, serious and persistent
mental illness, or serious emotional disturbance, without approval of the county board of
the county in which the demonstration is being implemented.
(b) Notwithstanding chapter 245B, sections 252.40 to 252.46, 256B.092, 256B.501
to 256B.5015, and Minnesota Rules, parts 9525.0004 to 9525.0036, 9525.1200 to
9525.1330, 9525.1580, and 9525.1800 to 9525.1930, the commissioner may implement
under this section projects for persons with developmental disabilities. The commissioner
may capitate payments for ICF/MR services, waivered services for developmental
disabilities, including case management services, day training and habilitation and
alternative active treatment services, and other services as approved by the state and by
the federal government. Case management and active treatment must be individualized
and developed in accordance with a person-centered plan. Costs under these projects may
not exceed costs that would have been incurred under fee-for-service. Beginning July 1,
2003, and until deleted text begin twodeleted text end new text begin four new text end years after the pilot project implementation date, subcontractor
participation in the long-term care developmental disability pilot is limited to a nonprofit
long-term care system providing ICF/MR services, home and community-based waiver
services, and in-home services to no more than 120 consumers with developmental
disabilities in Carver, Hennepin, and Scott Counties. The commissioner shall report to the
legislature prior to expansion of the developmental disability pilot project. This paragraph
expires deleted text begin twodeleted text end new text begin four new text end years after the implementation date of the pilot project.
(c) Before implementation of a demonstration project for disabled persons, the
commissioner must provide information to appropriate committees of the house of
representatives and senate and must involve representatives of affected disability groups
in the design of the demonstration projects.
(d) A nursing facility reimbursed under the alternative reimbursement methodology
in section 256B.434 may, in collaboration with a hospital, clinic, or other health care entity
provide services under paragraph (a). The commissioner shall amend the state plan and
seek any federal waivers necessary to implement this paragraph.
(e) The commissioner, in consultation with the commissioners of commerce and
health, may approve and implement programs for all-inclusive care for the elderly (PACE)
according to federal laws and regulations governing that program and state laws or rules
applicable to participating providers. The process for approval of these programs shall
begin only after the commissioner receives grant money in an amount sufficient to cover
the state share of the administrative and actuarial costs to implement the programs during
state fiscal years 2006 and 2007. Grant amounts for this purpose shall be deposited in an
account in the special revenue fund and are appropriated to the commissioner to be used
solely for the purpose of PACE administrative and actuarial costs. A PACE provider is
not required to be licensed or certified as a health plan company as defined in section
62Q.01, subdivision 4. Persons age 55 and older who have been screened by the county
and found to be eligible for services under the elderly waiver or community alternatives
for disabled individuals or who are already eligible for Medicaid but meet level of
care criteria for receipt of waiver services may choose to enroll in the PACE program.
Medicare and Medicaid services will be provided according to this subdivision and
federal Medicare and Medicaid requirements governing PACE providers and programs.
PACE enrollees will receive Medicaid home and community-based services through the
PACE provider as an alternative to services for which they would otherwise be eligible
through home and community-based waiver programs and Medicaid State Plan Services.
The commissioner shall establish Medicaid rates for PACE providers that do not exceed
costs that would have been incurred under fee-for-service or other relevant managed care
programs operated by the state.
(f) The commissioner shall seek federal approval to expand the Minnesota disability
health options (MnDHO) program established under this subdivision in stages, first to
regional population centers outside the seven-county metro area and then to all areas
of the state. Until deleted text begin January 1, 2008deleted text end new text begin July 1, 2009new text end , expansion for MnDHO projects that
include home and community-based services is limited to the two projects and service
areas in effect on March 1, 2006. Enrollment in integrated MnDHO programs that
include home and community-based services shall remain voluntary. Costs for home
and community-based services included under MnDHO must not exceed costs that
would have been incurred under the fee-for-service program. In developing program
specifications for expansion of integrated programs, the commissioner shall involve and
consult the state-level stakeholder group established in subdivision 28, paragraph (d),
including consultation on whether and how to include home and community-based waiver
programs. Plans for further expansion of MnDHO projects shall be presented to the chairs
of the house and senate committees with jurisdiction over health and human services
policy and finance by February 1, 2007.
(g) Notwithstanding section 256B.0261, health plans providing services under this
section are responsible for home care targeted case management and relocation targeted
case management. Services must be provided according to the terms of the waivers and
contracts approved by the federal government.
Sec. 61.
new text begin
[256C.261] SERVICES FOR DEAF-BLIND PERSONS.
new text end
new text begin (a) The commissioner of human services shall combine the existing biennial base
level funding for deaf-blind services into a single grant program. At least 35 percent
of the total funding is awarded for services and other supports to deaf-blind children
and their families and at least 25 percent is awarded for services and other supports to
deaf-blind adults.
new text end
new text begin
The commissioner shall award grants for the purposes of:
new text end
new text begin
(1) providing services and supports to individuals who are deaf-blind; and
new text end
new text begin
(2) developing and providing training to counties and the network of senior citizen
service providers. The purpose of the training grants is to teach counties how to use
existing programs that capture federal financial participation to meet the needs of eligible
deaf-blind persons and to build capacity of senior service programs to meet the needs of
seniors with a dual sensory hearing and vision loss.
new text end
new text begin
(b) The commissioner may make grants:
new text end
new text begin
(1) for services and training provided by organizations; and
new text end
new text begin
(2) to develop and administer consumer-directed services.
new text end
new text begin
(c) Any entity that is able to satisfy the grant criteria is eligible to receive a grant
under paragraph (a).
new text end
new text begin
(d) Deaf-blind service providers may, but are not required to, provide intervenor
services as part of the service package provided with grant funds under this section.
new text end
Sec. 62.
Minnesota Statutes 2006, section 256I.04, subdivision 3, is amended to read:
Subd. 3.
Moratorium on the development of group residential housing beds.
(a)
County agencies shall not enter into agreements for new group residential housing beds
with total rates in excess of the MSA equivalent rate except: (1) for group residential
housing establishments licensed under Minnesota Rules, parts 9525.0215 to 9525.0355,
provided the facility is needed to meet the census reduction targets for persons with
developmental disabilities at regional treatment centers; (2) to ensure compliance with
the federal Omnibus Budget Reconciliation Act alternative disposition plan requirements
for inappropriately placed persons with developmental disabilities or mental illness;
(3) up to 80 beds in a single, specialized facility located in Hennepin County that will
provide housing for chronic inebriates who are repetitive users of detoxification centers
and are refused placement in emergency shelters because of their state of intoxication,
and planning for the specialized facility must have been initiated before July 1, 1991, in
anticipation of receiving a grant from the Housing Finance Agency under section 462A.05,
subdivision 20a, paragraph (b); (4) notwithstanding the provisions of subdivision 2a, for
up to 190 supportive housing units in Anoka, Dakota, Hennepin, or Ramsey County
for homeless adults with a mental illness, a history of substance abuse, or human
immunodeficiency virus or acquired immunodeficiency syndrome. For purposes of this
section, "homeless adult" means a person who is living on the street or in a shelter or
discharged from a regional treatment center, community hospital, or residential treatment
program and has no appropriate housing available and lacks the resources and support
necessary to access appropriate housing. At least 70 percent of the supportive housing
units must serve homeless adults with mental illness, substance abuse problems, or human
immunodeficiency virus or acquired immunodeficiency syndrome who are about to be
or, within the previous six months, has been discharged from a regional treatment center,
or a state-contracted psychiatric bed in a community hospital, or a residential mental
health or chemical dependency treatment program. If a person meets the requirements of
subdivision 1, paragraph (a), and receives a federal or state housing subsidy, the group
residential housing rate for that person is limited to the supplementary rate under section
256I.05, subdivision 1a, and is determined by subtracting the amount of the person's
countable income that exceeds the MSA equivalent rate from the group residential housing
supplementary rate. A resident in a demonstration project site who no longer participates
in the demonstration program shall retain eligibility for a group residential housing
payment in an amount determined under section 256I.06, subdivision 8, using the MSA
equivalent rate. Service funding under section 256I.05, subdivision 1a, will end June 30,
1997, if federal matching funds are available and the services can be provided through a
managed care entity. If federal matching funds are not available, then service funding will
continue under section 256I.05, subdivision 1a; deleted text begin or (6)deleted text end new text begin (5)new text end for group residential housing
beds in settings meeting the requirements of subdivision 2a, clauses (1) and (3), which
are used exclusively for recipients receiving home and community-based waiver services
under sections 256B.0915, 256B.092, subdivision 5, 256B.093, and 256B.49, and who
resided in a nursing facility for the six months immediately prior to the month of entry
into the group residential housing setting. The group residential housing rate for these
beds must be set so that the monthly group residential housing payment for an individual
occupying the bed when combined with the nonfederal share of services delivered under
the waiver for that person does not exceed the nonfederal share of the monthly medical
assistance payment made for the person to the nursing facility in which the person resided
prior to entry into the group residential housing establishment. The rate may not exceed
the MSA equivalent rate plus $426.37 for any casedeleted text begin .deleted text end new text begin ; (6) for an additional two beds,
resulting in a total of 32 beds, for a facility located in Hennepin County providing services
for recovering and chemically dependent men that has had a group residential housing
contract with the county and has been licensed as a board and lodge facility with special
services since 1980; (7) for a group residential housing provider located in Stearns County
that operates a 40-bed facility, that received financing through the Minnesota Housing
Finance Agency Ending Long-Term Homelessness Initiative and serves chemically
dependent clientele, providing 24-hour-a-day supervision; (8) for a new 65-bed facility in
Crow Wing County that will serve chemically dependent persons, operated by a group
residential housing provider that currently operates a 304-bed facility in Minneapolis, and
a 44-bed facility in Duluth; (9) for a group residential housing provider that operates two
ten-bed facilities, one located in Hennepin County and one located in Ramsey County,
that provide community support and 24-hour-a-day supervision to serve the mental
health needs of individuals who have chronically lived unsheltered; and (10) for a group
residential facility in Hennepin County with a capacity of up to 48 beds that has been
licensed since 1978 as a board and lodging facility and that until August 1, 2007, operated
as a licensed chemical dependency treatment program.
new text end
(b) A county agency may enter into a group residential housing agreement for beds
with rates in excess of the MSA equivalent rate in addition to those currently covered
under a group residential housing agreement if the additional beds are only a replacement
of beds with rates in excess of the MSA equivalent rate which have been made available
due to closure of a setting, a change of licensure or certification which removes the beds
from group residential housing payment, or as a result of the downsizing of a group
residential housing setting. The transfer of available beds from one county to another can
only occur by the agreement of both counties.
Sec. 63.
Minnesota Statutes 2006, section 256I.05, is amended by adding a subdivision
to read:
new text begin Subd. 1h. new text end
new text begin
Supplementary rate for certain facilities serving chemically
dependent males.
new text end
new text begin
Notwithstanding subdivisions 1a and 1c, beginning July 1, 2007, a
county agency shall negotiate a supplementary rate in addition to the rate specified in
subdivision 1, not to exceed $737.87 per month, including any legislatively authorized
inflationary adjustments, for a group residential housing provider that:
new text end
new text begin
(1) is located in Ramsey County and has had a group residential housing contract
with the county since 1982 and has been licensed as a board and lodge facility with special
services since 1979; and
new text end
new text begin
(2) serves recovering and chemically dependent males, providing 24-hour-a-day
supervision.
new text end
Sec. 64.
Minnesota Statutes 2006, section 256I.05, is amended by adding a subdivision
to read:
new text begin Subd. 1i. new text end
new text begin
Supplementary rate for certain facilities; Hennepin County.
new text end
new text begin
Notwithstanding the provisions of subdivisions 1a and 1c, a county agency shall negotiate
a supplementary rate in addition to the rate specified in subdivision 1, not to exceed $700
per month, including any legislatively authorized inflationary adjustments, up to the
available appropriation, for a facility located in Hennepin County with a capacity of up to
48 beds that has been licensed since 1978 as a board and lodging facility and that until
August 1, 2007, operated as a licensed chemical dependency treatment program.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 65.
Minnesota Statutes 2006, section 256I.05, is amended by adding a subdivision
to read:
new text begin Subd. 1j. new text end
new text begin
Supplementary rate for certain facilities; Crow Wing County.
new text end
new text begin
Notwithstanding the provisions of subdivisions 1a and 1c, beginning July 1, 2007, a
county agency shall negotiate a supplementary rate in addition to the rate specified in
subdivision 1, not to exceed $700 per month, including any legislatively authorized
inflationary adjustments, for a new 65-bed facility in Crow Wing County that will serve
chemically dependent persons operated by a group residential housing provider that
currently operates a 304-bed facility in Minneapolis and a 44-bed facility in Duluth which
opened in January of 2006.
new text end
Sec. 66.
Minnesota Statutes 2006, section 256I.05, is amended by adding a subdivision
to read:
new text begin Subd. 1k. new text end
new text begin
Supplementary rate for certain facilities; Stearns County.
new text end
new text begin
Notwithstanding the provisions of this section, beginning July 1, 2007, a county agency
shall negotiate a supplementary service rate in addition to the rate specified in subdivision
1, not to exceed $700 per month, including any legislatively authorized inflationary
adjustments, for a group residential housing provider located in Stearns County that
operates a 40-bed facility, that received financing through the Minnesota Housing Finance
Agency Ending Long-Term Homelessness Initiative and serves chemically dependent
clientele, providing 24-hour-a-day supervision.
new text end
Sec. 67.
Minnesota Statutes 2006, section 256I.05, is amended by adding a subdivision
to read:
new text begin Subd. 1l. new text end
new text begin
Supplementary rate for certain facilities; St. Louis County.
new text end
new text begin
Notwithstanding the provisions of this section, beginning July 1, 2007, a county agency
shall negotiate a supplementary service rate in addition to the rate specified in subdivision
1, not to exceed $700 per month, including any legislatively authorized inflationary
adjustments, for a group residential housing provider located in St. Louis County that
operates a 30-bed facility, that received financing through the Minnesota Housing Finance
Agency Ending Long-Term Homelessness Initiative and serves chemically dependent
clientele, providing 24-hour-a-day supervision.
new text end
Sec. 68.
Minnesota Statutes 2006, section 256I.05, is amended by adding a subdivision
to read:
new text begin Subd. 1m. new text end
new text begin
Supplemental rate for certain facilities; Hennepin and Ramsey
Counties.
new text end
new text begin
(a) Notwithstanding the provisions of this section, beginning July 1, 2007, a
county agency shall negotiate a supplemental service rate in addition to the rate specified
in subdivision 1, not to exceed $700 per month or the existing monthly rate, whichever
is higher, including any legislatively authorized inflationary adjustments, for a group
residential housing provider that operates two ten-bed facilities, one located in Hennepin
County and one located in Ramsey County, which provide community support and serve
the mental health needs of individuals who have chronically lived unsheltered, providing
24-hour per day supervision.
new text end
new text begin
(b) An individual who has lived in one of the facilities under paragraph (a), who
is being transitioned to independent living as part of the program plan continues to be
eligible for group residential housing and the supplemental service rate negotiated with
the county under paragraph (a).
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2008.
new text end
Sec. 69.
Laws 2006, chapter 282, article 20, section 37, is amended to read:
Sec. 37. REPAYMENT DELAY.
new text begin (a) new text end A county that overspent its allowed amounts in calendar year 2004 or 2005 under
the waivered services program for persons with developmental disabilities shall not be
required to pay back the amount of overspending deleted text begin until May 31, 2007deleted text end .new text begin This section applies
to Fillmore, Steele, and St. Louis Counties.
new text end
new text begin
(b) Carver County is not required to pay back the amount of overspending under
the waivered services program for persons with developmental disabilities for calendar
years 2004 and 2005 until June 30, 2009.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 70. new text begin ASSISTIVE TECHNOLOGY RECOMMENDATIONS.
new text end
new text begin Subdivision 1. new text end
new text begin Review. new text end
new text begin
During the biennium ending June 30, 2009, the Council on
Disability shall facilitate a statewide review of the assistive technology needs of people
with disabling conditions, and seniors. The council shall identify community-based
service providers, state agencies, and other entities involved in providing assistive
technology supports.
new text end
new text begin Subd. 2. new text end
new text begin Recommendations. new text end
new text begin
The council shall present to the chairs of the house
and senate committees having jurisdiction over human services, by January 1, 2009,
recommendations, including proposed legislation creating a statewide comprehensive plan
to meet the assistive technology needs of people with disabling conditions and seniors.
The statewide plan must include steps to coordinate and streamline assistive technology
services.
new text end
Sec. 71. new text begin PROVIDER RATE INCREASES.
new text end
new text begin
(a) The commissioner of human services shall increase allocations, reimbursement
rates, or rate limits, as applicable, by new text begin 2.0new text end percent beginning October 1, 2007, and by 2.0
percent beginning July 1, 2008, effective for services rendered on or after those dates.
County contracts for services specified in this section must be amended to pass through
these rate adjustments within 60 days of the effective date of the increase and must be
retroactive from the effective date of the rate adjustment.
new text end
new text begin
(b) The annual rate increases described in this section must be provided to:
new text end
new text begin
(1) home and community-based waivered services for persons with developmental
disabilities or related conditions, including consumer-directed community supports, under
Minnesota Statutes, section 256B.501;
new text end
new text begin
(2) home and community-based waivered services for the elderly, including
consumer-directed community supports, under Minnesota Statutes, section 256B.0915;
new text end
new text begin
(3) waivered services under community alternatives for disabled individuals,
including consumer-directed community supports, under Minnesota Statutes, section
256B.49;
new text end
new text begin
(4) community alternative care waivered services, including consumer-directed
community supports, under Minnesota Statutes, section 256B.49;
new text end
new text begin
(5) traumatic brain injury waivered services, including consumer-directed
community supports, under Minnesota Statutes, section 256B.49;
new text end
new text begin
(6) nursing services and home health services under Minnesota Statutes, section
256B.0625, subdivision 6a;
new text end
new text begin
(7) personal care services and qualified professional supervision of personal care
services under Minnesota Statutes, section 256B.0625, subdivision 19a;
new text end
new text begin
(8) private duty nursing services under Minnesota Statutes, section 256B.0625,
subdivision 7;
new text end
new text begin
(9) day training and habilitation services for adults with developmental disabilities
or related conditions under Minnesota Statutes, sections 252.40 to 252.46, including the
additional cost of rate adjustments on day training and habilitation services, provided as a
social service under Minnesota Statutes, section 256M.60;
new text end
new text begin
(10) alternative care services under Minnesota Statutes, section 256B.0913;
new text end
new text begin
(11) adult residential program grants under Minnesota Statutes, section 245.73;
new text end
new text begin
(12) children's community-based mental health services grants and adult community
support and case management services grants under Minnesota Rules, parts 9535.1700
to 9535.1760;
new text end
new text begin
(13) the group residential housing supplementary service rate under Minnesota
Statutes, section 256I.05, subdivision 1a;
new text end
new text begin
(14) adult mental health integrated fund grants under Minnesota Statutes, section
245.4661;
new text end
new text begin
(15) semi-independent living services (SILS) under Minnesota Statutes, section
252.275, including SILS funding under county social services grants formerly funded
under Minnesota Statutes, chapter 256I;
new text end
new text begin
(16) community support services for deaf and hard-of-hearing adults with mental
illness who use or wish to use sign language as their primary means of communication
under Minnesota Statutes, section 256.01, subdivision 2; and deaf and hard-of-hearing
grants under Minnesota Statutes, sections 256C.233 and 256C.25; Laws 1985, chapter 9,
article 1; and Laws 1997, First Special Session chapter 5, section 20;
new text end
new text begin
(17) living skills training programs for persons with intractable epilepsy who need
assistance in the transition to independent living under Laws 1988, chapter 689;
new text end
new text begin
(18) physical therapy services under sections 256B.0625, subdivision 8, and
256D.03, subdivision 4;
new text end
new text begin
(19) occupational therapy services under sections 256B.0625, subdivision 8a, and
256D.03, subdivision 4;
new text end
new text begin
(20) speech-language therapy services under section 256D.03, subdivision 4, and
Minnesota Rules, part 9505.0390;
new text end
new text begin
(21) respiratory therapy services under section 256D.03, subdivision 4, and
Minnesota Rules, part 9505.0295;
new text end
new text begin
(22) adult rehabilitative mental health services under section 256B.0623;
new text end
new text begin
(23) children's therapeutic services and support services under section 256B.0943;
new text end
new text begin
(24) tier I chemical health services under Minnesota Statutes, chapter 254B;
new text end
new text begin
(25) consumer support grants under Minnesota Statutes, section 256.476;
new text end
new text begin
(26) family support grants under Minnesota Statutes, section 252.32;
new text end
new text begin
(27) grants for case management services to persons with HIV or AIDS under
Minnesota Statutes, section 256.01, subdivision 19; and
new text end
new text begin
(28) aging grants under Minnesota Statutes, sections 256.975 to 256.977, 256B.0917,
and 256B.0928.
new text end
new text begin
(c) For services funded through Minnesota disability health options, the rate
increases under this section apply to all medical assistance payments, including former
group residential housing supplementary rates under Minnesota Statutes, chapter 256I.
new text end
new text begin
(d) The commissioner may recoup payments made under this section from a provider
that does not comply with paragraphs (f) and (g).
new text end
new text begin
(e) A managed care plan receiving state payments for the services in this section
must include these increases in their payments to providers on a prospective basis,
effective on January 1 following the effective date of the rate increase.
new text end
new text begin
(f) Providers that receive a rate increase under this section shall use 75 percent of
the additional revenue to increase compensation-related costs for employees directly
employed by the program on or after the effective date of the rate adjustments, except:
new text end
new text begin
(1) the administrator;
new text end
new text begin
(2) persons employed in the central office of a corporation or entity that has an
ownership interest in the provider or exercises control over the provider; and
new text end
new text begin
(3) persons paid by the provider under a management contract.
new text end
new text begin
Compensation-related costs include: wages and salaries; FICA taxes, Medicare taxes,
state and federal unemployment taxes, and workers' compensation; and the employer's
share of health and dental insurance, life insurance, disability insurance, long-term care
insurance, uniform allowance, and pensions.
new text end
new text begin
(g) Two-thirds of the money available under paragraph (f) must be used for wage
increases for all employees directly employed by the provider on or after the effective
date of the rate adjustments, except those listed in paragraph (f), clauses (1) to (3). The
wage adjustment that employees receive under this paragraph must be paid as an equal
hourly percentage wage increase for all eligible employees. All wage increases under this
paragraph must be effective on the same date. This paragraph shall not apply to employees
covered by a collective bargaining agreement.
new text end
new text begin
(h) For public employees, the increase for wages and benefits for certain staff is
available and pay rates must be increased only to the extent that they comply with laws
governing public employees collective bargaining. Money received by a provider for pay
increases under this section may be used only for increases implemented on or after the
first day of the rate period in which the increase is available and must not be used for
increases implemented prior to that date.
new text end
new text begin
(i) The commissioner shall amend state grant contracts that include direct
personnel-related grant expenditures to include the allocation for the portion of the contract
that is employee compensation related. Grant contracts for compensation-related services
must be amended to pass through these adjustments within 60 days of the effective date of
the increase and must be retroactive to the effective date of the rate adjustment.
new text end
new text begin
(j) The Board on Aging and its Area Agencies on Aging shall amend their
grants that include direct personnel-related grant expenditures to include the rate
adjustment for the portion of the grant that is employee compensation related. Grants
for compensation-related services must be amended to pass through these adjustments
within 60 days of the effective date of the increase and must be retroactive to the effective
date of the rate adjustment.
new text end
new text begin
(k) The calendar year 2008 rate for vendors reimbursed under Minnesota Statutes,
chapter 254B, shall be at least 2.0 percent above the rate in effect on January 1, 2007. The
calendar year 2009 rate shall be at least 2.0 percent above the rate in effect on January
1, 2008.
new text end
new text begin
(l) Providers that receive a rate adjustment under paragraph (a) that is subject to
paragraphs (f) and (g) shall provide to the commissioner, and those counties with whom
they have a contract, within six months after the effective date of each rate adjustment, a
letter, in a format specified by the commissioner, that provides assurances that the provider
has developed and implemented a compensation plan and complied with paragraphs (f)
and (g). The provider shall keep on file, and produce for the commissioner or county
upon request, its plan, which must specify:
new text end
new text begin
(1) an estimate of the amounts of money that must be used as specified in paragraphs
(f) and (g); and
new text end
new text begin
(2) a detailed distribution plan specifying the allowable compensation-related and
wage increases the provider will implement to use the funds available in clause (1).
new text end
new text begin
(m) Within six months after the effective date of each rate adjustment, the provider
shall post this plan, excluding the information required in paragraph (l), clause (1), for
a period of at least six weeks in an area of the provider's operation to which all eligible
employees have access and provide instructions for employees who believe they have
not received the wage and other compensation-related increases specified in paragraph
(l), clause (2). Instructions must include a mailing address, e-mail address, and the
telephone number that may be used by the employee to contact the commissioner or the
commissioner's representative. Providers shall also make assurances to the commissioner
and counties with whom they have a contract that they have complied with the requirement
in this paragraph.
new text end
Sec. 72. new text begin MINNESOTA RULES.
new text end
new text begin
The Department of Administration shall publish adopted rules in the State Register
making the terminology changes specified in section 75 in Minnesota Rules. Upon
publication in the State Register, the terminology changes for Minnesota Rules are
adopted without further administrative action.
new text end
Sec. 73. new text begin HOUSING WITH SERVICES AND HOME CARE PROVIDERS
STUDY; REPORT.
new text end
new text begin
The commissioner of human services shall conduct a study of how the state of
Minnesota can most effectively assist persons age 65 and older in selecting long-term care
services that meet their needs, reflect their preferences, and enable them to maintain
financial self-sufficiency as long as possible. The study shall include surveys of both
consumers and providers of housing with services, assisted living, and in-home services,
as well as an evaluation of what role the long-term care consultation program under
Minnesota Statutes, section 256B.0911, does or could play in helping consumers to
evaluate their options. Upon request of the commissioner, providers covered by the
study shall provide data that the commissioner determines is reasonably necessary to
achieve study outcomes. The preliminary results of this study shall be reported to the
senate and house of representatives committees with jurisdiction over health and human
services policy and finance issues by February 15, 2008, with a final report completed
by December 15, 2008.
new text end
Sec. 74. new text begin PROVIDER RATE INCREASE.
new text end
new text begin
Effective July 1, 2007, a day training and habilitation provider in St. Louis County
providing services for up to 80 individuals shall have a reimbursement rate that equals 94
percent of 125 percent of the statewide median per diem.
new text end
Sec. 75. new text begin REVISOR'S INSTRUCTION.
new text end
new text begin
The revisor of statutes shall change the terms in column A to the terms in column B
wherever they appear in Minnesota Statutes:
new text end
|
new text begin
Column A new text end |
new text begin
Column B new text end |
||
|
new text begin
"Office of Ombudsman for Older Minnesotans" and "Office of the Ombudsman for Older Minnesotans" new text end |
new text begin
"Office of Ombudsman for Long-Term Care" new text end |
||
|
new text begin
"ombudsman for older Minnesotans" new text end |
new text begin
"ombudsman for long-term care" new text end |
Sec. 76. new text begin REPEALER.
new text end
new text begin
Minnesota Statutes 2006, sections 252.21; 252.22; 252.23; 252.24; 252.25; 252.261;
252.275, subdivision 5; 256.9743; 256B.0913, subdivisions 5b, 5c, 5d, 5e, 5f, 5g, and 5h;
and 256B.441, subdivisions 12, 16, 21, 26, 28, 42, and 45,
new text end
new text begin
are repealed.
new text end
ARTICLE 8
MENTAL HEALTH
Section 1.
new text begin
[16C.155] JANITORIAL CONTRACTS FOR REHABILITATION
PROGRAMS AND EXTENDED EMPLOYMENT PROVIDERS.
new text end
new text begin
The commissioner of administration shall ensure that a portion of all janitorial
services contracts be awarded by the state to rehabilitation programs and extended
employment providers listed under section 16C.15. The total value of the contracts under
this section must exceed 19 percent of the total value of janitorial services contracts
entered into in the previous fiscal year. The amount of each contract awarded under this
section may exceed the estimated fair market price for the same goods and services by
up to five percent.
new text end
Sec. 2.
Minnesota Statutes 2006, section 148C.11, subdivision 1, is amended to read:
Subdivision 1.
Other professionals.
(a) Nothing in this chapter prevents members
of other professions or occupations from performing functions for which they are qualified
or licensed. This exception includes, but is not limited to: licensed physicians; registered
nurses; licensed practical nurses; licensed psychological practitioners; members of
the clergy; American Indian medicine men and women; licensed attorneys; probation
officers; licensed marriage and family therapists; licensed social workers; social workers
employed by city, county, or state agencies; licensed professional counselors; licensed
school counselors; registered occupational therapists or occupational therapy assistants;
city, county, or state employees when providing assessments or case management under
Minnesota Rules, chapter 9530; and until July 1, deleted text begin 2007deleted text end new text begin 2009new text end , individuals providing
integrated dual-diagnosis treatment in adult mental health rehabilitative programs certified
by the Department of Human Services under section 256B.0622 or 256B.0623.
(b) Nothing in this chapter prohibits technicians and resident managers in programs
licensed by the Department of Human Services from discharging their duties as provided
in Minnesota Rules, chapter 9530.
(c) Any person who is exempt under this subdivision but who elects to obtain a
license under this chapter is subject to this chapter to the same extent as other licensees.
The board shall issue a license without examination to an applicant who is licensed or
registered in a profession identified in paragraph (a) if the applicant:
(1) shows evidence of current licensure or registration; and
(2) has submitted to the board a plan for supervision during the first 2,000 hours of
professional practice or has submitted proof of supervised professional practice that is
acceptable to the board.
(d) Any person who is exempt from licensure under this section must not use a
title incorporating the words "alcohol and drug counselor" or "licensed alcohol and drug
counselor" or otherwise hold themselves out to the public by any title or description
stating or implying that they are engaged in the practice of alcohol and drug counseling,
or that they are licensed to engage in the practice of alcohol and drug counseling unless
that person is also licensed as an alcohol and drug counselor. Persons engaged in the
practice of alcohol and drug counseling are not exempt from the board's jurisdiction
solely by the use of one of the above titles.
Sec. 3.
Minnesota Statutes 2006, section 245.462, subdivision 20, is amended to read:
Subd. 20.
Mental illness.
(a) "Mental illness" means an organic disorder of the
brain or a clinically significant disorder of thought, mood, perception, orientation,
memory, or behavior that is listed in the clinical manual of the International Classification
of Diseases (ICD-9-CM), current edition, code range 290.0 to 302.99 or 306.0 to 316.0
or the corresponding code in the American Psychiatric Association's Diagnostic and
Statistical Manual of Mental Disorders (DSM-MD), current edition, Axes I, II, or III, and
that seriously limits a person's capacity to function in primary aspects of daily living such
as personal relations, living arrangements, work, and recreation.
(b) An "adult with acute mental illness" means an adult who has a mental illness that
is serious enough to require prompt intervention.
(c) For purposes of case management and community support services, a "person
with serious and persistent mental illness" means an adult who has a mental illness and
meets at least one of the following criteria:
(1) the adult has undergone two or more episodes of inpatient care for a mental
illness within the preceding 24 months;
(2) the adult has experienced a continuous psychiatric hospitalization or residential
treatment exceeding six months' duration within the preceding 12 months;
(3) new text begin the adult has been treated by a crisis team two or more times within the preceding
24 months;
new text end
new text begin (4) new text end the adult:
(i) has a diagnosis of schizophrenia, bipolar disorder, major depression, or borderline
personality disorder;
(ii) indicates a significant impairment in functioning; and
(iii) has a written opinion from a mental health professional, in the last three years,
stating that the adult is reasonably likely to have future episodes requiring inpatient or
residential treatment, of a frequency described in clause (1) or (2), unless ongoing case
management or community support services are provided;
deleted text begin (4)deleted text end new text begin (5)new text end the adult has, in the last three years, been committed by a court as a person
who is mentally ill under chapter 253B, or the adult's commitment has been stayed or
continued; or
deleted text begin (5)deleted text end new text begin (6)new text end the adult (i) was eligible under clauses (1) to deleted text begin (4)deleted text end new text begin (5)new text end , but the specified time
period has expired or the adult was eligible as a child under section 245.4871, subdivision
6; and (ii) has a written opinion from a mental health professional, in the last three years,
stating that the adult is reasonably likely to have future episodes requiring inpatient or
residential treatment, of a frequency described in clause (1) or (2), unless ongoing case
management or community support services are provided.
Sec. 4.
Minnesota Statutes 2006, section 245.465, is amended by adding a subdivision
to read:
new text begin Subd. 3. new text end
new text begin Responsibility not duplicated. new text end
new text begin
For individuals who have health care
coverage, the county board is not responsible for providing mental health services which
are within the limits of the individual's health care coverage.
new text end
Sec. 5.
new text begin
[245.4682] MENTAL HEALTH SERVICE DELIVERY AND FINANCE
REFORM.
new text end
new text begin Subdivision 1. new text end
new text begin Policy. new text end
new text begin
The commissioner of human services shall undertake a series
of reforms to address the underlying structural, financial, and organizational problems in
Minnesota's mental health system with the goal of improving the availability, quality, and
accountability of mental health care within the state.
new text end
new text begin Subd. 2. new text end
new text begin General provisions. new text end
new text begin
(a) In the design and implementation of reforms to
the mental health system, the commissioner shall:
new text end
new text begin
(1) consult with consumers, families, counties, tribes, advocates, providers, and
other stakeholders;
new text end
new text begin
(2) bring to the legislature, and the State Advisory Council on Mental Health, by
January 15, 2008, recommendations for legislation to update the role of counties and to
clarify the case management roles, functions, and decision-making authority of health
plans and counties, and to clarify county retention of the responsibility for the delivery of
social services as required under subdivision 3, paragraph (a);
new text end
new text begin
(3) withhold implementation of any recommended changes in case management
roles, functions, and decision-making authority until after the release of the report due
January 15, 2008;
new text end
new text begin
(4) ensure continuity of care for persons affected by these reforms including
ensuring client choice of provider by requiring broad provider networks and developing
mechanisms to facilitate a smooth transition of service responsibilities;
new text end
new text begin
(5) provide accountability for the efficient and effective use of public and private
resources in achieving positive outcomes for consumers;
new text end
new text begin
(6) ensure client access to applicable protections and appeals; and
new text end
new text begin
(7) make budget transfers necessary to implement the reallocation of services and
client responsibilities between counties and health care programs that do not increase the
state and county costs and efficiently allocate state funds.
new text end
new text begin
(b) When making transfers under paragraph (a) necessary to implement movement
of responsibility for clients and services between counties and health care programs,
the commissioner, in consultation with counties, shall ensure that any transfer of state
grants to health care programs, including the value of case management transfer grants
under section 256B.0625, subdivision 20, does not exceed the value of the services being
transferred for the latest 12-month period for which data is available. The commissioner
may make quarterly adjustments based on the availability of additional data during the
first four quarters after the transfers first occur. If case management transfer grants under
section 256B.0625, subdivision 20, are repealed and the value, based on the last year prior
to repeal, exceeds the value of the services being transferred, the difference becomes an
ongoing part of each county's adult and children's mental health grants under sections
245.4661, 245.4889, and 256E.12.
new text end
new text begin
(c) This appropriation is not authorized to be expended after December 31, 2010,
unless approved by the legislature.
new text end
new text begin Subd. 3. new text end
new text begin Projects for coordination of care. new text end
new text begin
(a) Consistent with section 256B.69
and chapters 256D and 256L, the commissioner is authorized to solicit, approve, and
implement up to three projects to demonstrate the integration of physical and mental
health services within prepaid health plans and their coordination with social services.
The commissioner shall require that each project be based on locally defined partnerships
that include at least one health maintenance organization, community integrated service
network, or accountable provider network authorized and operating under chapter 62D,
62N, or 62T, or county-based purchasing entity under section 256B.692 that is eligible to
contract with the commissioner as a prepaid health plan, and the county or counties within
the service area. Counties shall retain responsibility and authority for social services in
these locally defined partnerships.
new text end
new text begin
(b) The commissioner, in consultation with consumers, families, and their
representatives, shall:
new text end
new text begin
(1) determine criteria for approving the projects and use those criteria to solicit
proposals for preferred integrated networks. The commissioner must develop criteria to
evaluate the partnership proposed by the county and prepaid health plan to coordinate
access and delivery of services. The proposal must at a minimum address how the
partnership will coordinate the provision of:
new text end
new text begin
(i) client outreach and identification of health and social service needs paired with
expedited access to appropriate resources;
new text end
new text begin
(ii) activities to maintain continuity of health care coverage;
new text end
new text begin
(iii) children's residential mental health treatment and treatment foster care;
new text end
new text begin
(iv) court-ordered assessments and treatments;
new text end
new text begin
(v) prepetition screening and commitments under chapter 253B;
new text end
new text begin
(vi) assessment and treatment of children identified through mental health screening
of child welfare and juvenile corrections cases;
new text end
new text begin
(vii) home and community-based waiver services;
new text end
new text begin
(viii) assistance with finding and maintaining employment;
new text end
new text begin
(ix) housing; and
new text end
new text begin
(x) transportation;
new text end
new text begin
(2) determine specifications for contracts with prepaid health plans to improve the
plan's ability to serve persons with mental health conditions, including specifications
addressing:
new text end
new text begin
(i) early identification and intervention of physical and behavioral health problems;
new text end
new text begin
(ii) communication between the enrollee and the health plan;
new text end
new text begin
(iii) facilitation of enrollment for persons who are also eligible for a Medicare
special needs plan offered by the health plan;
new text end
new text begin
(iv) risk screening procedures;
new text end
new text begin
(v) health care coordination;
new text end
new text begin
(vi) member services and access to applicable protections and appeal processes;
new text end
new text begin
(vii) specialty provider networks;
new text end
new text begin
(viii) transportation services;
new text end
new text begin
(ix) treatment planning; and
new text end
new text begin
(x) administrative simplification for providers;
new text end
new text begin
(3) begin implementation of the projects no earlier than January 1, 2009, with not
more than 40 percent of the statewide population included during calendar year 2009 and
additional counties included in subsequent years;
new text end
new text begin
(4) waive any administrative rule not consistent with the implementation of the
projects;
new text end
new text begin
(5) allow potential bidders at least 90 days to respond to the request for proposals;
and
new text end
new text begin
(6) conduct an independent evaluation to determine if mental health outcomes have
improved in that county or counties according to measurable standards designed in
consultation with the advisory body established under this subdivision and reviewed by
the State Advisory Council on Mental Health.
new text end
new text begin
(c) Notwithstanding any statute or administrative rule to the contrary, the
commissioner may enroll all persons eligible for medical assistance with serious mental
illness or emotional disturbance in the prepaid plan of their choice within the project
service area unless:
new text end
new text begin
(1) the individual is eligible for home and community-based services for persons
with developmental disabilities and related conditions under section 256B.092; or
new text end
new text begin
(2) the individual has a basis for exclusion from the prepaid plan under section
256B.69, subdivision 4, other than disability, mental illness, or emotional disturbance.
new text end
new text begin
(d) The commissioner shall involve organizations representing persons with mental
illness and their families in the development and distribution of information used to
educate potential enrollees regarding their options for health care and mental health
service delivery under this subdivision.
new text end
new text begin
(e) If the person described in paragraph (c) does not elect to remain in fee-for-service
medical assistance, or declines to choose a plan, the commissioner may preferentially
assign that person to the prepaid plan participating in the preferred integrated network.
The commissioner shall implement the enrollment changes within a project's service area
on the timeline specified in that project's approved application.
new text end
new text begin
(f) A person enrolled in a prepaid health plan under paragraphs (c) and (d) may
disenroll from the plan at any time.
new text end
new text begin
(g) The commissioner, in consultation with consumers, families, and their
representatives, shall evaluate the projects begun in 2009, and shall refine the design of the
service integration projects before expanding the projects. The commissioner shall report
to the chairs of the legislative committees with jurisdiction over mental health services
by March 1, 2008, on plans for evaluation of preferred integrated networks established
under this subdivision.
new text end
new text begin
(h) The commissioner shall apply for any federal waivers necessary to implement
these changes.
new text end
new text begin
(i) Payment for Medicaid service providers under this subdivision for the months of
May and June will be made no earlier than July 1 of the same calendar year.
new text end
Sec. 6.
Minnesota Statutes 2006, section 245.4712, subdivision 1, is amended to read:
Subdivision 1.
Availability of community support services.
new text begin (a) new text end County boards
must provide or contract for sufficient community support services within the county to
meet the needs of adults with serious and persistent mental illness who are residents of the
county. Adults may be required to pay a fee according to section 245.481. The community
support services program must be designed to improve the ability of adults with serious
and persistent mental illness to:
(1) work in a regular or supported work environment;
(2) handle basic activities of daily living;
(3) participate in leisure time activities;
(4) set goals and plans; and
(5) obtain and maintain appropriate living arrangements.
The community support services program must also be designed to reduce the
need for and use of more intensive, costly, or restrictive placements both in number of
admissions and length of stay.
new text begin
(b) Community support services are those services that are supportive in nature and
not necessarily treatment oriented, and include:
new text end
new text begin
(1) conducting outreach activities such as home visits, health and wellness checks,
and problem solving;
new text end
new text begin
(2) connecting people to resources to meet their basic needs;
new text end
new text begin
(3) finding, securing, and supporting people in their housing;
new text end
new text begin
(4) attaining and maintaining health insurance benefits;
new text end
new text begin
(5) assisting with job applications, finding and maintaining employment, and
securing a stable financial situation;
new text end
new text begin
(6) fostering social support, including support groups, mentoring, peer support, and
other efforts to prevent isolation and promote recovery; and
new text end
new text begin
(7) educating about mental illness, treatment, and recovery.
new text end
new text begin
(c) Community support services shall use all available funding streams. The county
shall maintain the level of expenditures for this program, as required under section
245.4835. County boards must continue to provide funds for those services not covered
by other funding streams and to maintain an infrastructure to carry out these services.
new text end
new text begin
(d) The commissioner shall collect data on community support services programs,
including, but not limited to, demographic information such as age, sex, race, the number
of people served, and information related to housing, employment, hospitalization,
symptoms, and satisfaction with services.
new text end
Sec. 7.
Minnesota Statutes 2006, section 245.4874, is amended to read:
245.4874 DUTIES OF COUNTY BOARD.
new text begin Subdivision 1. new text end
new text begin Duties of the county board. new text end
(a) The county board must:
(1) develop a system of affordable and locally available children's mental health
services according to sections 245.487 to 245.4887;
(2) establish a mechanism providing for interagency coordination as specified in
section 245.4875, subdivision 6;
(3) consider the assessment of unmet needs in the county as reported by the local
children's mental health advisory council under section 245.4875, subdivision 5, paragraph
(b), clause (3). The county shall provide, upon request of the local children's mental health
advisory council, readily available data to assist in the determination of unmet needs;
(4) assure that parents and providers in the county receive information about how to
gain access to services provided according to sections 245.487 to 245.4887;
(5) coordinate the delivery of children's mental health services with services
provided by social services, education, corrections, health, and vocational agencies to
improve the availability of mental health services to children and the cost-effectiveness of
their delivery;
(6) assure that mental health services delivered according to sections 245.487
to 245.4887 are delivered expeditiously and are appropriate to the child's diagnostic
assessment and individual treatment plan;
(7) provide the community with information about predictors and symptoms of
emotional disturbances and how to access children's mental health services according to
sections 245.4877 and 245.4878;
(8) provide for case management services to each child with severe emotional
disturbance according to sections 245.486; 245.4871, subdivisions 3 and 4; and 245.4881,
subdivisions 1, 3, and 5;
(9) provide for screening of each child under section 245.4885 upon admission
to a residential treatment facility, acute care hospital inpatient treatment, or informal
admission to a regional treatment center;
(10) prudently administer grants and purchase-of-service contracts that the county
board determines are necessary to fulfill its responsibilities under sections 245.487 to
245.4887;
(11) assure that mental health professionals, mental health practitioners, and case
managers employed by or under contract to the county to provide mental health services
are qualified under section 245.4871;
(12) assure that children's mental health services are coordinated with adult mental
health services specified in sections 245.461 to 245.486 so that a continuum of mental
health services is available to serve persons with mental illness, regardless of the person's
age;
(13) assure that culturally deleted text begin informeddeleted text end new text begin competentnew text end mental health consultants are used as
necessary to assist the county board in assessing and providing appropriate treatment for
children of cultural or racial minority heritage; and
(14) consistent with section 245.486, arrange for or provide a children's mental
health screening to a child receiving child protective services or a child in out-of-home
placement, a child for whom parental rights have been terminated, a child found to be
delinquent, and a child found to have committed a juvenile petty offense for the third or
subsequent time, unless a screening has been performed within the previous 180 days, or
the child is currently under the care of a mental health professional. The court or county
agency must notify a parent or guardian whose parental rights have not been terminated of
the potential mental health screening and the option to prevent the screening by notifying
the court or county agency in writing. The screening shall be conducted with a screening
instrument approved by the commissioner of human services according to criteria that
are updated and issued annually to ensure that approved screening instruments are valid
and useful for child welfare and juvenile justice populations, and shall be conducted
by a mental health practitioner as defined in section 245.4871, subdivision 26, or a
probation officer or local social services agency staff person who is trained in the use of
the screening instrument. Training in the use of the instrument shall include training in the
administration of the instrument, the interpretation of its validity given the child's current
circumstances, the state and federal data practices laws and confidentiality standards, the
parental consent requirement, and providing respect for families and cultural values.
If the screen indicates a need for assessment, the child's family, or if the family lacks
mental health insurance, the local social services agency, in consultation with the child's
family, shall have conducted a diagnostic assessment, including a functional assessment,
as defined in section 245.4871. The administration of the screening shall safeguard the
privacy of children receiving the screening and their families and shall comply with the
Minnesota Government Data Practices Act, chapter 13, and the federal Health Insurance
Portability and Accountability Act of 1996, Public Law 104-191. Screening results shall be
considered private data and the commissioner shall not collect individual screening results.
(b) When the county board refers clients to providers of children's therapeutic
services and supports under section 256B.0943, the county board must clearly identify
the desired services components not covered under section 256B.0943 and identify the
reimbursement source for those requested services, the method of payment, and the
payment rate to the provider.
new text begin Subd. 2. new text end
new text begin Responsibility not duplicated. new text end
new text begin
For individuals who have health care
coverage, the county board is not responsible for providing mental health services which
are within the limits of the individual's health care coverage.
new text end
Sec. 8.
new text begin
[245.4889] CHILDREN'S MENTAL HEALTH GRANTS.
new text end
new text begin Subdivision 1. new text end
new text begin Establishment and authority. new text end
new text begin
(a) The commissioner is authorized
to make grants from available appropriations to assist:
new text end
new text begin
(1) counties;
new text end
new text begin
(2) Indian tribes;
new text end
new text begin
(3) children's collaboratives under section 124D.23 or 245.493; or
new text end
new text begin
(4) mental health service providers
new text end
new text begin
for providing services to children with emotional disturbances as defined in section
245.4871, subdivision 15, and their families. The commissioner may also authorize
grants to young adults meeting the criteria for transition services in section 245.4875,
subdivision 8, and their families.
new text end
new text begin
(b) Services under paragraph (a) must be designed to help each child to function and
remain with the child's family in the community and delivered consistent with the child's
treatment plan. Transition services to eligible young adults under paragraph (a) must be
designed to foster independent living in the community.
new text end
new text begin Subd. 2. new text end
new text begin Grant application and reporting requirements. new text end
new text begin
To apply for a grant,
an applicant organization shall submit an application and budget for the use of the
money in the form specified by the commissioner. The commissioner shall make grants
only to entities whose applications and budgets are approved by the commissioner. In
awarding grants, the commissioner shall give priority to applications that indicate plans
to collaborate in the development, funding, and delivery of services with other agencies
in the local system of care. The commissioner shall specify requirements for reports,
including quarterly fiscal reports under section 256.01, subdivision 2, paragraph (q). The
commissioner shall require collection of data and periodic reports that the commissioner
deems necessary to demonstrate the effectiveness of each service.
new text end
Sec. 9.
Minnesota Statutes 2006, section 245.50, subdivision 5, is amended to read:
Subd. 5.
Special contracts; bordering states.
(a) An individual who is detained,
committed, or placed on an involuntary basis under chapter 253B may be confined or
treated in a bordering state pursuant to a contract under this section. An individual who is
detained, committed, or placed on an involuntary basis under the civil law of a bordering
state may be confined or treated in Minnesota pursuant to a contract under this section. A
peace or health officer who is acting under the authority of the sending state may transport
an individual to a receiving agency that provides services pursuant to a contract under
this section and may transport the individual back to the sending state under the laws
of the sending state. Court orders valid under the law of the sending state are granted
recognition and reciprocity in the receiving state for individuals covered by a contract
under this section to the extent that the court orders relate to confinement for treatment
or care of mental illness or chemical dependency. Such treatment or care may address
other conditions that may be co-occurring with the mental illness or chemical dependency.
These court orders are not subject to legal challenge in the courts of the receiving state.
Individuals who are detained, committed, or placed under the law of a sending state and
who are transferred to a receiving state under this section continue to be in the legal
custody of the authority responsible for them under the law of the sending state. Except
in emergencies, those individuals may not be transferred, removed, or furloughed from
a receiving agency without the specific approval of the authority responsible for them
under the law of the sending state.
(b) While in the receiving state pursuant to a contract under this section, an
individual shall be subject to the sending state's laws and rules relating to length of
confinement, reexaminations, and extensions of confinement. No individual may be sent
to another state pursuant to a contract under this section until the receiving state has
enacted a law recognizing the validity and applicability of this section.
(c) If an individual receiving services pursuant to a contract under this section leaves
the receiving agency without permission and the individual is subject to involuntary
confinement under the law of the sending state, the receiving agency shall use all
reasonable means to return the individual to the receiving agency. The receiving agency
shall immediately report the absence to the sending agency. The receiving state has the
primary responsibility for, and the authority to direct, the return of these individuals
within its borders and is liable for the cost of the action to the extent that it would be
liable for costs of its own resident.
(d) Responsibility for payment for the cost of care remains with the sending agency.
(e) This subdivision also applies to county contracts under subdivision 2 which
include emergency care and treatment provided to a county resident in a bordering state.
new text begin
(f) If a Minnesota resident is admitted to a facility in a bordering state under this
chapter, a physician, licensed psychologist who has a doctoral degree in psychology, or
an advance practice registered nurse certified in mental health, who is licensed in the
bordering state, may act as an examiner under sections 253B.07, 253B.08, 253B.092,
253B.12, and 253B.17 subject to the same requirements and limitations in section
253B.02, subdivision 7.
new text end
Sec. 10.
Minnesota Statutes 2006, section 245.98, subdivision 2, is amended to read:
Subd. 2.
Program.
The commissioner of human services shall establish a program
for the treatment of compulsive gamblers. The commissioner may contract with an
entity with expertise regarding the treatment of compulsive gambling to operate the
program. The program may include the establishment of a statewide toll-free number,
resource library, public education programs; regional in-service training programs and
conferences for health care professionals, educators, treatment providers, employee
assistance programs, and criminal justice representatives; and the establishment of
certification standards for programs and service providers. The commissioner may enter
into agreements with other entities and may employ or contract with consultants to
facilitate the provision of these services or the training of individuals to qualify them to
provide these services. The program may also include inpatient and outpatient treatment
and rehabilitation services deleted text begin anddeleted text end new text begin for residents in different settings, including a temporary or
permanent residential setting for mental health or chemical dependency, and individuals
in jails or correctional facilities. The program may also includenew text end research studies. The
research studies must include baseline and prevalence studies for adolescents and adults to
identify those at the highest risk. The program must be approved by the commissioner
before it is established.
Sec. 11.
new text begin
[245A.175] MENTAL HEALTH TRAINING REQUIREMENT.
new text end
new text begin
Prior to a nonemergency placement of a child in a foster care home, the child
foster care provider, licensed after July 1, 2007, must complete two hours of training
that addresses the causes, symptoms, and key warning signs of mental health disorders;
cultural considerations; and effective approaches for dealing with a child's behaviors. At
least one hour of the annual 12-hour training requirement for foster parents must be on
children's mental health issues and treatment. Training curriculum shall be approved
by the commissioner of human services.
new text end
Sec. 12.
Minnesota Statutes 2006, section 246.54, subdivision 1, is amended to read:
Subdivision 1.
County portion for cost of care.
new text begin (a)new text end Except for chemical
dependency services provided under sections 254B.01 to 254B.09, the client's county
shall pay to the state of Minnesota a portion of the cost of care provided in a regional
treatment center or a state nursing facility to a client legally settled in that county. A
county's payment shall be made from the county's own sources of revenue and payments
shall deleted text begin be paid as follows: payments to the state from the county shalldeleted text end equal deleted text begin 20 percentdeleted text end new text begin a
percentage new text end of the cost of care, as determined by the commissioner, for each day, or the
portion thereof, that the client spends at a regional treatment center or a state nursing
facilitydeleted text begin .deleted text end new text begin according to the following schedule:
new text end
new text begin
(1) zero percent for the first 30 days;
new text end
new text begin
(2) 20 percent for days 31 to 60; and
new text end
new text begin
(3) 50 percent for any days over 60.
new text end
new text begin
(b) The increase in the county portion for cost of care under paragraph (a), clause
(3), shall be imposed when the treatment facility has determined that it is clinically
appropriate for the client to be discharged.
new text end
new text begin (c)new text end If payments received by the state under sections 246.50 to 246.53 exceed 80
percent of the cost of carenew text begin for days 31 to 60, or 50 percent for days over 60new text end , the county
shall be responsible for paying the state only the remaining amount. The county shall
not be entitled to reimbursement from the client, the client's estate, or from the client's
relatives, except as provided in section 246.53. deleted text begin No such payments shall be made for any
client who was last committed prior to July 1, 1947.deleted text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2008.
new text end
Sec. 13.
Minnesota Statutes 2006, section 246.54, subdivision 2, is amended to read:
Subd. 2.
Exceptions.
new text begin (a) new text end Subdivision 1 does not apply to services provided at the
Minnesota Security Hospital, the Minnesota sex offender program, or the Minnesota
extended treatment options program. For services at these facilities, a county's payment
shall be made from the county's own sources of revenue and payments shall be paid as
follows: payments to the state from the county shall equal ten percent of the cost of care,
as determined by the commissioner, for each day, or the portion thereof, that the client
spends at the facility. If payments received by the state under sections 246.50 to 246.53
exceed 90 percent of the cost of care, the county shall be responsible for paying the state
only the remaining amount. The county shall not be entitled to reimbursement from the
client, the client's estate, or from the client's relatives, except as provided in section 246.53.
new text begin
(b) Regardless of the facility to which the client is committed, subdivision 1 does not
apply to the following individuals:
new text end
new text begin
(1) clients who are committed as mentally ill and dangerous under section 253B.02,
subdivision 17;
new text end
new text begin
(2) clients who are committed as sexual psychopathic personalities under section
253B.02, subdivision 18b; and
new text end
new text begin
(3) clients who are committed as sexually dangerous persons under section 253B.02,
subdivision 18c.
new text end
new text begin
For each of the individuals in clauses (1) to (3), the payment by the county to the state
shall equal ten percent of the cost of care for each day as determined by the commissioner.
new text end
Sec. 14.
Minnesota Statutes 2006, section 253B.185, is amended by adding a
subdivision to read:
new text begin Subd. 8. new text end
new text begin Petition and report required. new text end
new text begin
(a) Within 120 days of receipt of a
preliminary determination from a court under section 609.1351, or a referral from the
commissioner of corrections pursuant to section 244.05, subdivision 7, a county attorney
shall determine whether good cause under this section exists to file a petition, and if good
cause exists, the county attorney or designee shall file the petition with the court.
new text end
new text begin
(b) Failure to meet the requirements of paragraph (a) does not bar filing a petition
under subdivision 1 any time the county attorney determines pursuant to subdivision 1
that good cause for such a petition exists.
new text end
new text begin
(c) By February 1 of each year, the commissioner of human services shall annually
report to the respective chairs of the divisions or committees of the senate and house
of representatives that oversee human services finance regarding compliance with this
subdivision.
new text end
Sec. 15.
new text begin
[254A.25] DUTIES OF COMMISSIONER RELATED TO CHEMICAL
HEALTH.
new text end
new text begin
The commissioner shall develop a directory that identifies key characteristics of
each licensed chemical dependency treatment program.
new text end
Sec. 16.
new text begin
[256B.0615] MENTAL HEALTH CERTIFIED PEER SPECIALIST.
new text end
new text begin Subdivision 1. new text end
new text begin Scope. new text end
new text begin
Medical assistance covers mental health certified peers
specialists services, as established in subdivision 2, subject to federal approval, if provided
to recipients who are eligible for services under sections 256B.0622 and 256B.0623,
and are provided by a certified peer specialist who has completed the training under
subdivision 5.
new text end
new text begin Subd. 2. new text end
new text begin Establishment. new text end
new text begin
The commissioner of human services shall establish a
certified peer specialists program model, which:
new text end
new text begin
(1) provides nonclinical peer support counseling by certified peer specialists;
new text end
new text begin
(2) provides a part of a wraparound continuum of services in conjunction with
other community mental health services;
new text end
new text begin
(3) is individualized to the consumer; and
new text end
new text begin
(4) promotes socialization, recovery, self-sufficiency, self-advocacy, development of
natural supports, and maintenance of skills learned in other support services.
new text end
new text begin Subd. 3. new text end
new text begin Eligibility. new text end
new text begin
Peer support services may be made available to consumers
of the intensive rehabilitative mental health services under section 256B.0622 and adult
rehabilitative mental health services under section 256B.0623.
new text end
new text begin Subd. 4. new text end
new text begin Peer support specialist program providers. new text end
new text begin
The commissioner shall
develop a process to certify peer support specialist programs, in accordance with the
federal guidelines, in order for the program to bill for reimbursable services. Peer support
programs may be freestanding or within existing mental health community provider
centers.
new text end
new text begin Subd. 5. new text end
new text begin Certified peer specialist training and certification. new text end
new text begin
The commissioner
of human services shall develop a training and certification process for certified peer
specialists, who must be at least 21 years of age and have a high school diploma or its
equivalent. The candidates must have had a primary diagnosis of mental illness, be a
current or former consumer of mental health services, and must demonstrate leadership
and advocacy skills and a strong dedication to recovery. The training curriculum must
teach participating consumers specific skills relevant to providing peer support to other
consumers. In addition to initial training and certification, the commissioner shall develop
ongoing continuing educational workshops on pertinent issues related to peer support
counseling.
new text end
Sec. 17.
Minnesota Statutes 2006, section 256B.0622, subdivision 2, is amended to
read:
Subd. 2.
Definitions.
For purposes of this section, the following terms have the
meanings given them.
(a) "Intensive nonresidential rehabilitative mental health services" means adult
rehabilitative mental health services as defined in section 256B.0623, subdivision 2,
paragraph (a), except that these services are provided by a multidisciplinary staff using
a total team approach consistent with assertive community treatment, the Fairweather
Lodge treatment model, as defined by the standards established by the National Coalition
for Community Living, and other evidence-based practices, and directed to recipients with
a serious mental illness who require intensive services.
(b) "Intensive residential rehabilitative mental health services" means short-term,
time-limited services provided in a residential setting to recipients who are in need of
more restrictive settings and are at risk of significant functional deterioration if they do
not receive these services. Services are designed to develop and enhance psychiatric
stability, personal and emotional adjustment, self-sufficiency, and skills to live in a more
independent setting. Services must be directed toward a targeted discharge date with
specified client outcomes and must be consistent with the Fairweather Lodge treatment
model as defined in paragraph (a), and other evidence-based practices.
(c) "Evidence-based practices" are nationally recognized mental health services that
are proven by substantial research to be effective in helping individuals with serious
mental illness obtain specific treatment goals.
(d) "Overnight staff" means a member of the intensive residential rehabilitative
mental health treatment team who is responsible during hours when recipients are
typically asleep.
(e) "Treatment team" means all staff who provide services under this section
to recipients. At a minimum, this includes the clinical supervisor, mental health
professionalsdeleted text begin ,deleted text end new text begin as defined in section 245.462, subdivision 18, clauses (1) to (5);new text end mental
health practitionersdeleted text begin , anddeleted text end new text begin as defined in section 245.462, subdivision 17;new text end mental health
rehabilitation workersnew text begin under section 256B.0623, subdivision 5, clause (3); and certified
peer specialists under section 256B.0615new text end .
Sec. 18.
Minnesota Statutes 2006, section 256B.0623, subdivision 5, is amended to
read:
Subd. 5.
Qualifications of provider staff.
Adult rehabilitative mental health
services must be provided by qualified individual provider staff of a certified provider
entity. Individual provider staff must be qualified under one of the following criteria:
(1) a mental health professional as defined in section 245.462, subdivision 18,
clauses (1) to (5). If the recipient has a current diagnostic assessment by a licensed
mental health professional as defined in section 245.462, subdivision 18, clauses (1) to
(5), recommending receipt of adult mental health rehabilitative services, the definition of
mental health professional for purposes of this section includes a person who is qualified
under section 245.462, subdivision 18, clause (6), and who holds a current and valid
national certification as a certified rehabilitation counselor or certified psychosocial
rehabilitation practitioner;
(2) a mental health practitioner as defined in section 245.462, subdivision 17. The
mental health practitioner must work under the clinical supervision of a mental health
professional; deleted text begin ordeleted text end
new text begin
(3) a certified peer specialist under section 256B.0615. The certified peer specialist
must work under the clinical supervision of a mental health professional; or
new text end
deleted text begin (3)deleted text end new text begin (4)new text end a mental health rehabilitation worker. A mental health rehabilitation worker
means a staff person working under the direction of a mental health practitioner or mental
health professional and under the clinical supervision of a mental health professional in
the implementation of rehabilitative mental health services as identified in the recipient's
individual treatment plan who:
(i) is at least 21 years of age;
(ii) has a high school diploma or equivalent;
(iii) has successfully completed 30 hours of training during the past two years in all
of the following areas: recipient rights, recipient-centered individual treatment planning,
behavioral terminology, mental illness, co-occurring mental illness and substance abuse,
psychotropic medications and side effects, functional assessment, local community
resources, adult vulnerability, recipient confidentiality; and
(iv) meets the qualifications in subitem (A) or (B):
(A) has an associate of arts degree in one of the behavioral sciences or human
services, or is a registered nurse without a bachelor's degree, or who within the previous
ten years has:
(1) three years of personal life experience with serious and persistent mental illness;
(2) three years of life experience as a primary caregiver to an adult with a serious
mental illness or traumatic brain injury; or
(3) 4,000 hours of supervised paid work experience in the delivery of mental health
services to adults with a serious mental illness or traumatic brain injury; or
(B)(1) is fluent in the non-English language or competent in the culture of the
ethnic group to which at least 20 percent of the mental health rehabilitation worker's
clients belong;
(2) receives during the first 2,000 hours of work, monthly documented individual
clinical supervision by a mental health professional;
(3) has 18 hours of documented field supervision by a mental health professional
or practitioner during the first 160 hours of contact work with recipients, and at least six
hours of field supervision quarterly during the following year;
(4) has review and cosignature of charting of recipient contacts during field
supervision by a mental health professional or practitioner; and
(5) has 40 hours of additional continuing education on mental health topics during
the first year of employment.
Sec. 19.
Minnesota Statutes 2006, section 256B.0625, is amended by adding a
subdivision to read:
new text begin Subd. 5l. new text end
new text begin Intensive mental health outpatient treatment. new text end
new text begin
Medical assistance
covers intensive mental health outpatient treatment for dialectical behavioral therapy for
adults. The commissioner shall establish:
new text end
new text begin
(1) certification procedures to ensure that providers of these services are qualified;
and
new text end
new text begin
(2) treatment protocols including required service components and criteria for
admission, continued treatment, and discharge.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2008, and subject to federal
approval. The commissioner shall notify the revisor of statutes when federal approval is
obtained.
new text end
Sec. 20.
Minnesota Statutes 2006, section 256B.0625, subdivision 20, is amended to
read:
Subd. 20.
Mental health case management.
(a) To the extent authorized by rule
of the state agency, medical assistance covers case management services to persons with
serious and persistent mental illness and children with severe emotional disturbance.
Services provided under this section must meet the relevant standards in sections 245.461
to 245.4887, the Comprehensive Adult and Children's Mental Health Acts, Minnesota
Rules, parts 9520.0900 to 9520.0926, and 9505.0322, excluding subpart 10.
(b) Entities meeting program standards set out in rules governing family community
support services as defined in section 245.4871, subdivision 17, are eligible for medical
assistance reimbursement for case management services for children with severe
emotional disturbance when these services meet the program standards in Minnesota
Rules, parts 9520.0900 to 9520.0926 and 9505.0322, excluding subparts 6 and 10.
(c) Medical assistance and MinnesotaCare payment for mental health case
management shall be made on a monthly basis. In order to receive payment for an eligible
child, the provider must document at least a face-to-face contact with the child, the child's
parents, or the child's legal representative. To receive payment for an eligible adult, the
provider must document:
(1) at least a face-to-face contact with the adult or the adult's legal representative; or
(2) at least a telephone contact with the adult or the adult's legal representative and
document a face-to-face contact with the adult or the adult's legal representative within
the preceding two months.
(d) Payment for mental health case management provided by county or state staff
shall be based on the monthly rate methodology under section 256B.094, subdivision 6,
paragraph (b), with separate rates calculated for child welfare and mental health, and
within mental health, separate rates for children and adults.
(e) Payment for mental health case management provided by Indian health services
or by agencies operated by Indian tribes may be made according to this section or other
relevant federally approved rate setting methodology.
(f) Payment for mental health case management provided by vendors who contract
with a county or Indian tribe shall be based on a monthly rate negotiated by the host county
or tribe. The negotiated rate must not exceed the rate charged by the vendor for the same
service to other payers. If the service is provided by a team of contracted vendors, the
county or tribe may negotiate a team rate with a vendor who is a member of the team. The
team shall determine how to distribute the rate among its members. No reimbursement
received by contracted vendors shall be returned to the county or tribe, except to reimburse
the county or tribe for advance funding provided by the county or tribe to the vendor.
(g) If the service is provided by a team which includes contracted vendors, tribal
staff, and county or state staff, the costs for county or state staff participation in the team
shall be included in the rate for county-provided services. In this case, the contracted
vendor, the tribal agency, and the county may each receive separate payment for services
provided by each entity in the same month. In order to prevent duplication of services,
each entity must document, in the recipient's file, the need for team case management and
a description of the roles of the team members.
deleted text begin
(h) The commissioner shall calculate the nonfederal share of actual medical
assistance and general assistance medical care payments for each county, based on the
higher of calendar year 1995 or 1996, by service date, project that amount forward to 1999,
and transfer one-half of the result from medical assistance and general assistance medical
care to each county's mental health grants under section for calendar year 1999.
The annualized minimum amount added to each county's mental health grant shall be
$3,000 per year for children and $5,000 per year for adults. The commissioner may reduce
the statewide growth factor in order to fund these minimums. The annualized total amount
transferred shall become part of the base for future mental health grants for each county.
deleted text end
deleted text begin (i)deleted text end new text begin (h) new text end Notwithstanding section 256B.19, subdivision 1, the nonfederal share of
costs for mental health case management shall be provided by the recipient's county of
responsibility, as defined in sections 256G.01 to 256G.12, from sources other than federal
funds or funds used to match other federal funds. If the service is provided by a tribal
agency, the nonfederal share, if any, shall be provided by the recipient's tribe. new text begin When this
service is paid by the state without a federal share through fee-for-service, 50 percent of
the cost shall be provided by the recipient's county of responsibility.
new text end
new text begin
(i) Notwithstanding any administrative rule to the contrary, prepaid medical
assistance, general assistance medical care, and MinnesotaCare include mental health case
management. When the service is provided through prepaid capitation, the nonfederal
share is paid by the state and the county pays no share.
new text end
(j) The commissioner may suspend, reduce, or terminate the reimbursement to a
provider that does not meet the reporting or other requirements of this section. The county
of responsibility, as defined in sections 256G.01 to 256G.12, or, if applicable, the tribal
agency, is responsible for any federal disallowances. The county or tribe may share this
responsibility with its contracted vendors.
(k) The commissioner shall set aside a portion of the federal funds earned new text begin for county
expenditures new text end under this section to repay the special revenue maximization account under
section 256.01, subdivision 2, clause (15). The repayment is limited to:
(1) the costs of developing and implementing this section; and
(2) programming the information systems.
(l) Payments to counties and tribal agencies for case management expenditures
under this section shall only be made from federal earnings from services provided
under this section. new text begin When this service is paid by the state without a federal share through
fee-for-service, 50 percent of the cost shall be provided by the state. new text end Payments to
county-contracted vendors shall include deleted text begin bothdeleted text end the federal earningsnew text begin , the state share, new text end and the
county share.
deleted text begin
(m) Notwithstanding section , county payments for the cost of mental
health case management services provided by county or state staff shall not be made
to the commissioner of finance. For the purposes of mental health case management
services provided by county or state staff under this section, the centralized disbursement
of payments to counties under section consists only of federal earnings from
services provided under this section.
deleted text end
deleted text begin (n)deleted text end new text begin (m) new text end Case management services under this subdivision do not include therapy,
treatment, legal, or outreach services.
deleted text begin (o)deleted text end new text begin (n) new text end If the recipient is a resident of a nursing facility, intermediate care facility,
or hospital, and the recipient's institutional care is paid by medical assistance, payment
for case management services under this subdivision is limited to the last 180 days of
the recipient's residency in that facility and may not exceed more than six months in a
calendar year.
deleted text begin (p)deleted text end new text begin (o) new text end Payment for case management services under this subdivision shall not
duplicate payments made under other program authorities for the same purpose.
deleted text begin
(q) By July 1, 2000, the commissioner shall evaluate the effectiveness of the changes
required by this section, including changes in number of persons receiving mental health
case management, changes in hours of service per person, and changes in caseload size.
deleted text end
deleted text begin
(r) For each calendar year beginning with the calendar year 2001, the annualized
amount of state funds for each county determined under paragraph (h) shall be adjusted by
the county's percentage change in the average number of clients per month who received
case management under this section during the fiscal year that ended six months prior to
the calendar year in question, in comparison to the prior fiscal year.
deleted text end
deleted text begin
(s) For counties receiving the minimum allocation of $3,000 or $5,000 described
in paragraph (h), the adjustment in paragraph (s) shall be determined so that the county
receives the higher of the following amounts:
deleted text end
deleted text begin
(1) a continuation of the minimum allocation in paragraph (h); or
deleted text end
deleted text begin
(2) an amount based on that county's average number of clients per month who
received case management under this section during the fiscal year that ended six months
prior to the calendar year in question, times the average statewide grant per person per
month for counties not receiving the minimum allocation.
deleted text end
deleted text begin
(t) The adjustments in paragraphs (s) and (t) shall be calculated separately for
children and adults.
deleted text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2009, except the
amendments to paragraphs (h), (r), (s), and (t) are effective January 1, 2008.
new text end
Sec. 21.
Minnesota Statutes 2006, section 256B.0625, subdivision 47, is amended to
read:
Subd. 47.
Treatment foster care services.
Effective July 1, deleted text begin 2006deleted text end new text begin 2007new text end , and subject
to federal approval, medical assistance covers treatment foster care services according to
section 256B.0946.
Sec. 22.
Minnesota Statutes 2006, section 256B.0943, subdivision 8, is amended to
read:
Subd. 8.
Required preservice and continuing education.
(a) A provider entity
shall establish a plan to provide preservice and continuing education for staff. The plan
must clearly describe the type of training necessary to maintain current skills and obtain
new skills and that relates to the provider entity's goals and objectives for services offered.
(b) A provider that employs a mental health behavioral aide under this section must
require the mental health behavioral aide to complete 30 hours of preservice training. The
preservice training must include topics specified in Minnesota Rules, part 9535.4068,
subparts 1 and 2, and parent team training. The preservice training must include 15 hours
of in-person training of a mental health behavioral aide in mental health services delivery
and eight hours of parent team training.new text begin Curricula for parent team training must be
approved in advance by the commissioner.new text end Components of parent team training include:
(1) partnering with parents;
(2) fundamentals of family support;
(3) fundamentals of policy and decision making;
(4) defining equal partnership;
(5) complexities of the parent and service provider partnership in multiple service
delivery systems due to system strengths and weaknesses;
(6) sibling impacts;
(7) support networks; and
(8) community resources.
(c) A provider entity that employs a mental health practitioner and a mental health
behavioral aide to provide children's therapeutic services and supports under this section
must require the mental health practitioner and mental health behavioral aide to complete
20 hours of continuing education every two calendar years. The continuing education
must be related to serving the needs of a child with emotional disturbance in the child's
home environment and the child's family. The topics covered in orientation and training
must conform to Minnesota Rules, part 9535.4068.
(d) The provider entity must document the mental health practitioner's or mental
health behavioral aide's annual completion of the required continuing education. The
documentation must include the date, subject, and number of hours of the continuing
education, and attendance records, as verified by the staff member's signature, job
title, and the instructor's name. The provider entity must keep documentation for each
employee, including records of attendance at professional workshops and conferences,
at a central location and in the employee's personnel file.
Sec. 23.
Minnesota Statutes 2006, section 256B.0945, subdivision 4, is amended to
read:
Subd. 4.
Payment rates.
(a) Notwithstanding sections 256B.19 and 256B.041,
payments to counties for residential services provided by a residential facility shall only
be made of federal earnings for services provided under this section, and the nonfederal
share of costs for services provided under this section shall be paid by the county from
sources other than federal funds or funds used to match other federal funds. Payment to
counties for services provided according to this section shall be a proportion of the per
day contract rate that relates to rehabilitative mental health services and shall not include
payment for costs or services that are billed to the IV-E program as room and board.
(b) new text begin Per diem rates paid to providers under this section by prepaid plans shall be the
proportion of the per-day contract rate that relates to rehabilitative mental health services
and shall not include payment for group foster care costs or services that are billed to the
county of financial responsibility.
new text end
new text begin (c) new text end The commissioner shall set aside a portion not to exceed five percent of the
federal funds earned new text begin for county expenditures new text end under this section to cover the state costs of
administering this section. Any unexpended funds from the set-aside shall be distributed
to the counties in proportion to their earnings under this section.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2009.
new text end
Sec. 24.
Minnesota Statutes 2006, section 256B.69, subdivision 4, is amended to read:
Subd. 4.
Limitation of choice.
(a) The commissioner shall develop criteria to
determine when limitation of choice may be implemented in the experimental counties.
The criteria shall ensure that all eligible individuals in the county have continuing access
to the full range of medical assistance services as specified in subdivision 6.
(b) The commissioner shall exempt the following persons from participation in the
project, in addition to those who do not meet the criteria for limitation of choice:
(1) persons eligible for medical assistance according to section 256B.055,
subdivision 1;
(2) persons eligible for medical assistance due to blindness or disability as
determined by the Social Security Administration or the state medical review team, unless:
(i) they are 65 years of age or older; or
(ii) they reside in Itasca County or they reside in a county in which the commissioner
conducts a pilot project under a waiver granted pursuant to section 1115 of the Social
Security Act;
(3) recipients who currently have private coverage through a health maintenance
organization;
(4) recipients who are eligible for medical assistance by spending down excess
income for medical expenses other than the nursing facility per diem expense;
(5) recipients who receive benefits under the Refugee Assistance Program,
established under United States Code, title 8, section 1522(e);
(6) children who are both determined to be severely emotionally disturbed and
receiving case management services according to section 256B.0625, subdivision 20new text begin ,
except children who are eligible for and who decline enrollment in an approved preferred
integrated network under section 245.4682new text end ;
(7) adults who are both determined to be seriously and persistently mentally ill and
received case management services according to section 256B.0625, subdivision 20;
(8) persons eligible for medical assistance according to section 256B.057,
subdivision 10; and
(9) persons with access to cost-effective employer-sponsored private health
insurance or persons enrolled in a non-Medicare individual health plan determined to be
cost-effective according to section 256B.0625, subdivision 15.
Children under age 21 who are in foster placement may enroll in the project on an elective
basis. Individuals excluded under clauses (1), (6), and (7) may choose to enroll on an
elective basis. The commissioner may enroll recipients in the prepaid medical assistance
program for seniors who are (1) age 65 and over, and (2) eligible for medical assistance by
spending down excess income.
(c) The commissioner may allow persons with a one-month spenddown who are
otherwise eligible to enroll to voluntarily enroll or remain enrolled, if they elect to prepay
their monthly spenddown to the state.
(d) The commissioner may require those individuals to enroll in the prepaid medical
assistance program who otherwise would have been excluded under paragraph (b), clauses
(1), (3), and (8), and under Minnesota Rules, part 9500.1452, subpart 2, items H, K, and L.
(e) Before limitation of choice is implemented, eligible individuals shall be notified
and after notification, shall be allowed to choose only among demonstration providers.
The commissioner may assign an individual with private coverage through a health
maintenance organization, to the same health maintenance organization for medical
assistance coverage, if the health maintenance organization is under contract for medical
assistance in the individual's county of residence. After initially choosing a provider,
the recipient is allowed to change that choice only at specified times as allowed by the
commissioner. If a demonstration provider ends participation in the project for any reason,
a recipient enrolled with that provider must select a new provider but may change providers
without cause once more within the first 60 days after enrollment with the second provider.
(f) An infant born to a woman who is eligible for and receiving medical assistance
and who is enrolled in the prepaid medical assistance program shall be retroactively
enrolled to the month of birth in the same managed care plan as the mother once the
child is enrolled in medical assistance unless the child is determined to be excluded from
enrollment in a prepaid plan under this section.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2009.
new text end
Sec. 25.
Minnesota Statutes 2006, section 256B.69, subdivision 5g, is amended to read:
Subd. 5g.
Payment for covered services.
For services rendered on or after January
1, 2003, the total payment made to managed care plans for providing covered services
under the medical assistance and general assistance medical care programs is reduced by
.5 percent from their current statutory rates. This provision excludes payments for nursing
home services, home and community-based waivers, deleted text begin anddeleted text end payments to demonstration
projects for persons with disabilitiesnew text begin , and mental health services added as covered benefits
after December 31, 2007new text end .
Sec. 26.
Minnesota Statutes 2006, section 256B.69, subdivision 5h, is amended to read:
Subd. 5h.
Payment reduction.
In addition to the reduction in subdivision 5g,
the total payment made to managed care plans under the medical assistance program is
reduced 1.0 percent for services provided on or after October 1, 2003, and an additional
1.0 percent for services provided on or after January 1, 2004. This provision excludes
payments for nursing home services, home and community-based waivers, deleted text begin anddeleted text end payments
to demonstration projects for persons with disabilitiesnew text begin , and mental health services added as
covered benefits after December 31, 2007new text end .
Sec. 27.
Minnesota Statutes 2006, section 256B.763, is amended to read:
256B.763 CRITICAL ACCESS MENTAL HEALTH RATE INCREASE.
(a) For services defined in paragraph (b) and rendered on or after July 1, 2007,
payment rates shall be increased by 23.7 percent over the rates in effect on January 1,
2006, for:
(1) psychiatrists and advanced practice registered nurses with a psychiatric specialty;
(2) community mental health centers under section 256B.0625, subdivision 5; and
(3) mental health clinics and centers certified under Minnesota Rules, parts
9520.0750 to 9520.0870, or hospital outpatient psychiatric departments that are designated
as essential community providers under section 62Q.19.
(b) This increase applies to group skills training when provided as a component of
children's therapeutic services and support, psychotherapy, medication management,
evaluation and management, diagnostic assessment, explanation of findings, psychological
testing, neuropsychological services, direction of behavioral aides, and inpatient
consultation.
(c) This increase does not apply to rates that are governed by section 256B.0625,
subdivision 30, or 256B.761, paragraph (b), other cost-based rates, rates that are
negotiated with the county, rates that are established by the federal government, or rates
that increased between January 1, 2004, and January 1, 2005.
(d) The commissioner shall adjust rates paid to prepaid health plans under contract
with the commissioner to reflect the rate increases provided in deleted text begin paragraphdeleted text end new text begin paragraphs new text end (a)new text begin ,
(e), and (f)new text end . The prepaid health plan must pass this rate increase to the providers identified
in deleted text begin paragraphdeleted text end new text begin paragraphs new text end (a)new text begin , (e), (f), and (g)new text end .
new text begin
(e) Payment rates shall be increased by 23.7 percent over the rates in effect on
December 31, 2007, for:
new text end
new text begin
(1) medication education services provided on or after January 1, 2008, by adult
rehabilitative mental health services providers certified under section 256B.0623; and
new text end
new text begin
(2) mental health behavioral aide services provided on or after January 1, 2008, by
children's therapeutic services and support providers certified under section 256B.0943.
new text end
new text begin
(f) For services defined in paragraph (b) and rendered on or after January 1, 2008, by
children's therapeutic services and support providers certified under section 256B.0943
and not already included in paragraph (a), payment rates shall be increased by 23.7 percent
over the rates in effect on December 31, 2007.
new text end
new text begin
(g) Payment rates shall be increased by 2.3 percent over the rates in effect on
December 31, 2007, for individual and family skills training provided on or after January
1, 2008, by children's therapeutic services and support providers certified under section
256B.0943.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2008.
new text end
Sec. 28.
Minnesota Statutes 2006, section 256D.03, subdivision 4, is amended to read:
Subd. 4.
General assistance medical care; services.
(a)(i) For a person who is
eligible under subdivision 3, paragraph (a), clause (2), item (i), general assistance medical
care covers, except as provided in paragraph (c):
(1) inpatient hospital services;
(2) outpatient hospital services;
(3) services provided by Medicare certified rehabilitation agencies;
(4) prescription drugs and other products recommended through the process
established in section 256B.0625, subdivision 13;
(5) equipment necessary to administer insulin and diagnostic supplies and equipment
for diabetics to monitor blood sugar level;
(6) eyeglasses and eye examinations provided by a physician or optometrist;
(7) hearing aids;
(8) prosthetic devices;
(9) laboratory and X-ray services;
(10) physician's services;
(11) medical transportation except special transportation;
(12) chiropractic services as covered under the medical assistance program;
(13) podiatric services;
(14) dental services as covered under the medical assistance program;
(15) deleted text begin outpatient services provided by a mental health center or clinic that is under
contract with the county board and is established under section 245.62deleted text end new text begin mental health
services covered under chapter 256Bnew text end ;
deleted text begin
(16) day treatment services for mental illness provided under contract with the
county board;
deleted text end
deleted text begin (17)deleted text end new text begin (16) new text end prescribed medications for persons who have been diagnosed as mentally
ill as necessary to prevent more restrictive institutionalization;
deleted text begin (18) psychological services,deleted text end new text begin (17) new text end medical supplies and equipment, and Medicare
premiums, coinsurance and deductible payments;
deleted text begin (19)deleted text end new text begin (18) new text end medical equipment not specifically listed in this paragraph when the use
of the equipment will prevent the need for costlier services that are reimbursable under
this subdivision;
deleted text begin (20)deleted text end new text begin (19) new text end services performed by a certified pediatric nurse practitioner, a
certified family nurse practitioner, a certified adult nurse practitioner, a certified
obstetric/gynecological nurse practitioner, a certified neonatal nurse practitioner, or a
certified geriatric nurse practitioner in independent practice, if (1) the service is otherwise
covered under this chapter as a physician service, (2) the service provided on an inpatient
basis is not included as part of the cost for inpatient services included in the operating
payment rate, and (3) the service is within the scope of practice of the nurse practitioner's
license as a registered nurse, as defined in section 148.171;
deleted text begin (21)deleted text end new text begin (20) new text end services of a certified public health nurse or a registered nurse practicing
in a public health nursing clinic that is a department of, or that operates under the direct
authority of, a unit of government, if the service is within the scope of practice of the
public health nurse's license as a registered nurse, as defined in section 148.171;new text begin and
new text end
deleted text begin (22)deleted text end new text begin (21) new text end telemedicine consultations, to the extent they are covered under section
256B.0625, subdivision 3bdeleted text begin ; anddeleted text end new text begin .
new text end
deleted text begin
(23) mental health telemedicine and psychiatric consultation as covered under
section deleted text begin 256B.0625, subdivisions 46 and 48deleted text end .
deleted text end
(ii) Effective October 1, 2003, for a person who is eligible under subdivision 3,
paragraph (a), clause (2), item (ii), general assistance medical care coverage is limited
to inpatient hospital services, including physician services provided during the inpatient
hospital stay. A $1,000 deductible is required for each inpatient hospitalization.
(b) Effective August 1, 2005, sex reassignment surgery is not covered under this
subdivision.
(c) In order to contain costs, the commissioner of human services shall select
vendors of medical care who can provide the most economical care consistent with high
medical standards and shall where possible contract with organizations on a prepaid
capitation basis to provide these services. The commissioner shall consider proposals by
counties and vendors for prepaid health plans, competitive bidding programs, block grants,
or other vendor payment mechanisms designed to provide services in an economical
manner or to control utilization, with safeguards to ensure that necessary services are
provided. Before implementing prepaid programs in counties with a county operated or
affiliated public teaching hospital or a hospital or clinic operated by the University of
Minnesota, the commissioner shall consider the risks the prepaid program creates for the
hospital and allow the county or hospital the opportunity to participate in the program in a
manner that reflects the risk of adverse selection and the nature of the patients served by
the hospital, provided the terms of participation in the program are competitive with the
terms of other participants considering the nature of the population served. Payment for
services provided pursuant to this subdivision shall be as provided to medical assistance
vendors of these services under sections 256B.02, subdivision 8, and 256B.0625. For
payments made during fiscal year 1990 and later years, the commissioner shall consult
with an independent actuary in establishing prepayment rates, but shall retain final control
over the rate methodology.
(d) Recipients eligible under subdivision 3, paragraph (a), shall pay the following
co-payments for services provided on or after October 1, 2003:
(1) $25 for eyeglasses;
(2) $25 for nonemergency visits to a hospital-based emergency room;
(3) $3 per brand-name drug prescription and $1 per generic drug prescription,
subject to a $12 per month maximum for prescription drug co-payments. No co-payments
shall apply to antipsychotic drugs when used for the treatment of mental illness; and
(4) 50 percent coinsurance on restorative dental services.
(e) Co-payments shall be limited to one per day per provider for nonpreventive visits,
eyeglasses, and nonemergency visits to a hospital-based emergency room. Recipients of
general assistance medical care are responsible for all co-payments in this subdivision.
The general assistance medical care reimbursement to the provider shall be reduced by
the amount of the co-payment, except that reimbursement for prescription drugs shall not
be reduced once a recipient has reached the $12 per month maximum for prescription
drug co-payments. The provider collects the co-payment from the recipient. Providers
may not deny services to recipients who are unable to pay the co-payment, except as
provided in paragraph (f).
(f) If it is the routine business practice of a provider to refuse service to an individual
with uncollected debt, the provider may include uncollected co-payments under this
section. A provider must give advance notice to a recipient with uncollected debt before
services can be denied.
(g) Any county may, from its own resources, provide medical payments for which
state payments are not made.
(h) Chemical dependency services that are reimbursed under chapter 254B must not
be reimbursed under general assistance medical care.
(i) The maximum payment for new vendors enrolled in the general assistance
medical care program after the base year shall be determined from the average usual and
customary charge of the same vendor type enrolled in the base year.
(j) The conditions of payment for services under this subdivision are the same as the
conditions specified in rules adopted under chapter 256B governing the medical assistance
program, unless otherwise provided by statute or rule.
(k) Inpatient and outpatient payments shall be reduced by five percent, effective July
1, 2003. This reduction is in addition to the five percent reduction effective July 1, 2003,
and incorporated by reference in paragraph (i).
(l) Payments for all other health services except inpatient, outpatient, and pharmacy
services shall be reduced by five percent, effective July 1, 2003.
(m) Payments to managed care plans shall be reduced by five percent for services
provided on or after October 1, 2003.
(n) A hospital receiving a reduced payment as a result of this section may apply the
unpaid balance toward satisfaction of the hospital's bad debts.
(o) Fee-for-service payments for nonpreventive visits shall be reduced by $3
for services provided on or after January 1, 2006. For purposes of this subdivision, a
visit means an episode of service which is required because of a recipient's symptoms,
diagnosis, or established illness, and which is delivered in an ambulatory setting by
a physician or physician ancillary, chiropractor, podiatrist, advance practice nurse,
audiologist, optician, or optometrist.
(p) Payments to managed care plans shall not be increased as a result of the removal
of the $3 nonpreventive visit co-payment effective January 1, 2006.
new text begin
(q) Payments for mental health services added as covered benefits after December
31, 2007, are not subject to the reductions in paragraphs (i), (k), (l), and (m).
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2008, except mental health
case management under paragraph (a), clause (i), item (15), is effective January 1, 2009.
new text end
Sec. 29.
Minnesota Statutes 2006, section 256L.03, subdivision 1, is amended to read:
Subdivision 1.
Covered health services.
For individuals under section 256L.04,
subdivision 7, with income no greater than 75 percent of the federal poverty guidelines
or for families with children under section 256L.04, subdivision 1, all subdivisions of
this section apply. "Covered health services" means the health services reimbursed
under chapter 256B, with the exception of inpatient hospital services, special education
services, private duty nursing services, adult dental care services other than services
covered under section 256B.0625, subdivision 9, orthodontic services, nonemergency
medical transportation services, personal care assistant and case management services,
nursing home or intermediate care facilities services, inpatient mental health services,
and chemical dependency services. deleted text begin Outpatient mental health services covered under the
MinnesotaCare program are limited to diagnostic assessments, psychological testing,
explanation of findings, mental health telemedicine, psychiatric consultation, medication
management by a physician, day treatment, partial hospitalization, and individual, family,
and group psychotherapy.
deleted text end
No public funds shall be used for coverage of abortion under MinnesotaCare
except where the life of the female would be endangered or substantial and irreversible
impairment of a major bodily function would result if the fetus were carried to term; or
where the pregnancy is the result of rape or incest.
Covered health services shall be expanded as provided in this section.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2008, except coverage for
mental health case management under subdivision 1 is effective January 1, 2009.
new text end
Sec. 30.
Minnesota Statutes 2006, section 256L.03, subdivision 5, is amended to read:
Subd. 5.
Co-payments and coinsurance.
(a) Except as provided in paragraphs (b)
and (c), the MinnesotaCare benefit plan shall include the following co-payments and
coinsurance requirements for all enrollees:
(1) ten percent of the paid charges for inpatient hospital services for adult enrollees,
subject to an annual inpatient out-of-pocket maximum of $1,000 per individual and
$3,000 per family;
(2) $3 per prescription for adult enrollees;
(3) $25 for eyeglasses for adult enrollees;
(4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an
episode of service which is required because of a recipient's symptoms, diagnosis, or
established illness, and which is delivered in an ambulatory setting by a physician or
physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse,
audiologist, optician, or optometrist; and
(5) $6 for nonemergency visits to a hospital-based emergency room.
(b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of
children under the age of 21 in households with family income equal to or less than 175
percent of the federal poverty guidelines. Paragraph (a), clause (1), does not apply to
parents and relative caretakers of children under the age of 21 in households with family
income greater than 175 percent of the federal poverty guidelines for inpatient hospital
admissions occurring on or after January 1, 2001.
(c) Paragraph (a), clauses (1) to (4), do not apply to pregnant women and children
under the age of 21.
(d) new text begin Paragraph (a), clause (4), does not apply to mental health services.
new text end
new text begin (e) new text end Adult enrollees with family gross income that exceeds 175 percent of the
federal poverty guidelines and who are not pregnant shall be financially responsible for
the coinsurance amount, if applicable, and amounts which exceed the $10,000 inpatient
hospital benefit limit.
deleted text begin (e)deleted text end new text begin (f)new text end When a MinnesotaCare enrollee becomes a member of a prepaid health plan,
or changes from one prepaid health plan to another during a calendar year, any charges
submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket
expenses incurred by the enrollee for inpatient services, that were submitted or incurred
prior to enrollment, or prior to the change in health plans, shall be disregarded.
Sec. 31.
Minnesota Statutes 2006, section 256L.12, subdivision 9a, is amended to read:
Subd. 9a.
Rate setting; ratable reduction.
For services rendered on or after
October 1, 2003, the total payment made to managed care plans under the MinnesotaCare
program is reduced 1.0 percent.new text begin This provision excludes payments for mental health
services added as covered benefits after December 31, 2007.
new text end
Sec. 32.
Minnesota Statutes 2006, section 609.115, subdivision 9, is amended to read:
Subd. 9.
Compulsive gambling assessment required.
(a) If a person is convicted
of theft under section 609.52, embezzlement of public funds under section 609.54, or
forgery under section 609.625, 609.63, or 609.631, the probation officer shall determine in
the report prepared under subdivision 1 whether or not compulsive gambling contributed
to the commission of the offense. If so, the report shall contain the results of a compulsive
gambling assessment conducted in accordance with this subdivision. The probation officer
shall make an appointment for the offender to undergo the assessment if so indicated.
(b) The compulsive gambling assessment report must include a recommended level
of treatment for the offender if the assessor concludes that the offender is in need of
compulsive gambling treatment. The assessment must be conducted by an assessor
qualified new text begin either new text end under deleted text begin section 245.98, subdivision 2adeleted text end new text begin Minnesota Rules, part 9585.0040,
subpart 1, item C, or qualifications determined to be equivalent by the commissionernew text end , to
perform these assessments or to provide compulsive gambling treatment. An assessor
providing a compulsive gambling assessment may not have any direct or shared financial
interest or referral relationship resulting in shared financial gain with a treatment provider.
If an independent assessor is not available, the probation officer may use the services of an
assessor with a financial interest or referral relationship as authorized under rules adopted
by the commissioner of human services under section 245.98, subdivision 2a.
(c) The commissioner of human services shall reimburse the assessor for deleted text begin the
costs associated with adeleted text end new text begin each new text end compulsive gambling assessment at a rate established
by the commissioner deleted text begin up to a maximum of $100 for each assessmentdeleted text end . new text begin To the extent
practicable, the commissioner shall standardize reimbursement rates for assessments.new text end The
commissioner shall reimburse deleted text begin these costsdeleted text end new text begin the assessor new text end after receiving written verification
from the probation officer that the assessment was performed and found acceptable.
Sec. 33. new text begin REPORT.
new text end
new text begin
The commissioner shall make a report to the legislature by January 15, 2008,
regarding the transfer of funds to counties for state registered nurses employed in
community mental health pilot projects as part of the assertive community treatment
teams under Minnesota Statutes, section 245.4661. The report shall address the impact
of the nursing shortage on replacing these positions, continuity of patient care if these
positions cannot be filled, and ways to maintain state registered nurses in these positions
until the nurse retires or leaves employment. No funds for state registered nurse positions
referenced in this section may be transferred before the report date. This section does not
apply to positions vacated by routine attrition.
new text end
Sec. 34. new text begin CASE MANAGEMENT; BEST PRACTICES.
new text end
new text begin
The commissioner of human services, in consultation with consumers, families,
counties, and other interested stakeholders, will develop recommendations for changes in
the adult mental health act related to case management, consistent with evidence-based
and best practices.
new text end
Sec. 35. new text begin REGIONAL CHILDREN'S MENTAL HEALTH INITIATIVE.
new text end
new text begin Subdivision 1. new text end
new text begin Pilot project authorized; purpose. new text end
new text begin
A two-year Regional Children's
Mental Health Initiative pilot project is established to improve children's mental health
service coordination, communication, and processes in Blue Earth, Brown, Faribault,
Freeborn, Le Sueur, Martin, Nicollet, Rice, Sibley, Waseca, and Watonwan Counties. The
purpose of the Regional Children's Mental Health Initiative will be to plan and develop
new programs and services related to children's mental health in south central Minnesota.
new text end
new text begin Subd. 2. new text end
new text begin Goals. new text end
new text begin
To accomplish its purpose, the Regional Children's Mental Health
Initiative shall have the following goals:
new text end
new text begin
(1) work to streamline delivery and regional access to services;
new text end
new text begin
(2) share strategies and resources for the management of out-of-home placements;
new text end
new text begin
(3) establish standard protocols and operating procedures for functions that are
performed across all counties;
new text end
new text begin
(4) share information to improve resource allocation and service delivery across
counties;
new text end
new text begin
(5) evaluate outcomes of various treatment alternatives;
new text end
new text begin
(6) create a network for and provide support to service delivery groups;
new text end
new text begin
(7) establish a regional process to match children in need of out-of-home placement
with foster homes that can meet their needs; and
new text end
new text begin
(8) recruit and retain foster homes.
new text end
new text begin Subd. 3. new text end
new text begin Director's Council. new text end
new text begin
The Director's Council shall govern the operations of
the Regional Children's Mental Health Initiative. Members of the Director's Council shall
represent each of the 11 counties participating in the pilot project.
new text end
new text begin Subd. 4. new text end
new text begin Regional Children's Mental Health Initiative Team. new text end
new text begin
The members
of the Regional Children's Mental Health Initiative Team shall conduct planning and
development of new and modified children's mental health programs and services in the
region. Members of the team shall reflect the cultural, demographic, and geographic
diversity of the region and shall be composed of representatives from each of the
following:
new text end
new text begin
(1) the medical community;
new text end
new text begin
(2) human services;
new text end
new text begin
(3) corrections;
new text end
new text begin
(4) education;
new text end
new text begin
(5) mental health providers and vendors;
new text end
new text begin
(6) advocacy organizations;
new text end
new text begin
(7) parents; and
new text end
new text begin
(8) children and youth.
new text end
new text begin Subd. 5. new text end
new text begin Authority. new text end
new text begin
The regional children's mental health initiative shall have the
authority to develop and implement the following programs:
new text end
new text begin
(1) Flexible funding payments. This program will make funds available to respond to
the unique and unpredictable needs of children with mental health issues such as the need
for prescription drugs, transportation, clothing, and assessments not otherwise available.
new text end
new text begin
(2) Transition to self-sufficiency. This program will help youths between the ages of
14 and 21 establish professional relationships, find jobs, build financial foundations, and
learn to fulfill their roles as productive citizens.
new text end
new text begin
(3) Crisis response. This program will establish public and private partnerships
to offer a range of options to meet the needs of children in crisis. Methods to meet
these needs may include accessible local services, holistic assessments, urgent care and
stabilization services, and telehealth for specialized diagnosis and therapeutic sessions.
new text end
new text begin
(4) Integrated services for complex conditions. This program will design, develop,
and implement packages of integrated services to meet the needs of children with specific,
complex conditions.
new text end
new text begin Subd. 6. new text end
new text begin Evaluation and report. new text end
new text begin
The regional children's mental health initiative
shall develop a method for evaluating the effectiveness of this pilot project focusing on
identifiable goals and outcomes. An interim report on the pilot project's effectiveness
shall be submitted to the house and senate finance committees having jurisdiction over
mental health, the commissioner of human services, and the Minnesota Association of
County Social Service Administrators no later than December 31, 2008. A final report
is due no later than December 31, 2009.
new text end
Sec. 36. new text begin MINNESOTA FAMILY INVESTMENT PROGRAM AND CHILDREN'S
MENTAL HEALTH PILOT PROJECT.
new text end
new text begin Subdivision 1. new text end
new text begin Pilot project authorized. new text end
new text begin
The commissioner of human services
shall fund a three-year pilot project to measure the effect of children's identified mental
health needs, including social and emotional needs, on Minnesota family investment
program (MFIP) participants' ability to obtain and retain employment. The project shall
also measure the effect on work activity of MFIP participants' needs to address their
children's identified mental health needs.
new text end
new text begin Subd. 2. new text end
new text begin Provider and agency proposals. new text end
new text begin
(a) Interested MFIP providers and
agencies shall:
new text end
new text begin
(1) submit proposals defining how they will identify participants whose children
have mental health needs that hinder the employment process;
new text end
new text begin
(2) connect families with appropriate developmental, social, and emotional
screenings and services; and
new text end
new text begin
(3) incorporate those services into the participant's employment plan.
new text end
new text begin
Each proposal under this paragraph must include an evaluation component.
new text end
new text begin
(b) Interested MFIP providers and agencies shall develop a protocol to inform MFIP
participants of the following:
new text end
new text begin
(1) the availability of developmental, social, and emotional screening tools for
children and youth;
new text end
new text begin
(2) the purpose of the screenings;
new text end
new text begin
(3) how the information will be used to assist the participants in identifying and
addressing potential barriers to employment; and
new text end
new text begin
(4) that their employment plan may be modified based on the screening results.
new text end
new text begin Subd. 3. new text end
new text begin Program components. new text end
new text begin
(a) MFIP providers shall obtain the participant's
written consent for participation in the pilot project, including consent for developmental,
social, and emotional screening.
new text end
new text begin
(b) MFIP providers shall coordinate with county social service agencies and health
plans to assist recipients in arranging referrals indicated by the screening results.
new text end
new text begin
(c) Tools used for developmental, social, and emotional screenings shall be approved
by the commissioner of human services.
new text end
new text begin Subd. 4. new text end
new text begin Program evaluation. new text end
new text begin
The commissioner of human services shall conduct
an evaluation of the pilot project to determine:
new text end
new text begin
(1) the number of participants who took part in the screening;
new text end
new text begin
(2) the number of children who were screened and what screening tools were used;
new text end
new text begin
(3) the number of children who were identified in the screening who needed referral
or follow-up services;
new text end
new text begin
(4) the number of children who received services, what agency provided the services,
and what type of services were provided;
new text end
new text begin
(5) the number of employment plans that were adjusted to include the activities
recommended in the screenings;
new text end
new text begin
(6) the changes in work participation rates;
new text end
new text begin
(7) the changes in earned income;
new text end
new text begin
(8) the changes in sanction rates; and
new text end
new text begin
(9) the participants' report of program effectiveness.
new text end
new text begin Subd. 5. new text end
new text begin Work activity. new text end
new text begin
Participant involvement in screenings and subsequent
referral and follow-up services shall count as work activity under Minnesota Statutes,
section 256J.49, subdivision 13.
new text end
new text begin Subd. 6. new text end
new text begin Evaluation. new text end
new text begin
Of the amounts appropriated, the commissioner may use up
to $100,000 for evaluation of this pilot.
new text end
Sec. 37. new text begin SOCIAL AND ECONOMIC COSTS OF GAMBLING.
new text end
new text begin Subdivision 1. new text end
new text begin Report. new text end
new text begin
The commissioner of human services, in consultation with
the state affiliate of the National Council on Problem Gambling, stakeholders, and licensed
vendors, shall prepare a report that provides a process and funding mechanism to study the
issues in subdivisions 2 and 3. The commissioner, in consultation with the state affiliate
of the National Council on Problem Gambling, stakeholders, and licensed vendors, shall
include in the report potential financial commitments made by stakeholders and others in
order to fund the study. The report is due to the legislative committees having jurisdiction
over compulsive gambling issues by December 1, 2007.
new text end
new text begin Subd. 2. new text end
new text begin Issues to be addressed. new text end
new text begin
The study must address:
new text end
new text begin
(1) state, local, and tribal government policies and practices in Minnesota to legalize
or prohibit gambling;
new text end
new text begin
(2) the relationship between gambling and crime in Minnesota, including: (i) the
relationship between gambling and overall crime rates; (ii) the relationship between
gambling and crimes rates for specific crimes, such as forgery, domestic abuse, child
neglect and abuse, alcohol and drug offenses, and youth crime; and (iii) enforcement
and regulation practices that are intended to address the relationship between gambling
and levels of crime;
new text end
new text begin
(3) the relationship between expanded gambling and increased rates of problem
gambling in Minnesota, including the impact of pathological or problem gambling on
individuals, families, businesses, social institutions, and the economy;
new text end
new text begin
(4) the social impact of gambling on individuals, families, businesses, and social
institutions in Minnesota, including an analysis of the relationship between gambling and
depression, abuse, divorce, homelessness, suicide, and bankruptcy;
new text end
new text begin
(5) the economic impact of gambling on state, local, and tribal economies in
Minnesota; and
new text end
new text begin
(6) any other issues deemed necessary in assessing the social and economic impact
of gambling in Minnesota.
new text end
new text begin Subd. 3. new text end
new text begin Quantification of social and economic impact. new text end
new text begin
The study shall quantify
the social and economic impact on both (1) state, local, and tribal governments in
Minnesota, and (2) Minnesota's communities and social institutions, including individuals,
families, and businesses within those communities and institutions.
new text end
Sec. 38. new text begin REVISOR'S INSTRUCTION.
new text end
new text begin
(a) The revisor of statutes shall change the references to sections "245.487 to
245.4887" wherever it appears in statutes or rules to sections "245.487 to 245.4889."
new text end
new text begin
(b) The revisor of statutes shall correct all internal references that are necessary
from the relettering in section 20.
new text end
Sec. 39. new text begin REPEALER.
new text end
new text begin
Minnesota Rules, part 9585.0030,
new text end
new text begin
is repealed.
new text end
ARTICLE 9
DEPARTMENT OF HEALTH POLICY
Section 1.
Minnesota Statutes 2006, section 62J.17, subdivision 2, is amended to read:
Subd. 2.
Definitions.
For purposes of this section, the terms defined in this
subdivision have the meanings given.
deleted text begin
(a) "Access" means the financial, temporal, and geographic availability of health
care to individuals who need it.
deleted text end
deleted text begin (b)deleted text end new text begin (a) new text end "Capital expenditure" means an expenditure which, under generally accepted
accounting principles, is not properly chargeable as an expense of operation and
maintenance.
deleted text begin
(c) "Cost" means the amount paid by consumers or third party payers for health
care services or products.
deleted text end
deleted text begin
(d) "Date of the major spending commitment" means the date the provider formally
obligated itself to the major spending commitment. The obligation may be incurred
by entering into a contract, making a down payment, issuing bonds or entering a loan
agreement to provide financing for the major spending commitment, or taking some other
formal, tangible action evidencing the provider's intention to make the major spending
commitment.
deleted text end
deleted text begin (e)deleted text end new text begin (b) new text end "Health care service" means:
(1) a service or item that would be covered by the medical assistance program
under chapter 256B if provided in accordance with medical assistance requirements to an
eligible medical assistance recipient; and
(2) a service or item that would be covered by medical assistance except that it is
characterized as experimental, cosmetic, or voluntary.
"Health care service" does not include retail, over-the-counter sales of
nonprescription drugs and other retail sales of health-related products that are not generally
paid for by medical assistance and other third-party coverage.
deleted text begin (f)deleted text end new text begin (c) new text end "Major spending commitment" means an expenditure in excess of $1,000,000
for:
(1) acquisition of a unit of medical equipment;
(2) a capital expenditure for a single project for the purposes of providing health
care services, other than for the acquisition of medical equipment;
(3) offering a new specialized service not offered before;
(4) planning for an activity that would qualify as a major spending commitment
under this paragraph; or
(5) a project involving a combination of two or more of the activities in clauses
(1) to (4).
The cost of acquisition of medical equipment, and the amount of a capital
expenditure, is the total cost to the provider regardless of whether the cost is distributed
over time through a lease arrangement or other financing or payment mechanism.
deleted text begin (g)deleted text end new text begin (d) new text end "Medical equipment" means fixed and movable equipment that is used by
a provider in the provision of a health care service. "Medical equipment" includes, but
is not limited to, the following:
(1) an extracorporeal shock wave lithotripter;
(2) a computerized axial tomography (CAT) scanner;
(3) a magnetic resonance imaging (MRI) unit;
(4) a positron emission tomography (PET) scanner; and
(5) emergency and nonemergency medical transportation equipment and vehicles.
deleted text begin (h)deleted text end new text begin (e) new text end "New specialized service" means a specialized health care procedure or
treatment regimen offered by a provider that was not previously offered by the provider,
including, but not limited to:
(1) cardiac catheterization services involving high-risk patients as defined in the
Guidelines for Coronary Angiography established by the American Heart Association
and the American College of Cardiology;
(2) heart, heart-lung, liver, kidney, bowel, or pancreas transplantation service, or
any other service for transplantation of any other organ;
(3) megavoltage radiation therapy;
(4) open heart surgery;
(5) neonatal intensive care services; and
(6) any new medical technology for which premarket approval has been granted by
the United States Food and Drug Administration, excluding implantable and wearable
devices.
new text begin
(f) "Specialty care" includes but is not limited to cardiac, neurology, orthopedic,
obstetrics, mental health, chemical dependency, and emergency services.
new text end
Sec. 2.
Minnesota Statutes 2006, section 62J.17, subdivision 4a, is amended to read:
Subd. 4a.
Expenditure reporting.
deleted text begin
(a) A provider making a major spending
commitment after April 1, 1992, shall submit notification of the expenditure to the
commissioner and provide the commissioner with any relevant background information.
deleted text end
deleted text begin
(b) Notification must include a report, submitted within 60 days after the date of the
major spending commitment, using terms conforming to the definitions in section
and this section. Each report is subject to retrospective review and must contain:
deleted text end
deleted text begin
(1) a detailed description of the major spending commitment, including the specific
dollar amount of each expenditure, and its purpose;
deleted text end
deleted text begin
(2) the date of the major spending commitment;
deleted text end
deleted text begin
(3) a statement of the expected impact that the major spending commitment will
have on charges by the provider to patients and third party payers;
deleted text end
deleted text begin
(4) a statement of the expected impact on the clinical effectiveness or quality of care
received by the patients that the provider expects to serve;
deleted text end
deleted text begin
(5) a statement of the extent to which equivalent services or technology are already
available to the provider's actual and potential patient population;
deleted text end
deleted text begin
(6) a statement of the distance from which the nearest equivalent services or
technology are already available to the provider's actual and potential population;
deleted text end
deleted text begin
(7) a statement describing the pursuit of any lawful collaborative arrangements; and
deleted text end
deleted text begin
(8) a statement of assurance that the provider will not use, purchase, or perform
health care technologies and procedures that are not clinically effective and cost-effective,
unless the technology is used for experimental or research purposes to determine whether
a technology or procedure is clinically effective and cost-effective.
deleted text end
deleted text begin
The provider may submit any additional information that it deems relevant.
deleted text end
deleted text begin
(c) The commissioner may request additional information from a provider for the
purpose of review of a report submitted by that provider, and may consider relevant
information from other sources. A provider shall provide any information requested by
the commissioner within the time period stated in the request, or within 30 days after the
date of the request if the request does not state a time.
deleted text end
deleted text begin
(d) If the provider fails to submit a complete and timely expenditure report, including
any additional information requested by the commissioner, the commissioner may make
the provider's subsequent major spending commitments subject to the procedures of
prospective review and approval under subdivision 6a.
deleted text end
new text begin
Each hospital, outpatient surgical center, diagnostic imaging center, and physician
clinic shall report annually to the commissioner on all major spending commitments,
in the form and manner specified by the commissioner. The report shall include the
following information:
new text end
new text begin
(a) a description of major spending commitments made during the previous year,
including the total dollar amount of major spending commitments and purpose of the
expenditures;
new text end
new text begin
(b) the cost of land acquisition, construction of new facilities, and renovation of
existing facilities;
new text end
new text begin
(c) the cost of purchased or leased medical equipment, by type of equipment;
new text end
new text begin
(d) expenditures by type for specialty care and new specialized services;
new text end
new text begin
(e) information on the amount and types of added capacity for diagnostic imaging
services, outpatient surgical services, and new specialized services; and
new text end
new text begin
(f) information on investments in electronic medical records systems.
new text end
new text begin
For hospitals and outpatient surgical centers, this information shall be included in reports
to the commissioner that are required under section 144.698. For diagnostic imaging
centers, this information shall be included in reports to the commissioner that are required
under section 144.565. For physician clinics, this information shall be included in reports
to the commissioner that are required under section 62J.41. For all other health care
providers that are subject to this reporting requirement, reports must be submitted to the
commissioner by March 1 each year for the preceding calendar year.
new text end
Sec. 3.
Minnesota Statutes 2006, section 62J.17, subdivision 6a, is amended to read:
Subd. 6a.
Prospective review and approval.
(a) No health care provider subject
to prospective review under this subdivision shall make a major spending commitment
unless:
(1) the provider has filed an application with the commissioner to proceed with the
major spending commitment and has provided all supporting documentation and evidence
requested by the commissioner; and
(2) the commissioner determines, based upon this documentation and evidence, that
the major spending commitment is appropriate under the criteria provided in subdivision
5a in light of the alternatives available to the provider.
(b) A provider subject to prospective review and approval shall submit an
application to the commissioner before proceeding with any major spending commitment.
deleted text begin The application must address each item listed in subdivision 4a, paragraph (a), and must
also include documentation to support the response to each item.deleted text end The provider may
submit information, with supporting documentation, regarding why the major spending
commitment should be excepted from prospective review under subdivision 7. deleted text begin The
submission may be made either in addition to or instead of the submission of information
relating to the items listed in subdivision 4a, paragraph (a).
deleted text end
(c) The commissioner shall determine, based upon the information submitted,
whether the major spending commitment is appropriate under the criteria provided
in subdivision 5a, or whether it should be excepted from prospective review under
subdivision 7. In making this determination, the commissioner may also consider relevant
information from other sources. At the request of the commissioner, the health technology
advisory committee shall convene an expert review panel made up of persons with
knowledge and expertise regarding medical equipment, specialized services, health care
expenditures, and capital expenditures to review applications and make recommendations
to the commissioner. The commissioner shall make a decision on the application within
60 days after an application is received.
(d) The commissioner of health has the authority to issue fines, seek injunctions, and
pursue other remedies as provided by law.
Sec. 4.
Minnesota Statutes 2006, section 62J.17, subdivision 7, is amended to read:
Subd. 7.
Exceptions.
(a) The deleted text begin retrospective review process as described in
subdivision 5a and the prospective review and approval process as described in subdivision
6adeleted text end new text begin reporting requirement in subdivision 4anew text end deleted text begin dodeleted text end new text begin does new text end not apply to:
deleted text begin
(1) a major spending commitment to replace existing equipment with comparable
equipment used for direct patient care, upgrades of equipment beyond the current model,
or comparable model must be reported;
deleted text end
deleted text begin (2)deleted text end new text begin (1)new text end a major spending commitment made by a research and teaching institution
for purposes of conducting medical education, medical research supported or sponsored
by a medical school, or by a federal or foundation grant or clinical trials;
deleted text begin
(3) a major spending commitment to repair, remodel, or replace existing buildings or
fixtures if, in the judgment of the commissioner, the project does not involve a substantial
expansion of service capacity or a substantial change in the nature of health care services
provided;
deleted text end
deleted text begin (4)deleted text end new text begin (2)new text end a major spending commitment for building maintenance including heating,
water, electricity, and other maintenance-related expenditures;new text begin and
new text end
deleted text begin (5)deleted text end new text begin (3)new text end a major spending commitment for activities, not directly related to the
delivery of patient care services, including food service, laundry, housekeeping, and
other service-related activitiesdeleted text begin ; anddeleted text end new text begin .
new text end
deleted text begin
(6) a major spending commitment for computer equipment or data systems not
directly related to the delivery of patient care services, including computer equipment or
data systems related to medical record automation.
deleted text end
(b) In addition to the exceptions listed in paragraph (a), the deleted text begin prospective review and
approval process described in subdivision 6adeleted text end new text begin reporting requirement in subdivision 4anew text end does
not apply to mergers, acquisitions, and other changes in ownership or control that, in the
judgment of the commissioner, do not involve a substantial expansion of service capacity
or a substantial change in the nature of health care services provided.
Sec. 5.
Minnesota Statutes 2006, section 62J.41, subdivision 1, is amended to read:
Subdivision 1.
Cost containment data to be collected from providers.
The
commissioner shall require health care providers to collect and provide both patient
specific information and descriptive and financial aggregate data on:
(1) the total number of patients served;
(2) the total number of patients served by state of residence and Minnesota county;
(3) the site or sites where the health care provider provides services;
(4) the number of individuals employed, by type of employee, by the health care
provider;
(5) the services and their costs for which no payment was received;
(6) total revenue by type of payer or by groups of payers, including but not limited
to, revenue from Medicare, medical assistance, MinnesotaCare, nonprofit health service
plan corporations, commercial insurers, health maintenance organizations, and individual
patients;
(7) revenue from research activities;
(8) revenue from educational activities;
(9) revenue from out-of-pocket payments by patients;
(10) revenue from donations; deleted text begin and
deleted text end
new text begin
(11) a report on health care capital expenditures during the previous year, as required
by section 62J.17; and
new text end
deleted text begin (11)deleted text end new text begin (12)new text end any other data required by the commissioner, including data in
unaggregated form, for the purposes of developing spending estimates, setting spending
limits, monitoring actual spending, and monitoring costs.
The commissioner may, by rule, modify the data submission categories listed above if the
commissioner determines that this will reduce the reporting burden on providers without
having a significant negative effect on necessary data collection efforts.
Sec. 6.
Minnesota Statutes 2006, section 62J.52, subdivision 1, is amended to read:
Subdivision 1.
Uniform billing form CMS 1450.
(a) On and after January 1,
1996, all institutional inpatient hospital services, ancillary services, institutionally owned
or operated outpatient services rendered by providers in Minnesota, and institutional
or noninstitutional home health services that are not being billed using an equivalent
electronic billing format, must be billed using the uniform billing form CMS 1450, except
as provided in subdivision 5.
(b) The instructions and definitions for the use of the uniform billing form CMS
1450 shall be in accordance with the uniform billing form manual specified by the
commissioner. In promulgating these instructions, the commissioner may utilize the
manual developed by the National Uniform Billing Committee, as adopted and finalized
by the Minnesota Uniform Billing Committee.
(c) Services to be billed using the uniform billing form CMS 1450 include:
institutional inpatient hospital services and distinct units in the hospital such as psychiatric
unit services, physical therapy unit services, swing bed (SNF) services, inpatient state
psychiatric hospital services, inpatient skilled nursing facility services, home health
services (Medicare part A), and hospice services; ancillary services, where benefits are
exhausted or patient has no Medicare part A, from hospitals, state psychiatric hospitals,
skilled nursing facilities, and home health (Medicare part B); institutional owned or
operated outpatient services such as waivered services, hospital outpatient services,
including ambulatory surgical center services, hospital referred laboratory services,
hospital-based ambulance services, and other hospital outpatient services, skilled nursing
facilities, home health, freestanding renal dialysis centers, comprehensive outpatient
rehabilitation facilities (CORF), outpatient rehabilitation facilities (ORF), rural health
clinics, and community mental health centers; home health services such as home health
intravenous therapy providers, waivered services, personal care attendants, and hospice;
and any other health care provider certified by the Medicare program to use this form.
(d) On and after January 1, 1996, a mother and newborn child must be billed
separately, and must not be combined on one claim form.
new text begin
(e) Services provided by Medicare Critical Access Hospitals electing Method
II billing will be allowed an exception to this provision to allow the inclusion of the
professional fees on the CMS 1450.
new text end
Sec. 7.
Minnesota Statutes 2006, section 62J.52, subdivision 2, is amended to read:
Subd. 2.
Uniform billing form CMS 1500.
(a) On and after January 1, 1996, all
noninstitutional health care services rendered by providers in Minnesota except dental
or pharmacy providers, that are not currently being billed using an equivalent electronic
billing format, must be billed using the health insurance claim form CMS 1500, except as
provided in subdivision 5.
(b) The instructions and definitions for the use of the uniform billing form CMS
1500 shall be in accordance with the manual developed by the Administrative Uniformity
Committee entitled standards for the use of the CMS 1500 form, dated February 1994,
as further defined by the commissioner.
(c) Services to be billed using the uniform billing form CMS 1500 include physician
services and supplies, durable medical equipment, noninstitutional ambulance services,
independent ancillary services including occupational therapy, physical therapy, speech
therapy and audiology, home infusion therapy, podiatry services, optometry services,
mental health licensed professional services, substance abuse licensed professional
services, nursing practitioner professional services, certified registered nurse anesthetists,
chiropractors, physician assistants, laboratories, medical suppliers, and other health care
providers such as day activity centers and freestanding ambulatory surgical centers.
new text begin
(d) Services provided by Medicare Critical Access Hospitals electing Method
II billing will be allowed an exception to this provision to allow the inclusion of the
professional fees on the CMS 1450.
new text end
Sec. 8.
Minnesota Statutes 2006, section 62J.60, subdivision 2, is amended to read:
Subd. 2.
General characteristics.
(a) The Minnesota uniform health care
identification card must be a preprinted card constructed of plastic, paper, or any other
medium that conforms with ANSI and ISO 7810 physical characteristics standards. The
card dimensions must also conform to ANSI and ISO 7810 physical characteristics
standard. The use of a signature panel is optional. The uniform prescription drug
information contained on the card must conform with the format adopted by the NCPDP
and, except as provided in subdivision 3, paragraph (a), clause (2), must include all of
the fields required to submit a claim in conformance with the most recent pharmacy
identification card implementation guide produced by the NCPDP. All information
required to submit a prescription drug claim, exclusive of information provided on a
prescription that is required by law, must be included on the card in a clear, readable, and
understandable manner. If a health benefit plan requires a conditional or situational field,
as defined by the NCPDP, the conditional or situational field must conform to the most
recent pharmacy information card implementation guide produced by the NCPDP.
(b) The Minnesota uniform health care identification card must have an essential
information window on the front side with the following data elements: card issuer name,
electronic transaction routing information, card issuer identification number, cardholder
(insured) identification number, and cardholder (insured) identification name. No optional
data may be interspersed between these data elements.
(c) Standardized labels are required next to human readable data elementsnew text begin and
must come before the human data elementsnew text end .
Sec. 9.
Minnesota Statutes 2006, section 62J.60, subdivision 3, is amended to read:
Subd. 3.
Human readable data elements.
(a) The following are the minimum
human readable data elements that must be present on the front side of the Minnesota
uniform health care identification card:
(1) card issuer name or logo, which is the name or logo that identifies the card issuer.
The card issuer name or logo may be located at the top of the card. No standard label
is required for this data element;
(2) complete electronic transaction routing information including, at a minimum,
the international identification number. The standardized label of this data element
is "RxBIN." Processor control numbers and group numbers are required if needed to
electronically process a prescription drug claim. The standardized label for the process
control numbers data element is "RxPCN" and the standardized label for the group
numbers data element is "RxGrp," except that if the group number data element is a
universal element to be used by all health care providers, the standardized label may be
"Grp." To conserve vertical space on the card, the international identification number and
the processor control number may be printed on the same line;
(3) cardholder (insured) identification number, which is the unique identification
number of the individual card holder established and defined under this section. The
standardized label for the data element is "ID";
(4) cardholder (insured) identification name, which is the name of the individual
card holder. The identification name must be formatted as follows: first name, space,
optional middle initial, space, last name, optional space and name suffix. The standardized
label for this data element is "Name";
(5) care type, which is the description of the group purchaser's plan product under
which the beneficiary is covered. The description shall include the health plan company
name and the plan or product name. The standardized label for this data element is
"Care Type";
(6) service type, which is the description of coverage provided such as hospital,
dental, vision, prescription, or mental healthnew text begin . The standard label for this data element
is "Svc Type"new text end ; and
(7) provider/clinic name, which is the name of the primary care clinic the card
holder is assigned to by the health plan company. The standard label for this field is
"PCP." This information is mandatory only if the health plan company assigns a specific
primary care provider to the card holder.
(b) The following human readable data elements shall be present on the back side
of the Minnesota uniform health care identification card. These elements must be left
justified, and no optional data elements may be interspersed between them:
(1) claims submission names and addresses, which are the names and addresses of
the entity or entities to which claims should be submitted. If different destinations are
required for different types of claims, this must be labeled;
(2) telephone numbers and names that pharmacies and other health care providers
may call for assistance. These telephone numbers and names are required on the back
side of the card only if one of the contacts listed in clause (3) cannot provide pharmacies
or other providers with assistance or with the telephone numbers and names of contacts
for assistance; and
(3) telephone numbers and names; which are the telephone numbers and names of the
following contacts with a standardized label describing the service function as applicable:
(i) eligibility and benefit information;
(ii) utilization review;
(iii) precertification; or
(iv) customer services.
(c) The following human readable data elements are mandatory on the back
side of the Minnesota uniform health care identification card for health maintenance
organizations:
(1) emergency care authorization telephone number or instruction on how to receive
authorization for emergency care. There is no standard label required for this information;
and
(2) one of the following:
(i) telephone number to call to appeal to or file a complaint with the commissioner of
health; or
(ii) for persons enrolled under section 256B.69, 256D.03, or 256L.12, the telephone
number to call to file a complaint with the ombudsperson designated by the commissioner
of human services under section 256B.69 and the address to appeal to the commissioner of
human services. There is no standard label required for this information.
(d) All human readable data elements not required under paragraphs (a) to (c) are
optional and may be used at the issuer's discretion.
Sec. 10.
Minnesota Statutes 2006, section 62Q.80, subdivision 3, is amended to read:
Subd. 3.
Approval.
(a) Prior to the operation of a community-based health care
coverage program, a community-based health initiative shall submit to the commissioner
of health for approval the community-based health care coverage program developed by
the initiative. deleted text begin The commissioner shall only approve a program that has been awarded
a community access program grant from the United States Department of Health and
Human Services.deleted text end The commissioner shall ensure that the program meets the federal grant
requirements and any requirements described in this section and is actuarially sound based
on a review of appropriate records and methods utilized by the community-based health
initiative in establishing premium rates for the community-based health care coverage
program.
(b) Prior to approval, the commissioner shall also ensure that:
(1) the benefits offered comply with subdivision 8 and that there are adequate
numbers of health care providers participating in the community-based health network to
deliver the benefits offered under the program;
(2) the activities of the program are limited to activities that are exempt under this
section or otherwise from regulation by the commissioner of commerce;
(3) the complaint resolution process meets the requirements of subdivision 10; and
(4) the data privacy policies and procedures comply with state and federal law.
Sec. 11.
Minnesota Statutes 2006, section 62Q.80, subdivision 4, is amended to read:
Subd. 4.
Establishment.
deleted text begin (a)deleted text end The initiative shall establish and operate upon approval
by the commissioner of health a community-based health care coverage program. The
operational structure established by the initiative shall include, but is not limited to:
(1) establishing a process for enrolling eligible individuals and their dependents;
(2) collecting and coordinating premiums from enrollees and employers of enrollees;
(3) providing payment to participating providers;
(4) establishing a benefit set according to subdivision 8 and establishing premium
rates and cost-sharing requirements;
(5) creating incentives to encourage primary care and wellness services; and
(6) initiating disease management services, as appropriate.
deleted text begin
(b) The payments collected under paragraph (a), clause (2), may be used to capture
available federal funds.
deleted text end
Sec. 12.
Minnesota Statutes 2006, section 62Q.80, subdivision 13, is amended to read:
Subd. 13.
Report.
(a) The initiative shall submit quarterly status reports to the
commissioner of health on January 15, April 15, July 15, and October 15 of each year,
with the first report due January 15, deleted text begin 2007deleted text end new text begin 2008new text end . The status report shall include:
(1) the financial status of the program, including the premium rates, cost per member
per month, claims paid out, premiums received, and administrative expenses;
(2) a description of the health care benefits offered and the services utilized;
(3) the number of employers participating, the number of employees and dependents
covered under the program, and the number of health care providers participating;
(4) a description of the health outcomes to be achieved by the program and a status
report on the performance measurements to be used and collected; and
(5) any other information requested by the commissioner of health or commerce or
the legislature.
(b) The initiative shall contract with an independent entity to conduct an evaluation
of the program to be submitted to the commissioners of health and commerce and the
legislature by January 15, deleted text begin 2009deleted text end new text begin 2010new text end . The evaluation shall include:
(1) an analysis of the health outcomes established by the initiative and the
performance measurements to determine whether the outcomes are being achieved;
(2) an analysis of the financial status of the program, including the claims to
premiums loss ratio and utilization and cost experience;
(3) the demographics of the enrollees, including their age, gender, family income,
and the number of dependents;
(4) the number of employers and employees who have been denied access to the
program and the basis for the denial;
(5) specific analysis on enrollees who have aggregate medical claims totaling over
$5,000 per year, including data on the enrollee's main diagnosis and whether all the
medical claims were covered by the program;
(6) number of enrollees referred to state public assistance programs;
(7) a comparison of employer-subsidized health coverage provided in a comparable
geographic area to the designated community-based geographic area served by the
program, including, to the extent available:
(i) the difference in the number of employers with 50 or fewer employees offering
employer-subsidized health coverage;
(ii) the difference in uncompensated care being provided in each area; and
(iii) a comparison of health care outcomes and measurements established by the
initiative; and
(8) any other information requested by the commissioner of health or commerce.
Sec. 13.
Minnesota Statutes 2006, section 62Q.80, subdivision 14, is amended to read:
Subd. 14.
Sunset.
This section expires December 31, deleted text begin 2011deleted text end new text begin 2012new text end .
Sec. 14.
Minnesota Statutes 2006, section 144.552, is amended to read:
144.552 PUBLIC INTEREST REVIEW.
(a) The following entities must submit a plan to the commissioner:
(1) a hospital seeking to increase its number of licensed beds; or
(2) an organization seeking to obtain a hospital license and notified by the
commissioner under section 144.553, subdivision 1, paragraph (c), that it is subject
to this section.
The plan must include information that includes an explanation of how the expansion will
meet the public's interest. When submitting a plan to the commissioner, an applicant
shall pay the commissioner for the commissioner's cost of reviewing new text begin and monitoringnew text end the
plan, as determined by the commissioner and notwithstanding section 16A.1283. Money
received by the commissioner under this section is appropriated to the commissioner for
the purpose of administering this section.
(b) Plans submitted under this section shall include detailed information necessary
for the commissioner to review the plan and reach a finding. The commissioner may
request additional information from the hospital submitting a plan under this section and
from others affected by the plan that the commissioner deems necessary to review the
plan and make a finding.
(c) The commissioner shall review the plan and, within 90 days, but no more than
six months if extenuating circumstances apply, issue a finding on whether the plan is in
the public interest. In making the recommendation, the commissioner shall consider
issues including but not limited to:
(1) whether the new hospital or hospital beds are needed to provide timely access to
care or access to new or improved services;
(2) the financial impact of the new hospital or hospital beds on existing acute-care
hospitals that have emergency departments in the region;
(3) how the new hospital or hospital beds will affect the ability of existing hospitals
in the region to maintain existing staff;
(4) the extent to which the new hospital or hospital beds will provide services to
nonpaying or low-income patients relative to the level of services provided to these groups
by existing hospitals in the region; and
(5) the views of affected parties.
new text begin
(d) If the plan is being submitted by an existing hospital seeking authority to
construct a new hospital, the commissioner shall also consider:
new text end
new text begin
(1) the ability of the applicant to maintain the applicant's current level of community
benefit as defined in section 144.699, subdivision 5, at the existing facility; and
new text end
new text begin
(2) the impact on the workforce at the existing facility including the applicant's
plan for:
new text end
new text begin
(i) transitioning current workers to the new facility;
new text end
new text begin
(ii) retraining and employment security for current workers; and
new text end
new text begin
(iii) addressing the impact of layoffs at the existing facility on affected workers.
new text end
new text begin (e) new text end Prior to making a recommendation, the commissioner shall conduct a public
hearing in the affected hospital service area to take testimony from interested persons.
deleted text begin (d)deleted text end new text begin (f)new text end Upon making a recommendation under paragraph (c), the commissioner shall
provide a copy of the recommendation to the chairs of the house and senate committees
having jurisdiction over health and human services policy and finance.
new text begin
(g) If an exception to the moratorium is approved under section 144.551 after a
review under this section, the commissioner shall monitor the implementation of the
exception up to completion of the construction project. Thirty days after completion of
the construction project, the hospital shall submit to the commissioner a report on how
the construction has met the provisions of the plan originally submitted under the public
interest review process or a plan submitted pursuant to section 144.551, subdivision 1,
paragraph (b), clause (20).
new text end
Sec. 15.
Minnesota Statutes 2006, section 144.553, subdivision 3, is amended to read:
Subd. 3.
Process when hospital need is determined.
(a) If the commissioner
determines that a new hospital is needed in the proposed service area, the commissioner
shall notify the applicants of that finding and shall select the applicant determined under
the process established in this subdivision to be best able to provide services consistent
with the review criteria established in this subdivision.
(b) The commissioner shall:
(1) determine market-specific criteria that shall be used to evaluate all proposals.
The criteria must include standards regarding:
(i) access to care;
(ii) quality of care;
(iii) cost of care; and
(iv) overall project feasibility;
(2) establish additional criteria at the commissioner's discretion. In establishing the
criteria, the commissioner shall consider the need for:
(i) mental health services in the service area, including both inpatient and outpatient
services for adults, adolescents, and children;
(ii) a significant commitment to providing uncompensated care, including discounts
for uninsured patients and coordination with other providers of care to low-income
uninsured persons; and
(iii) coordination with other hospitals so that specialized services are not
unnecessarily duplicated and are provided in sufficient volume to ensure the maintenance
of high-quality care; and
(3) define a service area for the proposed hospital. The service area shall consist of:
(i) in the 11-county metropolitan area, in St. Cloud, and in Duluth, the zip codes
located within a 20-mile radius of the proposed new hospital location; and
(ii) in the remainder of the state, the zip codes within a 30-mile radius of the
proposed new hospital location.
(c) new text begin If the plan is being submitted by an existing hospital, the commissioner shall
also consider:
new text end
new text begin
(1) the ability of the applicant to maintain the applicant's current level of community
benefit as defined in section 144.699, subdivision 5, at the existing facility; and
new text end
new text begin
(2) the impact on the workforce at the existing facility including the applicant's
plan for:
new text end
new text begin
(i) transitioning current workers to the new facility;
new text end
new text begin
(ii) retraining and employment security for current workers; and
new text end
new text begin
(iii) addressing the impact of layoffs at the existing facility on affected workers.
new text end
new text begin (d) new text end The commissioner shall publish the criteria determined under deleted text begin paragraphdeleted text end new text begin
paragraphs new text end (b) new text begin and (c) new text end in the State Register within 60 days of the determination under
subdivision 2. Once published, the criteria shall not be modified with respect to the
particular project and applicants to which they apply. The commissioner shall publish with
the criteria guidelines for a proposal and submission review process.
deleted text begin (d)deleted text end new text begin (e)new text end For 60 days after the publication under paragraph deleted text begin (c)deleted text end new text begin (d)new text end , the commissioner
shall accept proposals to construct a hospital from organizations that have submitted a
letter of intent under subdivision 1, paragraph (a), or have notified the commissioner under
subdivision 1, paragraph (b). The proposal must include a plan for the new hospital and
evidence of compliance with the criteria specified under deleted text begin paragraphdeleted text end new text begin paragraphsnew text end (b)new text begin and (c)new text end .
Once submitted, the proposal may not be revised except:
(1) to submit corrections of material facts; or
(2) in response to a request from the commissioner to provide clarification or
further information.
deleted text begin (e)deleted text end new text begin (f)new text end The commissioner shall determine within 90 days of the deadline for
applications under paragraph deleted text begin (d)deleted text end new text begin (e)new text end , which applicant has demonstrated that it is best able
to provide services consistent with the published criteria. The commissioner shall make
this determination by order following a hearing according to this paragraph. The hearing
shall not constitute or be considered to be a contested case hearing under chapter 14 and
shall be conducted solely under the procedures specified in this paragraph. The hearing
shall commence upon at least 30 days' notice to the applicants by the commissioner.
The hearing may be conducted by the commissioner or by a person designated by the
commissioner. The designee may be an administrative law judge. The purpose of the
hearing shall be to receive evidence to assist the commissioner in determining which
applicant has demonstrated that it best meets the published criteria.
The parties to the hearing shall consist only of those applicants who have submitted
a completed application. Each applicant shall have the right to be represented by
counsel, to present evidence deemed relevant by the commissioner, and to examine and
cross-examine witnesses. Persons who are not parties to the proceeding but who wish to
present comments or submit information may do so in the manner determined by the
commissioner or the commissioner's designee. Any person who is not a party shall have
no right to examine or cross-examine witnesses. The commissioner may participate as an
active finder of fact in the hearing and may ask questions to elicit information or clarify
answers or responses.
deleted text begin (f)deleted text end new text begin (g)new text end Prior to making a determination selecting an application, the commissioner
shall hold a public hearing in the proposed hospital service area to accept comments from
members of the public. The commissioner shall take this information into consideration in
making the determination. The commissioner deleted text begin maydeleted text end new text begin shallnew text end appoint an advisory committee,
including legislators and local elected officials who represent the service area and outside
experts to assist in the recommendation process. new text begin The legislative appointees shall include,
at a minimum, the chairs of the senate and house of representatives committees with
jurisdiction over health care policy. new text end The commissioner shall issue an order selecting an
application following the closing of the record of the hearing as determined by the hearing
officer. The commissioner's order shall include a statement of the reasons the selected
application best meets the published criteria.
deleted text begin (g)deleted text end new text begin (h)new text end Within 30 days following the determination under paragraph deleted text begin (e)deleted text end new text begin (f)new text end , the
commissioner shall recommend the selected proposal to the legislature.
new text begin
(i) If an exception to the moratorium is approved under section 144.551 after a
review under this section, the commissioner shall monitor the implementation of the
exception up to completion of the construction project. Thirty days after completion of
the construction project, the hospital shall submit to the commissioner a report on how
the construction has met the provisions of the plan originally submitted under the public
interest review process or a plan submitted pursuant to section 144.551, subdivision 1,
paragraph (b), clause (20).
new text end
Sec. 16.
Minnesota Statutes 2006, section 144.565, is amended to read:
144.565 DIAGNOSTIC IMAGING FACILITIES.
Subdivision 1.
Utilization and services data; economic and financial interests.
The commissioner shall require diagnostic imaging facilities new text begin and providers of diagnostic
imaging services in Minnesota new text end to deleted text begin annuallydeleted text end report new text begin by March 1 each year for the preceding
fiscal year new text end to the commissioner, in the form and manner specified by the commissioner:
(1) utilization data for each health plan company and each public program,
including workers' compensation, deleted text begin as follows:deleted text end new text begin of diagnostic imaging services as defined
in subdivision 4, paragraph (b);
new text end
deleted text begin
(i) the number of computerized tomography (CT) procedures performed;
deleted text end
deleted text begin
(ii) the number of magnetic resonance imaging (MRI) procedures performed; and
deleted text end
deleted text begin
(iii) the number of positron emission tomography (PET) procedures performed; and
deleted text end
(2) the names of new text begin all physicians with any financial or economic interest excluding
salaried physicians, unless the physicians' salary is adjusted for volume of service, and new text end all
new text begin other new text end individuals with a new text begin ten percent or greater new text end financial or economic interest in the facilitydeleted text begin .deleted text end new text begin ;
new text end
new text begin
(3) the location where procedures were performed;
new text end
new text begin
(4) the number of units of each type of fixed, portable, and mobile scanner used at
each location;
new text end
new text begin
(5) the average number of hours per month each mobile scanner was operated at
each location;
new text end
new text begin
(6) the number of hours per month each scanner was leased, if applicable;
new text end
new text begin
(7) the total number of diagnostic imaging procedures billed for by the provider at
each location, by type of diagnostic imaging service as defined in subdivision 4, paragraph
(b); and
new text end
new text begin
(8) a report on major health care capital expenditures during the previous year, as
required by section 62J.17.
new text end
Subd. 2.
Commissioner's right to inspect records.
If the report is not filed or
the commissioner of health has reason to believe the report is incomplete or false, the
commissioner shall have the right to inspect diagnostic imaging facility books, audits,
and records.
Subd. 3.
Separate reports.
deleted text begin For a diagnostic imaging facility that is not attached
or not contiguous to a hospital or a hospital affiliate, the commissioner shall require
the information in subdivision 1 be reported separately for each detached diagnostic
imaging facility as part of the report required under section 144.702.deleted text end If any entity owns
more than one diagnostic imaging facility, that entity must report by individual facility.
new text begin Reports must include only services that were billed by the provider of diagnostic imaging
services submitting the report. If a diagnostic imaging facility leases capacity, technical
services, or professional services to one or more other providers of diagnostic imaging
services, each provider must submit a separate annual report to the commissioner for all
diagnostic imaging services that it provided and billed. The owner of the leased capacity
must provide a report listing the names and addresses of providers to whom the diagnostic
imaging services and equipment were leased.
new text end
Subd. 4.
Definitions.
For purposes of this section, the following terms have the
meanings given:
(a) "Diagnostic imaging facility" means a health care facility that deleted text begin providesdeleted text end new text begin is not
a hospital or location licensed as a hospital which offers new text end diagnostic imaging services
deleted text begin through the use of ionizing radiation or other imaging technique including, but not limited
to magnetic resonance imaging (MRI) or computerized tomography (CT) scan on a
freestanding or mobile basisdeleted text end new text begin in Minnesota, regardless of whether the equipment used
to provide the service is owned or leased.new text end new text begin For the purposes of this section, diagnostic
imaging facility includes, but is not limited to, facilities such as a physician's office, clinic,
mobile transport vehicle, outpatient imaging center, or surgical centernew text end .
new text begin
(b) "Diagnostic imaging service" means the use of ionizing radiation or other
imaging technique on a human patient including, but not limited to, magnetic resonance
imaging (MRI) or computerized tomography (CT), positron emission tomography (PET),
or single photon emission computerized tomography (SPECT) scans using fixed, portable,
or mobile equipment.
new text end
deleted text begin (b)deleted text end new text begin (c) new text end "Financial or economic interest" means a direct or indirect:
(1) equity or debt security issued by an entity, including, but not limited to, shares of
stock in a corporation, membership in a limited liability company, beneficial interest in
a trust, units or other interests in a partnership, bonds, debentures, notes or other equity
interests or debt instruments, or any contractual arrangements;
(2) membership, proprietary interest, or co-ownership with an individual, group, or
organization to which patients, clients, or customers are referred to; or
(3) employer-employee or independent contractor relationship, including, but not
limited to, those that may occur in a limited partnership, profit-sharing arrangement, or
other similar arrangement with any facility to which patients are referred, including any
compensation between a facility and a health care provider, the group practice of which
the provider is a member or employee or a related party with respect to any of them.
deleted text begin (c)deleted text end new text begin (d) new text end "deleted text begin Freestandingdeleted text end new text begin Fixed equipmentnew text end " means a new text begin stationary new text end diagnostic imaging
deleted text begin facility that is not located within a:deleted text end new text begin machine installed in a permanent location.
new text end
deleted text begin
(1) hospital;
deleted text end
deleted text begin
(2) location licensed as a hospital; or
deleted text end
deleted text begin
(3) physician's office or clinic where the professional practice of medicine by
licensed physicians is the primary purpose and not the provision of ancillary services
such as diagnostic imaging.
deleted text end
deleted text begin (d)deleted text end new text begin (e) new text end "Mobilenew text begin equipmentnew text end " means a diagnostic imaging deleted text begin facility that is transported to
various sites not including movement within a hospital or a physician's office or clinicdeleted text end new text begin
machine in a self-contained transport vehicle designed to be brought to a temporary offsite
location to perform diagnostic imaging servicesnew text end .
new text begin
(f) "Portable equipment" means a diagnostic imaging machine designed to be
temporarily transported within a permanent location to perform diagnostic imaging
services.
new text end
new text begin
(g) "Provider of diagnostic imaging services" means a diagnostic imaging facility
or an entity that offers and bills for diagnostic imaging services at a facility owned or
leased by the entity.
new text end
new text begin Subd. 5. new text end
new text begin Reports open to public inspection. new text end
new text begin
All reports filed pursuant to this
section shall be open to public inspection.
new text end
Sec. 17.
new text begin
[144.585] METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS
CONTROL PROGRAMS.
new text end
new text begin
In order to improve the prevention of hospital-associated infections due
to methicillin-resistant Staphylococcus aureus ("MRSA"), every hospital shall
establish an MRSA control program that meets Minnesota Department of Health
MRSA recommendations as published January 15, 2008. In developing the MRSA
recommendations, the Department of Health shall consider the following infection control
practices:
new text end
new text begin
(1) identification of MRSA-colonized patients in all intensive care units, or other
at-risk patients identified by the hospital;
new text end
new text begin
(2) isolation of identified MRSA-colonized or MRSA-infected patients in an
appropriate manner;
new text end
new text begin
(3) adherence to hand hygiene requirements; and
new text end
new text begin
(4) monitor trends in the incidence of MRSA in the hospital over time and modify
interventions if MRSA infection rates do not decrease.
new text end
new text begin
The Department of Health shall review the MRSA recommendations on an annual basis
and revise the recommendations as necessary, in accordance with available scientific data.
new text end
Sec. 18.
Minnesota Statutes 2006, section 144.651, subdivision 9, is amended to read:
Subd. 9.
Information about treatment.
Patients and residents shall be given by
their physicians complete and current information concerning their diagnosis, treatment,
alternatives, risks, and prognosis as required by the physician's legal duty to disclose. This
information shall be in terms and language the patients or residents can reasonably be
expected to understand. Patients and residents may be accompanied by a family member
or other chosen representativenew text begin , or bothnew text end . This information shall include the likely medical
or major psychological results of the treatment and its alternatives. In cases where it is
medically inadvisable, as documented by the attending physician in a patient's or resident's
medical record, the information shall be given to the patient's or resident's guardian or
other person designated by the patient or resident as a representative. Individuals have the
right to refuse this information.
Every patient or resident suffering from any form of breast cancer shall be fully
informed, prior to or at the time of admission and during her stay, of all alternative
effective methods of treatment of which the treating physician is knowledgeable, including
surgical, radiological, or chemotherapeutic treatments or combinations of treatments and
the risks associated with each of those methods.
Sec. 19.
Minnesota Statutes 2006, section 144.651, subdivision 10, is amended to read:
Subd. 10.
Participation in planning treatment; notification of family members.
(a) Patients and residents shall have the right to participate in the planning of their
health care. This right includes the opportunity to discuss treatment and alternatives
with individual caregivers, the opportunity to request and participate in formal care
conferences, and the right to include a family member or other chosen representativenew text begin , or
bothnew text end . In the event that the patient or resident cannot be present, a family member or other
representative chosen by the patient or resident may be included in such conferences.new text begin A
chosen representative may include a doula of the patient's choice.
new text end
(b) If a patient or resident who enters a facility is unconscious or comatose or is
unable to communicate, the facility shall make reasonable efforts as required under
paragraph (c) to notify either a family member or a person designated in writing by the
patient as the person to contact in an emergency that the patient or resident has been
admitted to the facility. The facility shall allow the family member to participate in
treatment planning, unless the facility knows or has reason to believe the patient or
resident has an effective advance directive to the contrary or knows the patient or resident
has specified in writing that they do not want a family member included in treatment
planning. After notifying a family member but prior to allowing a family member to
participate in treatment planning, the facility must make reasonable efforts, consistent
with reasonable medical practice, to determine if the patient or resident has executed an
advance directive relative to the patient or resident's health care decisions. For purposes of
this paragraph, "reasonable efforts" include:
(1) examining the personal effects of the patient or resident;
(2) examining the medical records of the patient or resident in the possession
of the facility;
(3) inquiring of any emergency contact or family member contacted under this
section whether the patient or resident has executed an advance directive and whether the
patient or resident has a physician to whom the patient or resident normally goes for
care; and
(4) inquiring of the physician to whom the patient or resident normally goes for care,
if known, whether the patient or resident has executed an advance directive. If a facility
notifies a family member or designated emergency contact or allows a family member
to participate in treatment planning in accordance with this paragraph, the facility is not
liable to the patient or resident for damages on the grounds that the notification of the
family member or emergency contact or the participation of the family member was
improper or violated the patient's privacy rights.
(c) In making reasonable efforts to notify a family member or designated emergency
contact, the facility shall attempt to identify family members or a designated emergency
contact by examining the personal effects of the patient or resident and the medical records
of the patient or resident in the possession of the facility. If the facility is unable to notify
a family member or designated emergency contact within 24 hours after the admission,
the facility shall notify the county social service agency or local law enforcement agency
that the patient or resident has been admitted and the facility has been unable to notify a
family member or designated emergency contact. The county social service agency and
local law enforcement agency shall assist the facility in identifying and notifying a family
member or designated emergency contact. A county social service agency or local law
enforcement agency that assists a facility in implementing this subdivision is not liable
to the patient or resident for damages on the grounds that the notification of the family
member or emergency contact or the participation of the family member was improper or
violated the patient's privacy rights.
Sec. 20.
Minnesota Statutes 2006, section 144.651, subdivision 26, is amended to read:
Subd. 26.
Right to associate.
new text begin (a) new text end Residents may meet with new text begin and receive new text end visitors
and participate in activities of commercial, religious, political, as defined in section
203B.11 and community groups without interference at their discretion if the activities
do not infringe on the right to privacy of other residents or are not programmatically
contraindicated. This includesnew text begin :new text end
new text begin (1)new text end the right to join with other individuals within and outside the facility to work for
improvements in long-term carenew text begin ;
new text end
new text begin
(2) the right to visitation by an individual the patient has appointed as the patient's
health care agent under chapter 145C;
new text end
new text begin (3) the right to visitation and health care decision making by an individual designated
by the patient under paragraph (c)new text end .
new text begin (b) new text end Upon admission to a facility where federal law prohibits unauthorized disclosure
of patient or resident identifying information to callers and visitors, the patient or
resident, or the legal guardian or conservator of the patient or resident, shall be given the
opportunity to authorize disclosure of the patient's or resident's presence in the facility
to callers and visitors who may seek to communicate with the patient or resident. To the
extent possible, the legal guardian or conservator of a patient or resident shall consider the
opinions of the patient or resident regarding the disclosure of the patient's or resident's
presence in the facility.
new text begin
(c) Upon admission to a facility, the patient or resident, or the legal guardian
or conservator of the patient or resident, must be given the opportunity to designate
a person who is not related who will have the status of the patient's next of kin with
respect to visitation and making a health care decision. A designation must be included
in the patient's health record. With respect to making a health care decision, a health
care directive or appointment of a health care agent under chapter 145C prevails over a
designation made under this paragraph. The unrelated person may also be identified as
such by the patient or by the patient's family.
new text end
Sec. 21.
Minnesota Statutes 2006, section 144.699, is amended by adding a subdivision
to read:
new text begin Subd. 5. new text end
new text begin
Annual reports on community benefit, community care amounts, and
state program underfunding.
new text end
new text begin
(a) For each hospital reporting health care cost information
under section 144.698 or 144.702, the commissioner shall report annually on the
hospital's community benefit and community care, including detailed information on each
component of those costs as defined in this subdivision. The information shall be reported
in terms of total dollars and as a percentage of total operating costs for each hospital.
new text end
new text begin
(b) For purposes of this subdivision, "community benefit" means the costs of
community care, underpayment for services provided under state health care programs,
research costs, community health services costs, financial and in-kind contributions, costs
of community building activities, costs of community benefit operations, education costs,
and the cost of operating subsidized services. The cost of bad debts and underpayment for
Medicare services are not included in the calculation of community benefit.
new text end
new text begin
(c) For purposes of this subdivision, "community care" means the costs for medical
care that a hospital has determined is charity care as defined under Minnesota Rules, part
4650.0115, or for which the hospital determines after billing for the services that there is a
demonstrated inability to pay. Any costs forgiven under a hospital's community care plan
or under section 62J.83 may be counted in the hospital's calculation of community care.
Bad debt expenses and discounted charges available to the uninsured shall not be included
in the calculation of community care. The amount of community care is the value of costs
incurred and not the charges made for services.
new text end
new text begin
(d) For purposes of this subdivision, "underpayment for services provided under
state health care programs" means the difference between hospital costs and public
program payments.
new text end
Sec. 22.
Minnesota Statutes 2006, section 145C.05, is amended to read:
145C.05 SUGGESTED FORMnew text begin ; PROVISIONS THAT MAY BE INCLUDEDnew text end .
Subdivision 1.
Content.
A health care directive executed pursuant to this chapter
may, but need not, be in the form contained in section 145C.16.
Subd. 2.
Provisions that may be included.
(a) A health care directive may include
provisions consistent with this chapter, including, but not limited to:
(1) the designation of one or more alternate health care agents to act if the named
health care agent is not reasonably available to serve;
(2) directions to joint health care agents regarding the process or standards by which
the health care agents are to reach a health care decision for the principal, and a statement
whether joint health care agents may act independently of one another;
(3) limitations, if any, on the right of the health care agent or any alternate health
care agents to receive, review, obtain copies of, and consent to the disclosure of the
principal's medical recordsnew text begin or to visit the principal when the principal is a patient in a
health care facilitynew text end ;
(4) limitations, if any, on the nomination of the health care agent as guardian for
purposes of sections 524.5-202, 524.5-211, 524.5-302, and 524.5-303;
(5) a document of gift for the purpose of making an anatomical gift, as set forth in
sections 525.921 to 525.9224, or an amendment to, revocation of, or refusal to make
an anatomical gift;
(6) a declaration regarding intrusive mental health treatment under section 253B.03,
subdivision 6d, or a statement that the health care agent is authorized to give consent for
the principal under section 253B.04, subdivision 1a;
(7) a funeral directive as provided in section 149A.80, subdivision 2;
(8) limitations, if any, to the effect of dissolution or annulment of marriage or
termination of domestic partnership on the appointment of a health care agent under
section 145C.09, subdivision 2;
(9) specific reasons why a principal wants a health care provider or an employee
of a health care provider attending the principal to be eligible to act as the principal's
health care agent;
(10) health care instructions by a woman of child bearing age regarding how she
would like her pregnancy, if any, to affect health care decisions made on her behalf; and
(11) health care instructions regarding artificially administered nutrition or hydration.
(b) A health care directive may include a statement of the circumstances under
which the directive becomes effective other than upon the judgment of the principal's
attending physician in the following situations:
(1) a principal who in good faith generally selects and depends upon spiritual means
or prayer for the treatment or care of disease or remedial care and does not have an
attending physician, may include a statement appointing an individual who may determine
the principal's decision-making capacity; and
(2) a principal who in good faith does not generally select a physician or a health
care facility for the principal's health care needs may include a statement appointing an
individual who may determine the principal's decision-making capacity, provided that if
the need to determine the principal's capacity arises when the principal is receiving care
under the direction of an attending physician in a health care facility, the determination
must be made by an attending physician after consultation with the appointed individual.
If a person appointed under clause (1) or (2) is not reasonably available and the
principal is receiving care under the direction of an attending physician in a health care
facility, an attending physician shall determine the principal's decision-making capacity.
(c) A health care directive may authorize a health care agent to make health care
decisions for a principal even though the principal retains decision-making capacity.
Sec. 23.
Minnesota Statutes 2006, section 145C.07, is amended by adding a
subdivision to read:
new text begin Subd. 5. new text end
new text begin Visitation. new text end
new text begin
A health care agent may visit the principal when the
principal is a patient in a health care facility regardless of whether the principal retains
decision-making capacity, unless:
new text end
new text begin
(1) the principal has otherwise specified in the health care directive;
new text end
new text begin
(2) a principal who retains decision-making capacity indicates otherwise; or
new text end
new text begin
(3) a health care provider reasonably determines that the principal must be isolated
from all visitors or that the presence of the health care agent would endanger the health or
safety of the principal, other patients, or the facility in which the care is being provided.
new text end
Sec. 24.
Minnesota Statutes 2006, section 148.6445, subdivision 1, is amended to read:
Subdivision 1.
Initial licensure fee.
The initial licensure fee for occupational
therapists is deleted text begin $180deleted text end new text begin $145new text end . The initial licensure fee for occupational therapy assistants is
deleted text begin $100deleted text end new text begin $80new text end . The commissioner shall prorate fees based on the number of quarters remaining
in the biennial licensure period.
Sec. 25.
Minnesota Statutes 2006, section 148.6445, subdivision 2, is amended to read:
Subd. 2.
Licensure renewal fee.
The biennial licensure renewal fee for
occupational therapists is deleted text begin $180deleted text end new text begin $145new text end . The biennial licensure renewal fee for occupational
therapy assistants is deleted text begin $100deleted text end new text begin $80new text end .
Sec. 26.
new text begin
[148.785] FEES.
new text end
new text begin
The fees charged by the board are fixed at the following rates:
new text end
new text begin
(1) application fee for physical therapists and physical therapist assistants, $100;
new text end
new text begin
(2) annual licensure for physical therapists and physical therapist assistants, $60;
new text end
new text begin
(3) licensure renewal late fee, $20;
new text end
new text begin
(4) temporary permit, $25;
new text end
new text begin
(5) duplicate license or registration, $20;
new text end
new text begin
(6) certification letter, $25;
new text end
new text begin
(7) education or training program approval, $100;
new text end
new text begin
(8) report creation and generation, $60 per hour billed in quarter-hour increments
with a quarter-hour minimum; and
new text end
new text begin
(9) examination administration:
new text end
new text begin
(i) half day, $50; and
new text end
new text begin
(ii) full day, $80.
new text end
Sec. 27.
new text begin
[148.995] DEFINITIONS.
new text end
new text begin Subdivision 1. new text end
new text begin Applicability. new text end
new text begin
The definitions in this section apply to sections
148.995 to 148.997.
new text end
new text begin Subd. 2. new text end
new text begin Certified doula. new text end
new text begin
"Certified doula" means an individual who has received
a certification to perform doula services from the International Childbirth Education
Association, the Doulas of North America (DONA), the Association of Labor Assistants
and Childbirth Educators (ALACE), Birthworks, Childbirth and Postpartum Professional
Association (CAPPA), or Childbirth International.
new text end
new text begin Subd. 3. new text end
new text begin Commissioner. new text end
new text begin
"Commissioner" means the commissioner of health.
new text end
new text begin Subd. 4. new text end
new text begin Doula services. new text end
new text begin
"Doula services" means emotional and physical support
during pregnancy, labor, birth, and postpartum.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2007.
new text end
Sec. 28.
new text begin
[148.996] REGISTRY.
new text end
new text begin Subdivision 1. new text end
new text begin Establishment. new text end
new text begin
The commissioner of health shall maintain a registry
of certified doulas who have met the requirements listed in subdivision 2.
new text end
new text begin Subd. 2. new text end
new text begin Qualifications. new text end
new text begin
The commissioner shall include on the registry any
individual who:
new text end
new text begin
(1) submits an application on a form provided by the commissioner. The form must
include the applicant's name, address, and contact information;
new text end
new text begin
(2) maintains a current certification from one of the organizations listed in section
146B.01, subdivision 2; and
new text end
new text begin
(3) pays the fees required under section 148.997.
new text end
new text begin Subd. 3. new text end
new text begin Criminal background check. new text end
new text begin
The commissioner shall conduct a
criminal background check by reviewing the Bureau of Criminal Apprehension's Web
site. If the review indicates that an applicant has been engaged in criminal behavior,
the commissioner shall indicate this on the registry and provide a link to the Bureau of
Criminal Apprehension's Web site.
new text end
new text begin Subd. 4. new text end
new text begin Renewal. new text end
new text begin
Inclusion on the registry maintained by the commissioner is
valid for three years. At the end of the three-year period, the certified doula may submit a
new application to remain on the doula registry by meeting the requirements described in
subdivision 2.
new text end
new text begin Subd. 5. new text end
new text begin Public access. new text end
new text begin
The commissioner shall provide a link to the registry
on the Department of Health's Web site.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2007.
new text end
Sec. 29.
new text begin
[148.997] FEES.
new text end
new text begin Subdivision 1. new text end
new text begin Fees. new text end
new text begin
(a) The application fee is $130.
new text end
new text begin
(b) The criminal background check fee is $6.
new text end
new text begin Subd. 2. new text end
new text begin Nonrefundable fees. new text end
new text begin
The fees in this section are nonrefundable.
new text end
new text begin Subd. 3. new text end
new text begin Deposit. new text end
new text begin
Fees received under sections 148.995 to 148.997 shall be
deposited in the state government special revenue fund.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2007.
new text end
Sec. 30.
Minnesota Statutes 2006, section 148B.53, subdivision 3, is amended to read:
Subd. 3.
Fee.
Nonrefundable fees are as follows:
(1) initial license application fee for licensed professional counseling (LPC) - deleted text begin $250deleted text end new text begin
$150new text end ;
(2) new text begin initial license fee for LPC - $250;
new text end
new text begin (3) new text end annual active license renewal fee for LPC - deleted text begin $200deleted text end new text begin $250new text end or equivalent;
deleted text begin (3)deleted text end new text begin (4)new text end annual inactive license renewal fee for LPC - deleted text begin $100deleted text end new text begin $125new text end ;
new text begin
(5) initial license application fee for licensed professional clinical counseling
(LPCC) - $150;
new text end
new text begin
(6) initial license fee for LPCC - $250;
new text end
new text begin
(7) annual active license renewal fee for LPCC - $250 or equivalent;
new text end
new text begin
(8) annual inactive license renewal fee for LPCC - $125;
new text end
deleted text begin (4)deleted text end new text begin (9)new text end license renewal late fee - $100 per month or portion thereof;
deleted text begin (5)deleted text end new text begin (10)new text end copy of board order or stipulation - $10;
deleted text begin (6)deleted text end new text begin (11)new text end certificate of good standing or license verification - deleted text begin $10deleted text end new text begin $25new text end ;
deleted text begin (7)deleted text end new text begin (12)new text end duplicate certificate fee - deleted text begin $10deleted text end new text begin $25new text end ;
deleted text begin (8)deleted text end new text begin (13)new text end professional firm renewal fee - $25;
deleted text begin
(9)
deleted text end
new text begin
(14) sponsor application for approval of a continuing education course - $60;
new text end
new text begin (15)new text end initial registration fee - $50; deleted text begin and
deleted text end
deleted text begin (10)deleted text end new text begin (16)new text end annual registration renewal fee - $25new text begin ; and
new text end
new text begin (17) approved supervisor application processing fee - $30new text end .
Sec. 31.
Minnesota Statutes 2006, section 149A.52, subdivision 3, is amended to read:
Subd. 3.
Application procedure; documentation; initial inspection.
An applicant
for a license to operate a crematory shall submit to the commissioner a completed
application. A completed application includes:
(1) a completed application form, as provided by the commissioner;
(2) proof of business form and ownership; and
(3) proof of liability insurance coverage or other financial documentation, as
determined by the commissioner, that demonstrates the applicant's ability to respond in
damages for liability arising from the ownership, maintenance, management, or operation
of a crematory.
Upon receipt of the applicationnew text begin and appropriate feenew text end , the commissioner shall review
and verify all information. Upon completion of the verification process and resolution
of any deficiencies in the application information, the commissioner shall conduct an
initial inspection of the premises to be licensed. After the inspection and resolution of
any deficiencies found and any reinspections as may be necessary, the commissioner shall
make a determination, based on all the information available, to grant or deny licensure. If
the commissioner's determination is to grant the license, the applicant shall be notified and
the license shall issue and remain valid for a period prescribed on the license, but not to
exceed one calendar year from the date of issuance of the license. If the commissioner's
determination is to deny the license, the commissioner must notify the applicant, in
writing, of the denial and provide the specific reason for denial.
Sec. 32.
new text begin
[149A.65] FEES.
new text end
new text begin Subdivision 1. new text end
new text begin Generally. new text end
new text begin
This section establishes the fees for registrations,
examinations, initial and renewal licenses, and late fees authorized under the provisions
of this chapter.
new text end
new text begin Subd. 2. new text end
new text begin Mortuary science fees. new text end
new text begin
Fees for mortuary science are:
new text end
new text begin
(1) $50 for the initial and renewal registration of a mortuary science intern;
new text end
new text begin
(2) $100 for the mortuary science examination;
new text end
new text begin
(3) $125 for issuance of initial and renewal mortuary science licenses;
new text end
new text begin
(4) $25 late fee charge for a license renewal; and
new text end
new text begin
(5) $200 for issuing a mortuary science license by endorsement.
new text end
new text begin Subd. 3. new text end
new text begin Funeral directors. new text end
new text begin
The license renewal fee for funeral directors is $125.
The late fee charge for a license renewal is $25.
new text end
new text begin Subd. 4. new text end
new text begin Funeral establishments. new text end
new text begin
The initial and renewal fee for funeral
establishments is $300. The late fee charge for a license renewal is $25.
new text end
new text begin Subd. 5. new text end
new text begin Crematories. new text end
new text begin
The initial and renewal fee for a crematory is $300. The
late fee charge for a license renewal is $25.
new text end
Sec. 33.
Minnesota Statutes 2006, section 149A.97, subdivision 7, is amended to read:
Subd. 7.
Reports to commissioner.
Every funeral provider lawfully doing business
in Minnesota that accepts funds under subdivision 2 must make a complete annual report
to the commissioner. The reports may be on forms provided by the commissioner or
substantially similar forms containing, at least, identification and the state of each trust
account, including all transactions involving principal and accrued interest, and must be
filed by March 31 of the calendar year following the reporting year along with a filing
fee of deleted text begin $15deleted text end new text begin $25new text end for each report. Fees shall be paid to the commissioner of finance, state of
Minnesota, for deposit in the state government special revenue fund in the state treasury.
Reports must be signed by an authorized representative of the funeral provider and
notarized under oath. All reports to the commissioner shall be reviewed for account
inaccuracies or possible violations of this section. If the commissioner has a reasonable
belief to suspect that there are account irregularities or possible violations of this section,
the commissioner shall report that belief, in a timely manner, to the state auditor. The
commissioner shall also file an annual letter with the state auditor disclosing whether or
not any irregularities or possible violations were detected in review of the annual trust
fund reports filed by the funeral providers. This letter shall be filed with the state auditor
by May 31 of the calendar year following the reporting year.
Sec. 34.
Minnesota Statutes 2006, section 157.16, subdivision 1, is amended to read:
Subdivision 1.
License required annually.
A license is required annually for every
person, firm, or corporation engaged in the business of conducting a food and beverage
service establishment, hotel, motel, lodging establishment, or resort. Any person wishing
to operate a place of business licensed in this section shall first make application, pay the
required fee specified in this section, and receive approval for operation, including plan
review approval. Seasonal and temporary food stands and special event food stands are
not required to submit plans. new text begin Nonprofit organizations operating a special event food
stand with multiple locations at an annual one-day event shall be issued only one license.
new text end Application shall be made on forms provided by the commissioner and shall require
the applicant to state the full name and address of the owner of the building, structure,
or enclosure, the lessee and manager of the food and beverage service establishment,
hotel, motel, lodging establishment, or resort; the name under which the business is to
be conducted; and any other information as may be required by the commissioner to
complete the application for license.
Sec. 35. new text begin INJUNCTIVE RELIEF REPORT.
new text end
new text begin
The commissioner of health shall present to the 2008 legislature, by December 15,
2007, recommendations to fund the cost of bringing actions for injunctive relief under
Minnesota Statutes, section 144G.02, subdivision 2, paragraph (b).
new text end
Sec. 36. new text begin HEARING AID DISPENSER FEES.
new text end
new text begin
Fees relating to hearing aid dispensers, as provided in Minnesota Statutes, section
153A.17, may not be increased until after the Department of Health provides a report to
the legislature regarding the need and reasons for fee increases.
new text end
Sec. 37. new text begin APPROPRIATION.
new text end
new text begin
$18,000 in fiscal year 2008 and $5,000 in fiscal year 2009 are appropriated to the
commissioner of health from the state government special revenue fund to implement the
doula registry in Minnesota Statutes, sections 148.995 to 148.997.
new text end
Sec. 38. new text begin REPEALER.
new text end
new text begin
Minnesota Rules, part 4610.2800,
new text end
new text begin
is repealed.
new text end
ARTICLE 10
DEPARTMENT OF HEALTH
Section 1.
Minnesota Statutes 2006, section 62Q.80, is amended by adding a
subdivision to read:
new text begin Subd. 1a. new text end
new text begin Demonstration project. new text end
new text begin
The commissioner of health shall award a
demonstration project grant to a community-based health care initiative to develop and
operate a community-based health care coverage program to operate within Carlton, Cook,
Lake, and St. Louis County. The demonstration project shall extend for five years and
must comply with the requirements of this section.
new text end
Sec. 2.
new text begin
[144.291] MINNESOTA HEALTH RECORDS ACT.
new text end
new text begin Subdivision 1. new text end
new text begin Short title. new text end
new text begin
Sections 144.291 to 144.298 may be cited as the
Minnesota Health Records Act.
new text end
new text begin Subd. 2. new text end
new text begin Definitions. new text end
new text begin
For the purposes of sections 144.291 to 144.298, the following
terms have the meanings given.
new text end
new text begin
(a) new text begin Group purchaser.new text end "Group purchaser" has the meaning given in section 62J.03,
subdivision 6.
new text end
new text begin
(b) Health information exchange. "Health information exchange" means a legal
arrangement between health care providers and group purchasers to enable and oversee the
business and legal issues involved in the electronic exchange of health records between
the entities for the delivery of patient care.
new text end
new text begin
(c) new text begin Health record.new text end "Health record" means any information, whether oral or recorded
in any form or medium, that relates to the past, present, or future physical or mental health
or condition of a patient; the provision of health care to a patient; or the past, present, or
future payment for the provision of health care to a patient.
new text end
new text begin
(d) new text begin Identifying information.new text end "Identifying information" means the patient's name,
address, date of birth, gender, parent's or guardian's name regardless of the age of the
patient, and other nonclinical data which can be used to uniquely identify a patient.
new text end
new text begin
(e) new text begin Individually identifiable form.new text end "Individually identifiable form" means a form in
which the patient is or can be identified as the subject of the health records.
new text end
new text begin
(f) new text begin Medical emergency.new text end "Medical emergency" means medically necessary care
which is immediately needed to preserve life, prevent serious impairment to bodily
functions, organs, or parts, or prevent placing the physical or mental health of the patient
in serious jeopardy.
new text end
new text begin
(g) new text begin Patient.new text end "Patient" means a natural person who has received health care services
from a provider for treatment or examination of a medical, psychiatric, or mental
condition, the surviving spouse and parents of a deceased patient, or a person the patient
appoints in writing as a representative, including a health care agent acting according to
chapter 145C, unless the authority of the agent has been limited by the principal in the
principal's health care directive. Except for minors who have received health care services
under sections 144.341 to 144.347, in the case of a minor, patient includes a parent or
guardian, or a person acting as a parent or guardian in the absence of a parent or guardian.
new text end
new text begin
(h) new text begin Provider.new text end "Provider" means:
new text end
new text begin
(1) any person who furnishes health care services and is regulated to furnish the
services under chapter 147, 147A, 147B, 147C, 147D, 148, 148B, 148C, 148D, 150A,
151, 153, or 153A;
new text end
new text begin
(2) a home care provider licensed under section 144A.46;
new text end
new text begin
(3) a health care facility licensed under this chapter or chapter 144A;
new text end
new text begin
(4) a physician assistant registered under chapter 147A; and
new text end
new text begin
(5) an unlicensed mental health practitioner regulated under sections 148B.60 to
148B.71.
new text end
new text begin
(i) new text begin Record locator service.new text end "Record locator service" means an electronic index of
patient identifying information that directs providers in a health information exchange to
the location of patient health records held by providers and group purchasers.
new text end
new text begin
(j) new text begin Related health care entity.new text end "Related health care entity" means an affiliate, as
defined in section 144.6521, subdivision 3, paragraph (b), of the provider releasing the
health records.
new text end
Sec. 3.
new text begin
[144.292] PATIENT RIGHTS.
new text end
new text begin Subdivision 1. new text end
new text begin Scope. new text end
new text begin
Patients have the rights specified in this section regarding the
treatment the patient receives and the patient's health record.
new text end
new text begin Subd. 2. new text end
new text begin Patient access. new text end
new text begin
Upon request, a provider shall supply to a patient complete
and current information possessed by that provider concerning any diagnosis, treatment,
and prognosis of the patient in terms and language the patient can reasonably be expected
to understand.
new text end
new text begin Subd. 3. new text end
new text begin Additional patient rights. new text end
new text begin
A patient's right specified in this section and
sections 144.293 to 144.298 are in addition to the rights specified in sections 144.651 and
144.652 and any other provision of law relating to the access of a patient to the patient's
health records.
new text end
new text begin Subd. 4. new text end
new text begin Notice of rights; information on release. new text end
new text begin
A provider shall provide to
patients, in a clear and conspicuous manner, a written notice concerning practices and
rights with respect to access to health records. The notice must include an explanation of:
new text end
new text begin
(1) disclosures of health records that may be made without the written consent of the
patient, including the type of records and to whom the records may be disclosed; and
new text end
new text begin
(2) the right of the patient to have access to and obtain copies of the patient's health
records and other information about the patient that is maintained by the provider.
new text end
new text begin
The notice requirements of this subdivision are satisfied if the notice is included with
the notice and copy of the patient and resident bill of rights under section 144.652 or if it
is displayed prominently in the provider's place of business. The commissioner of health
shall develop the notice required in this subdivision and publish it in the State Register.
new text end
new text begin Subd. 5. new text end
new text begin Copies of health records to patients. new text end
new text begin
Except as provided in section
144.296, upon a patient's written request, a provider, at a reasonable cost to the patient,
shall promptly furnish to the patient:
new text end
new text begin
(1) copies of the patient's health record, including but not limited to laboratory
reports, x-rays, prescriptions, and other technical information used in assessing the
patient's health conditions; or
new text end
new text begin
(2) the pertinent portion of the record relating to a condition specified by the patient.
new text end
new text begin
With the consent of the patient, the provider may instead furnish only a summary
of the record. The provider may exclude from the health record written speculations
about the patient's health condition, except that all information necessary for the patient's
informed consent must be provided.
new text end
new text begin Subd. 6. new text end
new text begin Cost. new text end
new text begin
(a) When a patient requests a copy of the patient's record for
purposes of reviewing current medical care, the provider must not charge a fee.
new text end
new text begin
(b) When a provider or its representative makes copies of patient records upon a
patient's request under this section, the provider or its representative may charge the
patient or the patient's representative no more than 75 cents per page, plus $10 for time
spent retrieving and copying the records, unless other law or a rule or contract provide for
a lower maximum charge. This limitation does not apply to x-rays. The provider may
charge a patient no more than the actual cost of reproducing x-rays, plus no more than
$10 for the time spent retrieving and copying the x-rays.
new text end
new text begin
(c) The respective maximum charges of 75 cents per page and $10 for time provided
in this subdivision are in effect for calendar year 1992 and may be adjusted annually each
calendar year as provided in this subdivision. The permissible maximum charges shall
change each year by an amount that reflects the change, as compared to the previous year,
in the Consumer Price Index for all Urban Consumers, Minneapolis-St. Paul (CPI-U),
published by the Department of Labor.
new text end
new text begin
(d) A provider or its representative must not charge a fee to provide copies of records
requested by a patient or the patient's authorized representative if the request for copies
of records is for purposes of appealing a denial of Social Security disability income or
Social Security disability benefits under title II or title XVI of the Social Security Act. For
the purpose of further appeals, a patient may receive no more than two medical record
updates without charge, but only for medical record information previously not provided.
For purposes of this paragraph, a patient's authorized representative does not include units
of state government engaged in the adjudication of Social Security disability claims.
new text end
new text begin Subd. 7. new text end
new text begin Withholding health records from patient. new text end
new text begin
(a) If a provider, as defined in
section 144.291, subdivision 2, paragraph (h), clause (1), reasonably determines that the
information is detrimental to the physical or mental health of the patient, or is likely to
cause the patient to inflict self harm, or to harm another, the provider may withhold the
information from the patient and may supply the information to an appropriate third party
or to another provider, as defined in section 144.291, subdivision 2, paragraph (h), clause
(1). The other provider or third party may release the information to the patient.
new text end
new text begin
(b) A provider, as defined in section 144.291, subdivision 2, paragraph (h), clause
(3), shall release information upon written request unless, prior to the request, a provider,
as defined in section 144.291, subdivision 2, paragraph (h), clause (1), has designated and
described a specific basis for withholding the information as authorized by paragraph (a).
new text end
new text begin Subd. 8. new text end
new text begin Form. new text end
new text begin
By January 1, 2008, the Department of Health must develop a form
that may be used by a patient to request access to health records under this section. A form
developed by the commissioner must be accepted by a provider as a legally enforceable
request under this section.
new text end
Sec. 4.
new text begin
[144.293] RELEASE OR DISCLOSURE OF HEALTH RECORDS.
new text end
new text begin Subdivision 1. new text end
new text begin Release or disclosure of health records. new text end
new text begin
Health records can be
released or disclosed as specified in subdivisions 2 to 9 and sections 144.294 and 144.295.
new text end
new text begin Subd. 2. new text end
new text begin Patient consent to release of records. new text end
new text begin
A provider, or a person who
receives health records from a provider, may not release a patient's health records to a
person without:
new text end
new text begin
(1) a signed and dated consent from the patient or the patient's legally authorized
representative authorizing the release;
new text end
new text begin
(2) specific authorization in law; or
new text end
new text begin
(3) a representation from a provider that holds a signed and dated consent from the
patient authorizing the release.
new text end
new text begin Subd. 3. new text end
new text begin Release from one provider to another. new text end
new text begin
A patient's health record,
including, but not limited to, laboratory reports, x-rays, prescriptions, and other technical
information used in assessing the patient's condition, or the pertinent portion of the record
relating to a specific condition, or a summary of the record, shall promptly be furnished to
another provider upon the written request of the patient. The written request shall specify
the name of the provider to whom the health record is to be furnished. The provider who
furnishes the health record or summary may retain a copy of the materials furnished. The
patient shall be responsible for the reasonable costs of furnishing the information.
new text end
new text begin Subd. 4. new text end
new text begin Duration of consent. new text end
new text begin
Except as provided in this section, a consent is
valid for one year or for a lesser period specified in the consent or for a different period
provided by law.
new text end
new text begin Subd. 5. new text end
new text begin Exceptions to consent requirement. new text end
new text begin
This section does not prohibit the
release of health records:
new text end
new text begin
(1) for a medical emergency when the provider is unable to obtain the patient's
consent due to the patient's condition or the nature of the medical emergency;
new text end
new text begin
(2) to other providers within related health care entities when necessary for the
current treatment of the patient; or
new text end
new text begin
(3) to a health care facility licensed by this chapter, chapter 144A, or to the same
types of health care facilities licensed by this chapter and chapter 144A that are licensed
in another state when a patient:
new text end
new text begin
(i) is returning to the health care facility and unable to provide consent; or
new text end
new text begin
(ii) who resides in the health care facility, has services provided by an outside
resource under Code of Federal Regulations, title 42, section 483.75(h), and is unable
to provide consent.
new text end
new text begin Subd. 6. new text end
new text begin Consent does not expire. new text end
new text begin
Notwithstanding subdivision 4, if a patient
explicitly gives informed consent to the release of health records for the purposes and
restrictions in clauses (1) and (2), the consent does not expire after one year for:
new text end
new text begin
(1) the release of health records to a provider who is being advised or consulted with
in connection with the releasing provider's current treatment of the patient;
new text end
new text begin
(2) the release of health records to an accident and health insurer, health service plan
corporation, health maintenance organization, or third-party administrator for purposes of
payment of claims, fraud investigation, or quality of care review and studies, provided that:
new text end
new text begin
(i) the use or release of the records complies with sections 72A.49 to 72A.505;
new text end
new text begin
(ii) further use or release of the records in individually identifiable form to a person
other than the patient without the patient's consent is prohibited; and
new text end
new text begin
(iii) the recipient establishes adequate safeguards to protect the records from
unauthorized disclosure, including a procedure for removal or destruction of information
that identifies the patient.
new text end
new text begin Subd. 7. new text end
new text begin Exception to consent. new text end
new text begin
Subdivision 2 does not apply to the release of health
records to the commissioner of health or the Health Data Institute under chapter 62J,
provided that the commissioner encrypts the patient identifier upon receipt of the data.
new text end
new text begin Subd. 8. new text end
new text begin Record locator service. new text end
new text begin
(a) A provider or group purchaser may release
patient identifying information and information about the location of the patient's health
records to a record locator service without consent from the patient, unless the patient
has elected to be excluded from the service under paragraph (d). The Department of
Health may not access the record locator service or receive data from the record locator
service. Only a provider may have access to patient identifying information in a record
locator service. Except in the case of a medical emergency, a provider participating in a
health information exchange using a record locator service does not have access to patient
identifying information and information about the location of the patient's health records
unless the patient specifically consents to the access. A consent does not expire but may
be revoked by the patient at any time by providing written notice of the revocation to the
provider.
new text end
new text begin
(b) A health information exchange maintaining a record locator service must
maintain an audit log of providers accessing information in a record locator service that
at least contains information on:
new text end
new text begin
(1) the identity of the provider accessing the information;
new text end
new text begin
(2) the identity of the patient whose information was accessed by the provider; and
new text end
new text begin
(3) the date the information was accessed.
new text end
new text begin
(c) No group purchaser may in any way require a provider to participate in a record
locator service as a condition of payment or participation.
new text end
new text begin
(d) A provider or an entity operating a record locator service must provide
a mechanism under which patients may exclude their identifying information and
information about the location of their health records from a record locator service. At
a minimum, a consent form that permits a provider to access a record locator service
must include a conspicuous check-box option that allows a patient to exclude all of the
patient's information from the record locator service. A provider participating in a health
information exchange with a record locator service who receives a patient's request to
exclude all of the patient's information from the record locator service or to have a specific
provider contact excluded from the record locator service is responsible for removing that
information from the record locator service.
new text end
new text begin Subd. 9. new text end
new text begin Documentation of release. new text end
new text begin
(a) In cases where a provider releases health
records without patient consent as authorized by law, the release must be documented in
the patient's health record. In the case of a release under section 144.294, subdivision 2, the
documentation must include the date and circumstances under which the release was made,
the person or agency to whom the release was made, and the records that were released.
new text end
new text begin
(b) When a health record is released using a representation from a provider that
holds a consent from the patient, the releasing provider shall document:
new text end
new text begin
(1) the provider requesting the health records;
new text end
new text begin
(2) the identity of the patient;
new text end
new text begin
(3) the health records requested; and
new text end
new text begin
(4) the date the health records were requested.
new text end
new text begin Subd. 10. new text end
new text begin Warranties regarding consents, requests, and disclosures. new text end
new text begin
(a) When
requesting health records using consent, a person warrants that the consent:
new text end
new text begin
(1) contains no information known to the person to be false; and
new text end
new text begin
(2) accurately states the patient's desire to have health records disclosed or that there
is specific authorization in law.
new text end
new text begin
(b) When requesting health records using consent, or a representation of holding a
consent, a provider warrants that the request:
new text end
new text begin
(1) contains no information known to the provider to be false;
new text end
new text begin
(2) accurately states the patient's desire to have health records disclosed or that
there is specific authorization in law; and
new text end
new text begin
(3) does not exceed any limits imposed by the patient in the consent.
new text end
new text begin
(c) When disclosing health records, a person releasing health records warrants that
the person:
new text end
new text begin
(1) has complied with the requirements of this section regarding disclosure of
health records;
new text end
new text begin
(2) knows of no information related to the request that is false; and
new text end
new text begin
(3) has complied with the limits set by the patient in the consent.
new text end
Sec. 5.
new text begin
[144.294] RECORDS RELATING TO MENTAL HEALTH.
new text end
new text begin Subdivision 1. new text end
new text begin Provider inquiry. new text end
new text begin
Upon the written request of a spouse, parent,
child, or sibling of a patient being evaluated for or diagnosed with mental illness, a
provider shall inquire of a patient whether the patient wishes to authorize a specific
individual to receive information regarding the patient's current and proposed course of
treatment. If the patient so authorizes, the provider shall communicate to the designated
individual the patient's current and proposed course of treatment. Section 144.293,
subdivisions 2 and 4, apply to consents given under this subdivision.
new text end
new text begin Subd. 2. new text end
new text begin Disclosure to law enforcement agency. new text end
new text begin
Notwithstanding section 144.293,
subdivisions 2 and 4, a provider must disclose health records relating to a patient's mental
health to a law enforcement agency if the law enforcement agency provides the name
of the patient and communicates that the:
new text end
new text begin
(1) patient is currently involved in an emergency interaction with the law
enforcement agency; and
new text end
new text begin
(2) disclosure of the records is necessary to protect the health or safety of the patient
or of another person.
new text end
new text begin
The scope of disclosure under this subdivision is limited to the minimum necessary
for law enforcement to respond to the emergency. A law enforcement agency that obtains
health records under this subdivision shall maintain a record of the requestor, the provider
of the information, and the patient's name. Health records obtained by a law enforcement
agency under this subdivision are private data on individuals as defined in section 13.02,
subdivision 12, and must not be used by law enforcement for any other purpose.
new text end
new text begin Subd. 3. new text end
new text begin Records release for family and caretaker; mental health care. new text end
new text begin
(a)
Notwithstanding section 144.293, a provider providing mental health care and treatment
may disclose health record information described in paragraph (b) about a patient to a
family member of the patient or other person who requests the information if:
new text end
new text begin
(1) the request for information is in writing;
new text end
new text begin
(2) the family member or other person lives with, provides care for, or is directly
involved in monitoring the treatment of the patient;
new text end
new text begin
(3) the involvement under clause (2) is verified by the patient's mental health care
provider, the patient's attending physician, or a person other than the person requesting the
information, and is documented in the patient's medical record;
new text end
new text begin
(4) before the disclosure, the patient is informed in writing of the request, the name
of the person requesting the information, the reason for the request, and the specific
information being requested;
new text end
new text begin
(5) the patient agrees to the disclosure, does not object to the disclosure, or is
unable to consent or object, and the patient's decision or inability to make a decision is
documented in the patient's medical record; and
new text end
new text begin
(6) the disclosure is necessary to assist in the provision of care or monitoring of the
patient's treatment.
new text end
new text begin
(b) The information disclosed under this paragraph is limited to diagnosis, admission
to or discharge from treatment, the name and dosage of the medications prescribed, side
effects of the medication, consequences of failure of the patient to take the prescribed
medication, and a summary of the discharge plan.
new text end
new text begin
(c) If a provider reasonably determines that providing information under this
subdivision would be detrimental to the physical or mental health of the patient or is
likely to cause the patient to inflict self harm or to harm another, the provider must not
disclose the information.
new text end
new text begin
(d) This subdivision does not apply to disclosures for a medical emergency or
to family members as authorized or required under subdivision 1 or section 144.293,
subdivision 5, clause (1).
new text end
Sec. 6.
new text begin
[144.295] DISCLOSURE OF HEALTH RECORDS FOR EXTERNAL
RESEARCH.
new text end
new text begin Subdivision 1. new text end
new text begin Methods of release. new text end
new text begin
(a) Notwithstanding section 144.293,
subdivisions 2 and 4, health records may be released to an external researcher solely for
purposes of medical or scientific research only as follows:
new text end
new text begin
(1) health records generated before January 1, 1997, may be released if the patient
has not objected or does not elect to object after that date;
new text end
new text begin
(2) for health records generated on or after January 1, 1997, the provider must:
new text end
new text begin
(i) disclose in writing to patients currently being treated by the provider that health
records, regardless of when generated, may be released and that the patient may object, in
which case the records will not be released; and
new text end
new text begin
(ii) use reasonable efforts to obtain the patient's written general authorization that
describes the release of records in item (i), which does not expire but may be revoked or
limited in writing at any time by the patient or the patient's authorized representative;
new text end
new text begin
(3) the provider must advise the patient of the rights specified in clause (4); and
new text end
new text begin
(4) the provider must, at the request of the patient, provide information on how the
patient may contact an external researcher to whom the health record was released and
the date it was released.
new text end
new text begin
(b) Authorization may be established if an authorization is mailed at least two
times to the patient's last known address with a postage prepaid return envelope and a
conspicuous notice that the patient's medical records may be released if the patient does
not object, and at least 60 days have expired since the second notice was sent.
new text end
new text begin Subd. 2. new text end
new text begin Duties of researcher. new text end
new text begin
In making a release for research purposes, the
provider shall make a reasonable effort to determine that:
new text end
new text begin
(1) the use or disclosure does not violate any limitations under which the record
was collected;
new text end
new text begin
(2) the use or disclosure in individually identifiable form is necessary to accomplish
the research or statistical purpose for which the use or disclosure is to be made;
new text end
new text begin
(3) the recipient has established and maintains adequate safeguards to protect the
records from unauthorized disclosure, including a procedure for removal or destruction of
information that identifies the patient; and
new text end
new text begin
(4) further use or release of the records in individually identifiable form to a person
other than the patient without the patient's consent is prohibited.
new text end
Sec. 7.
new text begin
[144.296] COPIES OF VIDEOTAPES.
new text end
new text begin
A provider may not release a copy of a videotape of a child victim or alleged victim
of physical or sexual abuse without a court order under section 13.03, subdivision 6, or
as provided in section 611A.90. This section does not limit the right of a patient to view
the videotape.
new text end
Sec. 8.
new text begin
[144.297] INDEPENDENT MEDICAL EXAMINATION.
new text end
new text begin
Sections 144.291 to 144.298 apply to the subject and provider of an independent
medical examination requested by or paid for by a third party. Notwithstanding section
144.293, a provider may release health records created as part of an independent medical
examination to the third party who requested or paid for the examination.
new text end
Sec. 9.
new text begin
[144.298] PENALTIES.
new text end
new text begin Subdivision 1. new text end
new text begin Licensing action. new text end
new text begin
A violation of sections 144.291 to 144.298 may
be grounds for disciplinary action against a provider by the appropriate licensing board
or agency.
new text end
new text begin Subd. 2. new text end
new text begin Liability of provider or other person. new text end
new text begin
A person who does any of the
following is liable to the patient for compensatory damages caused by an unauthorized
release, plus costs and reasonable attorney fees:
new text end
new text begin
(1) negligently or intentionally requests or releases a health record in violation
of sections 144.291 to 144.297;
new text end
new text begin
(2) forges a signature on a consent form or materially alters the consent form of
another person without the person's consent; or
new text end
new text begin
(3) obtains a consent form or the health records of another person under false
pretenses.
new text end
new text begin Subd. 3. new text end
new text begin Liability for record locator service. new text end
new text begin
A patient is entitled to receive
compensatory damages plus costs and reasonable attorney fees if a health information
exchange maintaining a record locator service, or an entity maintaining a record locator
service for a health information exchange, negligently or intentionally violates the
provisions of section 144.293, subdivision 8.
new text end
Sec. 10.
Minnesota Statutes 2006, section 144.3345, is amended to read:
144.3345 INTERCONNECTED ELECTRONIC HEALTH RECORD
GRANTS.
Subdivision 1.
Definitions.
The following definitions are used for the purposes
of this section.
(a) "Eligible community e-health collaborative" means an existing or newly
established collaborative to support the adoption and use of interoperable electronic
health records. A collaborative must consist of at least deleted text begin threedeleted text end new text begin twonew text end or more eligible health
care entities in at least two of the categories listed in paragraph (b) and have a focus on
interconnecting the members of the collaborative for secure and interoperable exchange of
health care information.
(b) "Eligible health care entity" means one of the following:
(1) community clinics, as defined under section 145.9268;
(2) hospitals eligible for rural hospital capital improvement grants, as defined
in section 144.148;
(3) physician clinics located in a community with a population of less than 50,000
according to United States Census Bureau statistics and outside the seven-county
metropolitan area;
(4) nursing facilities licensed under sections 144A.01 to 144A.27;
(5) community health boards new text begin or boards of health new text end as established under chapter 145A;
(6) nonprofit entities with a purpose to provide health information exchange
coordination governed by a representative, multi-stakeholder board of directors; and
(7) other providers of health or health care services approved by the commissioner
for which interoperable electronic health record capability would improve quality of
care, patient safety, or community health.
Subd. 2.
Grants authorized.
The commissioner of health shall award grants tonew text begin :
new text end
new text begin (a)new text end eligible community e-health collaborative projects to improve the implementation
and use of interoperable electronic health records including but not limited to the
following projects:
(1) collaborative efforts to host and support fully functional interoperable electronic
health records in multiple care settings;
(2) electronic medication history and electronic patient deleted text begin registrationdeleted text end new text begin medical historynew text end
information;
(3) electronic personal health records for persons with chronic diseases and for
prevention services;
(4) rural and underserved community models for electronic prescribing; deleted text begin and
deleted text end
(5) deleted text begin enablingdeleted text end new text begin modernizenew text end local public health new text begin information new text end systems to rapidly and
electronically exchange information needed to participate in community e-health
collaboratives or for public health emergency preparedness and responsedeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(6) implement regional or community-based health information exchange
organizations;
new text end
new text begin
(b) community clinics, as defined under section 145.9268, to implement and use
interoperable electronic health records, including but not limited to the following projects:
new text end
new text begin
(1) efforts to plan for and implement fully functional, standards-based interoperable
electronic health records; and
new text end
new text begin
(2) purchases and implementation of computer hardware, software, and technology
to fully implement interoperable electronic health records;
new text end
new text begin
(c) regional or community-based health information exchange organizations to
connect and facilitate the exchange of health information between eligible health care
entities, including but not limited to the development, testing, and implementation of:
new text end
new text begin
(1) data exchange standards, including data, vocabulary, and messaging standards,
for the exchange of health information, provided that such standards are consistent with
state and national standards;
new text end
new text begin
(2) security standards necessary to ensure the confidentiality and integrity of health
records;
new text end
new text begin
(3) computer interfaces and mechanisms for standardizing health information
exchanged between eligible health care entities;
new text end
new text begin
(4) a record locator service for identifying the location of patient health records; or
new text end
new text begin
(5) interfaces and mechanisms for implementing patient consent requirements; and
new text end
new text begin
(d) community health boards and boards of health as established under chapter
145A to modernize local public health information systems to be standards-based and
interoperable with other electronic health records and information systems, or for
enhanced public health emergency preparedness and response.
new text end
Grant funds may not be used for construction of health care or other buildings or
facilities.
Subd. 3.
Allocation of grants.
(a) To receive a grant under this section, an eligible
community e-health collaborativenew text begin , community clinic, regional or community-based health
information exchange, or community health boards and boards of healthnew text end must submit an
application to the commissioner of health by the deadline established by the commissioner.
A grant may be awarded upon the signing of a grant contract. In awarding grants, the
commissioner shall give preference to projects benefiting providers located in rural and
underserved areas of Minnesota which the commissioner has determined have an unmet
need for the development and funding of electronic health records. Applicants may apply
for and the commissioner may award grants for one-year, two-year, or three-year periods.
(b) An application must be on a form and contain information as specified by the
commissioner but at a minimum must contain:
(1) a description of the purpose or project for which grant funds will be used;
(2) a description of the problem or problems the grant funds will be used to address,
including an assessment new text begin of the new text end likelihood of the project occurring absent grant funding;
(3) a description of achievable objectives, a workplan, budget, budget narrative, a
project communications plan, a timeline for implementation and completion of processes
or projects enabled by the grant, and an assessment of privacy and security issues and a
proposed approach to address these issues;
(4) a description of the health care entities and other groups participating in the
project, including identification of the lead entity responsible for applying for and
receiving grant funds;
(5) a plan for how patients and consumers will be involved in development of
policies and procedures related to the access to and interchange of information;
(6) evidence of consensus and commitment among the health care entities and others
who developed the proposal and are responsible for its implementation; deleted text begin and
deleted text end
(7) a plan for documenting and evaluating results of the grantdeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(8) a plan for use of data exchange standards, including data and vocabulary.
new text end
(c) The commissioner shall review each application to determine whether the
application is complete and whether the applicant and the project are eligible for a
grant. In evaluating applications, the commissioner shall take into consideration factors,
including but not limited to, the following:
(1) the degree to which the proposal interconnects deleted text begin the various providers of caredeleted text end new text begin with
other health care entitiesnew text end in the applicant's geographic community;
(2) the degree to which the project provides for the interoperability of electronic
health records or related health information technology deleted text begin between the members of the
collaborative, and presence and scope of a description of how the project intends to
interconnect with other providers not part of the project into the futuredeleted text end ;
(3) the degree to which the project addresses current unmet needs pertaining
to interoperable electronic health records in a geographic area of Minnesota and the
likelihood that the needs would not be met absent grant funds;
(4) the applicant's thoroughness and clarity in describing the project, how the project
will improve patient safety, quality of care, and consumer empowerment, and the role of
the various collaborative members;
(5) the recommendations of the Health Information and Technology Infrastructure
Advisory Committee; and
(6) other factors that the commissioner deems relevant.
(d) Grant funds shall be awarded on a three-to-one match basis. Applicants shall
be required to provide $1 in the form of cash or in-kind staff or services for each $3
provided under the grant program.
(e) Grants shall not exceed $900,000 per grant. The commissioner has discretion
over the size and number of grants awarded.
Subd. 4.
Evaluation and report.
The commissioner of health shall evaluate the
overall effectiveness of the grant program. The commissioner shall collect progress
and expenditure reports to evaluate the grant program from the eligible community
collaboratives receiving grants.
Sec. 11.
Minnesota Statutes 2006, section 144D.03, subdivision 1, is amended to read:
Subdivision 1.
Registration procedures.
The commissioner shall establish forms
and procedures for annual registration of housing with services establishments. The
commissioner shall charge an annual registration fee of deleted text begin $35deleted text end new text begin $155new text end . No fee shall be
refunded. A registered establishment shall notify the commissioner within 30 days of the
date it is no longer required to be registered under this chapter or of any change in the
business name or address of the establishment, the name or mailing address of the owner
or owners, or the name or mailing address of the managing agent. There shall be no
fee for submission of the notice.
Sec. 12.
new text begin
[145.9269] FEDERALLY QUALIFIED HEALTH CENTERS.
new text end
new text begin Subdivision 1. new text end
new text begin Definitions. new text end
new text begin
For purposes of this section, "federally qualified health
center" means an entity that is receiving a grant under United States Code, title 42,
section 254b, or, based on the recommendation of the Health Resources and Services
Administration within the Public Health Service, is determined by the secretary to meet
the requirements for receiving such a grant.
new text end
new text begin Subd. 2. new text end
new text begin Allocation of subsidies. new text end
new text begin
The commissioner of health shall distribute
subsidies to federally qualified health centers operating in Minnesota to continue, expand,
and improve federally qualified health center services to low-income populations. The
commissioner shall distribute the funds appropriated under this section to federally
qualified health centers operating in Minnesota as of January 1, 2007. The amount of
each subsidy shall be in proportion to each federally qualified health center's amount of
discounts granted to patients during calendar year 2006 as reported on the federal Uniform
Data System report in conformance with the Bureau of Primary Health Care Program
Expectations Policy Information Notice 98-23, except that each eligible federally qualified
health center shall receive at least two percent but no more than 30 percent of the total
amount of money available under this section.
new text end
Sec. 13. new text begin HEALTH PROMOTION PROGRAM.
new text end
new text begin
The commissioner of health, in consultation with the State Community Health
Services Advisory Committee established in Minnesota Statutes, section 145A.10,
subdivision 10, shall develop a plan to fund and implement an ongoing comprehensive
health promotion program that can effect change more effectively and at lower cost at
a community level rather than through individual counseling and change promotion.
The program shall use proven public health strategies to promote healthy lifestyles and
behaviors in order to establish a sustainable, long-term approach to reducing preventable
disability, chronic health conditions, and disease. The focus shall be on community
based initiatives that address childhood and adult obesity, tobacco and substance abuse,
improved activity levels among senior citizens, and other lifestyle issues that impact
health and healthcare costs. Because of its population health focus, funding shall be
related to the size of the population to be served. The plan shall be completed by October
1, 2007, and shared with the Legislative Health Care Access Commission.
new text end
Sec. 14. new text begin CERVICAL CANCER PREVENTION AND HUMAN PAPILLOMA
VIRUS VACCINE STUDY.
new text end
new text begin
The commissioner of health shall reconvene the cervical cancer elimination study
required under Laws 2005, First Special Session chapter 4, article 6, section 52, to conduct
a study, in collaboration with the Minnesota Immunization Practices Advisory Committee,
on the human papilloma virus vaccine, including, but not limited to, the following:
new text end
new text begin
(1) the risks and benefits of the human papilloma virus vaccine;
new text end
new text begin
(2) the availability and effectiveness of the vaccine;
new text end
new text begin
(3) the extent to which health plan companies cover the cost of this vaccination; and
new text end
new text begin
(4) ways to cover the cost of vaccination for persons without coverage.
new text end
new text begin
The commissioner shall submit a report to the legislature by February 1, 2008, on
the findings of the study and recommendations as to whether the human papilloma virus
vaccine should be made mandatory statewide.
new text end
Sec. 15. new text begin REVISOR'S INSTRUCTION.
new text end
new text begin
In Minnesota Statutes and Minnesota Rules, the revisor shall change the references
in column A with the references in column B.
new text end
|
new text begin
Column A new text end |
new text begin
Column B new text end |
|
new text begin
section 144.335 new text end |
new text begin
sections 144.291 to 144.298 new text end |
|
new text begin
section 144.335, subdivision 1 new text end |
new text begin
section 144.291, subdivision 2 new text end |
|
new text begin
section 144.335, subdivision 1, paragraph (b) new text end |
new text begin
section 144.291, subdivision 2, paragraph (h) new text end |
|
new text begin
section 144.335, subdivision 2, paragraphs (a) and (b) new text end |
new text begin
section 144.292, subdivisions 2 and 5 new text end |
|
new text begin
section 144.335, subdivision 2 new text end |
new text begin
section 144.292 new text end |
|
new text begin
section 144.335, subdivision 3a new text end |
new text begin
section 144.294, subdivision 2 new text end |
|
new text begin
section 144.335, subdivision 3a, paragraph (d) new text end |
new text begin
section 144.295 new text end |
|
new text begin
section 144.335, subdivision 3a, paragraph (f) new text end |
new text begin
section 144.294 new text end |
|
new text begin
section 144.335, subdivision 3b new text end |
new text begin
section 144.293, subdivision 7 new text end |
Sec. 16. new text begin REPEALER.
new text end
new text begin
Minnesota Statutes 2006, section 144.335,
new text end
new text begin
and
new text end
new text begin
Laws 2006, chapter 249, section
6,
new text end
new text begin
are repealed.
new text end
ARTICLE 11
MISCELLANEOUS POLICY
Section 1.
Minnesota Statutes 2006, section 13.381, is amended by adding a
subdivision to read:
new text begin Subd. 16a. new text end
new text begin Prescription electronic reporting system. new text end
new text begin
Access to data in the
prescription electronic reporting system is governed by section 152.126.
new text end
Sec. 2.
Minnesota Statutes 2006, section 144.5509, is amended to read:
144.5509 RADIATION THERAPY FACILITY CONSTRUCTION.
(a) A radiation therapy facility may be constructed only by an entity owned,
operated, or controlled by a hospital licensed according to sections 144.50 to 144.56 either
alone or in cooperation with another entity.
(b) deleted text begin This section expires August 1, 2013deleted text end new text begin Notwithstanding paragraph (a), there shall
be a two-year moratorium on the construction of any radiation therapy facility located in
the following counties: Hennepin, Ramsey, Dakota, Washington, Anoka, Carver, Scott,
St. Louis, Sherburne, Benton, Stearns, Chisago, Isanti, and Wright. This paragraph does
not apply to the relocation or reconstruction of an existing facility owned by a hospital if
the relocation or reconstruction is within one mile of the existing facility. This paragraph
expires August 1, 2009new text end .new text begin This paragraph does not apply to a radiation therapy facility
that is being built attached to a community hospital in Wright County and meets the
following conditions prior to August 1, 2007: the capital expenditure report required
under Minnesota Statutes, section 62J.17, has been filed with the commissioner of health;
a timely construction schedule is developed, stipulating dates for beginning, achieving
various stages, and completing construction; and all zoning and building permits applied
for.
new text end
Sec. 3.
Minnesota Statutes 2006, section 148.235, is amended by adding a subdivision
to read:
new text begin Subd. 11. new text end
new text begin Dispensing by protocol. new text end
new text begin
A registered nurse in a family planning agency
as defined in Minnesota Rules, part 9505.0280, subpart 3, may dispense oral contraceptives
prescribed by a licensed practitioner as defined in section 151.01, subdivision 23, pursuant
to a dispensing protocol established by the agency's medical director or under the direction
of a physician. The dispensing protocol must address the requirements of sections 151.01,
subdivision 30, and 151.212, subdivision 1.
new text end
Sec. 4.
Minnesota Statutes 2006, section 151.19, subdivision 2, is amended to read:
Subd. 2.
Nonresident pharmacies.
The board shall require and provide for an
annual nonresident special pharmacy registration for all pharmacies located outside of this
state that regularly dispense medications for Minnesota residents and mail, ship, or deliver
prescription medications into this state. Nonresident special pharmacy registration shall
be granted by the board upon the disclosure and certification by a pharmacy:
(1) that it is licensed in the state in which the dispensing facility is located and from
which the drugs are dispensed;
(2) the location, names, and titles of all principal corporate officers and all
pharmacists who are dispensing drugs to residents of this state;
(3) that it complies with all lawful directions and requests for information from
the Board of Pharmacy of all states in which it is licensed or registered, except that it
shall respond directly to all communications from the board concerning emergency
circumstances arising from the dispensing of drugs to residents of this state;
(4) that it maintains its records of drugs dispensed to residents of this state so that the
records are readily retrievable from the records of other drugs dispensed;
(5) that it cooperates with the board in providing information to the Board of
Pharmacy of the state in which it is licensed concerning matters related to the dispensing
of drugs to residents of this state; deleted text begin and
deleted text end
(6) that during its regular hours of operation, but not less than six days per week, for
a minimum of 40 hours per week, a toll-free telephone service is provided to facilitate
communication between patients in this state and a pharmacist at the pharmacy who has
access to the patients' records; the toll-free number must be disclosed on the label affixed
to each container of drugs dispensed to residents of this statedeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(7) that, upon request of a resident of a long-term care facility located within the
state of Minnesota, the resident's authorized representative, or a contract pharmacy or
licensed health care facility acting on behalf of the resident, the pharmacy will dispense
medications prescribed for the resident in unit-dose packaging or, alternatively, comply
with the provisions of section 151.415, subdivision 5.
new text end
Sec. 5.
new text begin
[151.415] LONG-TERM CARE RESIDENT ACCESS TO
PHARMACEUTICALS ACT.
new text end
new text begin Subdivision 1. new text end
new text begin Title; citation. new text end
new text begin
This section may be cited as the "Long-Term Care
Resident Access to Pharmaceuticals Act."
new text end
new text begin Subd. 2. new text end
new text begin Definitions. new text end
new text begin
For the purposes of this section, the following terms have the
meanings given them unless otherwise provided by text:
new text end
new text begin
(a) "Board" means the Board of Pharmacy.
new text end
new text begin
(b) "Contract pharmacy" means a pharmacy, licensed under this chapter, which is
under contract to a long-term care facility.
new text end
new text begin
(c) "Long-term care facility" means a nursing home licensed under sections 144A.02
to 144A.10, or a boarding care home licensed under sections 144.50 to 144.56. Facilities
not certified under title XIX of the federal Social Security Act are not included in this
definition.
new text end
new text begin
(d) "Original dispensing pharmacy" shall mean a pharmacy, licensed in any state in
the United States, which dispenses drugs in bulk prescription containers to a person who
is a resident in a long-term care facility.
new text end
new text begin Subd. 3. new text end
new text begin Authorization to administer and repackage drugs. new text end
new text begin
(a) A contract
pharmacist or pharmacy may repackage a resident's prescription drugs, which have been
lawfully dispensed from bulk prescription containers by an original dispensing pharmacy,
into a unit-dose system compatible with the system used by the long-term care facility.
new text end
new text begin
(b) A long-term care facility may administer drugs to residents of the facility that
have been repackaged according to this subdivision. The contract pharmacy shall notify
the long-term care facility whenever medications have been dispensed according to
this subdivision and must certify that the repackaging and dispensing has been done in
accordance with this subdivision.
new text end
new text begin
(c) Drugs may be dispensed for a resident of a long-term care facility according to
this subdivision, provided that:
new text end
new text begin
(1) the drug is dispensed by the original dispensing pharmacy according to a current,
valid prescription;
new text end
new text begin
(2) the original bulk prescription container for the resident is delivered by the
original dispensing pharmacy directly to the contract pharmacist or pharmacy;
new text end
new text begin
(3) the contract pharmacist or pharmacy verifies the name and strength of the drug,
the name of the manufacturer of the drug, the manufacturer's lot or control number, the
manufacturer's expiration date for the drug, and the date the drug was dispensed by the
original dispensing pharmacy;
new text end
new text begin
(4) the contract pharmacist or pharmacy verifies the validity and accuracy of the
current prescription order;
new text end
new text begin
(5) the contract pharmacist or pharmacy repackages the drug in board-approved
unit-dose packaging, with labeling that complies with Minnesota Rules, part 6800.6300,
and that identifies that the drug has been repackaged according to this section;
new text end
new text begin
(6) the resident for whom the medication is repackaged obtains medications from or
receives medications at a discounted rate from the original dispensing pharmacy under the
resident's state or federal health assistance program or a private health insurance plan; and
new text end
new text begin
(7) the resident for whom the medication is to be repackaged, or the resident's
authorized representative, has signed an informed consent form provided by the facility
which includes an explanation of the repackaging process and which notifies the resident
of the immunities from liability provided in this section.
new text end
new text begin Subd. 4. new text end
new text begin Maintenance of records. new text end
new text begin
For each drug repackaged by a contract
pharmacy under this section, the contract pharmacy shall maintain a record for at least
two years of the following information:
new text end
new text begin
(1) the name, manufacturer, manufacturer's lot number, manufacturer's expiration
date, and quantity of the drug prescribed;
new text end
new text begin
(2) the name and address of the resident for whom the drug was repackaged;
new text end
new text begin
(3) the name and address or other identifier of the prescriber;
new text end
new text begin
(4) the date the prescription was issued and the date the drug was repackaged;
new text end
new text begin
(5) the date the repackaged drug was delivered to the long-term care facility;
new text end
new text begin
(6) the directions for use;
new text end
new text begin
(7) a copy of the label that was affixed to the repackaged drug;
new text end
new text begin
(8) the initials of the packager;
new text end
new text begin
(9) the initials of the supervising pharmacist; and
new text end
new text begin
(10) the name and business address of the original dispensing pharmacy.
new text end
new text begin Subd. 5. new text end
new text begin Duties of the original dispensing pharmacy. new text end
new text begin
Upon request of the
resident, the resident's authorized representative, or a contract pharmacy or licensed
health care facility acting on behalf of the resident, the original dispensing pharmacy
is required to deliver medications dispensed for the resident directly to the contract
pharmacist or pharmacy. The original dispensing pharmacy is further required to provide
the contract pharmacist or pharmacy with the name and strength of the drug, the name of
the manufacturer of the drug, the manufacturer's lot or control number, the manufacturer's
expiration date for the drug, and the date the drug was dispensed.
new text end
new text begin Subd. 6. new text end
new text begin Redispensing of returned drugs prohibited. new text end
new text begin
Unused drugs repackaged
according to this section that are returned to any pharmacy shall not be redispensed.
new text end
new text begin Subd. 7. new text end
new text begin Immunity from civil liability. new text end
new text begin
(a) A contract pharmacist or pharmacy
and its employees or agents repackaging a drug acquired from an original dispensing
pharmacy shall be immune from civil liability arising from harm caused by the drug due
to acts or omissions of other persons outside of the contract pharmacist or pharmacy if the
contract pharmacist or pharmacy properly repackages the drug according to this section.
new text end
new text begin
(b) A long-term care facility and the facility's employees or agents who properly
administer a drug repackaged by a contract pharmacist or pharmacy under this section
shall be immune from civil liability arising from harm caused by the drug due to acts or
omissions of other persons outside the long-term care facility.
new text end
new text begin Subd. 8. new text end
new text begin Handling fee. new text end
new text begin
A contract pharmacist or pharmacy may charge a monthly
fee of no more than 250 percent of the medical assistance program dispensing fee for
each drug repackaged according to this section, but no more than $100 per month for
each individual resident.
new text end
Sec. 6.
Minnesota Statutes 2006, section 152.11, is amended by adding a subdivision to
read:
new text begin Subd. 2d. new text end
new text begin
Identification requirement for schedule II or III controlled substance.
new text end
new text begin
No person may dispense a controlled substance included in schedule II or III without
requiring the person purchasing the controlled substance, who need not be the person for
whom the controlled substance prescription is written, to present valid photographic
identification, unless the person purchasing the controlled substance, or if applicable the
person for whom the controlled substance prescription is written, is known to the dispenser.
new text end
Sec. 7.
new text begin
[152.126] SCHEDULE II AND III CONTROLLED SUBSTANCES
PRESCRIPTION ELECTRONIC REPORTING SYSTEM.
new text end
new text begin Subdivision 1. new text end
new text begin Definitions. new text end
new text begin
For purposes of this section, the terms defined in this
subdivision have the meanings given.
new text end
new text begin
(a) "Board" means the Minnesota State Board of Pharmacy established under
chapter 151.
new text end
new text begin
(b) "Controlled substances" means those substances listed in section 152.02,
subdivisions 3 and 4, and those substances defined by the board pursuant to section
152.02, subdivisions 7, 8, and 12.
new text end
new text begin
(c) "Dispense" or "dispensing" has the meaning given in section 151.01, subdivision
30. Dispensing does not include the direct administering of a controlled substance to a
patient by a licensed health care professional.
new text end
new text begin
(d) "Dispenser" means a person authorized by law to dispense a controlled substance,
pursuant to a valid prescription. A dispenser does not include a licensed hospital pharmacy
that distributes controlled substances for inpatient hospital care.
new text end
new text begin
(e) "Prescriber" means a licensed health care professional who is authorized to
prescribe a controlled substance under section 152.12, subdivision 1.
new text end
new text begin
(f) "Prescription" has the meaning given in section 151.01, subdivision 16.
new text end
new text begin Subd. 2. new text end
new text begin Prescription electronic reporting system. new text end
new text begin
(a) The board shall establish
by January 1, 2009, an electronic system for reporting the information required under
subdivision 4 for all controlled substances dispensed within the state. Data for controlled
substance prescriptions that are dispensed in a quantity small enough to provide treatment
to a patient for a period of 48 hours or less need not be reported.
new text end
new text begin
(b) The board may contract with a vendor for the purpose of obtaining technical
assistance in the design, implementation, and maintenance of the electronic reporting
system. The vendor's role shall be limited to providing technical support to the board
concerning the software, databases, and computer systems required to interface with the
existing systems currently used by pharmacies to dispense prescriptions and transmit
prescription data to other third parties.
new text end
new text begin Subd. 3. new text end
new text begin Prescription Electronic Reporting Advisory Committee. new text end
new text begin
(a) The
board shall convene an advisory committee. The committee must include at least one
representative of:
new text end
new text begin
(1) the Department of Health;
new text end
new text begin
(2) the Department of Human Services;
new text end
new text begin
(3) each health-related licensing board that licenses prescribers;
new text end
new text begin
(4) a professional medical association, which may include an association of pain
management and chemical dependency specialists;
new text end
new text begin
(5) a professional pharmacy association;
new text end
new text begin
(6) a consumer privacy or security advocate; and
new text end
new text begin
(7) a consumer or patient rights organization.
new text end
new text begin
(b) The advisory committee shall advise the board on the development and operation
of the electronic reporting system, including, but not limited to:
new text end
new text begin
(1) technical standards for electronic prescription drug reporting;
new text end
new text begin
(2) proper analysis and interpretation of prescription monitoring data; and
new text end
new text begin
(3) an evaluation process for the program.
new text end
new text begin
(c) The Board of Pharmacy, after consultation with the advisory committee, shall
present recommendations and draft legislation on the issues addressed by the advisory
committee under paragraph (b), to the legislature by December 15, 2007.
new text end
new text begin Subd. 4. new text end
new text begin Reporting requirements; notice. new text end
new text begin
(a) Each dispenser must submit the
following data to the board or its designated vendor, subject to the notice required under
paragraph (d):
new text end
new text begin
(1) name of the prescriber;
new text end
new text begin
(2) national provider identifier of the prescriber;
new text end
new text begin
(3) name of the dispenser;
new text end
new text begin
(4) national provider identifier of the dispenser;
new text end
new text begin
(5) name of the patient for whom the prescription was written;
new text end
new text begin
(6) date of birth of the patient for whom the prescription was written;
new text end
new text begin
(7) date the prescription was written;
new text end
new text begin
(8) date the prescription was filled;
new text end
new text begin
(9) name and strength of the controlled substance;
new text end
new text begin
(10) quantity of controlled substance prescribed; and
new text end
new text begin
(11) quantity of controlled substance dispensed.
new text end
new text begin
(b) The dispenser must submit the required information by a procedure and in a
format established by the board.
new text end
new text begin
(c) A dispenser is not required to submit this data for those controlled substance
prescriptions dispensed for:
new text end
new text begin
(1) individuals residing in licensed skilled nursing or intermediate care facilities;
new text end
new text begin
(2) individuals receiving assisted living services under chapter 144G or through a
medical assistance home and community-based waiver;
new text end
new text begin
(3) individuals receiving medication intravenously;
new text end
new text begin
(4) individuals receiving hospice and other palliative or end-of-life care; and
new text end
new text begin
(5) individuals receiving services from a home care provider regulated under chapter
144A.
new text end
new text begin
(d) A dispenser must not submit data under this subdivision unless a conspicuous
notice of the reporting requirements of this section is given to the patient for whom the
prescription was written.
new text end
new text begin Subd. 5. new text end
new text begin Use of data by board. new text end
new text begin
(a) The board shall develop and maintain a database
of the data reported under subdivision 4. The board shall maintain data that could identify
an individual prescriber or dispenser in encrypted form. The database may be used by
permissible users identified under subdivision 6 for the identification of:
new text end
new text begin
(1) individuals receiving prescriptions for controlled substances from prescribers
who subsequently obtain controlled substances from dispensers in quantities or with
a frequency inconsistent with standards accepted by national and international pain
management associations of dosage for those controlled substances; and
new text end
new text begin
(2) individuals presenting forged or otherwise false or altered prescriptions for
controlled substances to dispensers.
new text end
new text begin
(b) No permissible user identified under subdivision 6 may access the database
for the sole purpose of identifying prescribers of controlled substances for unusual or
excessive prescribing patterns without a valid search warrant or court order.
new text end
new text begin
(c) No personnel of a state or federal occupational licensing board or agency may
access the database for the purpose of obtaining information to be used to initiate or
substantiate a disciplinary action against a prescriber.
new text end
new text begin
(d) Data reported under subdivision 4 shall be retained by the board in the database
for a 12-month period, and shall be removed from the database 12 months from the date
the data was received.
new text end
new text begin Subd. 6. new text end
new text begin Access to reporting system data. new text end
new text begin
(a) Except as indicated in this
subdivision, the data submitted to the board under subdivision 4 is private data on
individuals as defined in section 13.02, subdivision 12, and not subject to public disclosure.
new text end
new text begin
(b) Except as specified in subdivision 5, the following persons shall be considered
permissible users and may access the data submitted under subdivision 4 in the same or
similar manner, and for the same or similar purposes, as those persons who are authorized
to access similar private data on individuals under federal and state law:
new text end
new text begin
(1) a prescriber, to the extent the information relates specifically to a current patient
of the prescriber, to whom the practitioner is prescribing or considering prescribing any
controlled substance;
new text end
new text begin
(2) a dispenser, to the extent the information relates specifically to a current patient
to whom that dispenser is dispensing or considering dispensing any controlled substance;
new text end
new text begin
(3) an individual who is the recipient of a controlled substance prescription for
which data was submitted under subdivision 4, or a guardian of the individual, parent or
guardian of a minor, or health care agent of the individual acting under a health care
directive under chapter 145C;
new text end
new text begin
(4) personnel of the board specifically assigned to conduct a bona fide investigation
of a specific licensee;
new text end
new text begin
(5) personnel of the board engaged in the collection of controlled substance
prescription information as part of the assigned duties and responsibilities under this
section;
new text end
new text begin
(6) authorized personnel of a vendor under contract with the board who are engaged
in the design, implementation, and maintenance of the electronic reporting system as part
of the assigned duties and responsibilities of their employment, provided that access to data
is limited to the minimum amount necessary to test and maintain the system databases;
new text end
new text begin
(7) federal, state, and local law enforcement authorities acting pursuant to a valid
search warrant; and
new text end
new text begin
(8) personnel of the medical assistance program assigned to use the data collected
under this section to identify recipients whose usage of controlled substances may warrant
restriction to a single primary care physician, a single outpatient pharmacy, or a single
hospital.
new text end
new text begin
For purposes of clause (3), access by an individual includes persons in the definition
of an individual under section 13.02.
new text end
new text begin
(c) Any permissible user identified in paragraph (b), who directly accesses
the data electronically, shall implement and maintain a comprehensive information
security program that contains administrative, technical, and physical safeguards that
are appropriate to the user's size and complexity, and the sensitivity of the personal
information obtained. The permissible user shall identify reasonably foreseeable internal
and external risks to the security, confidentiality, and integrity of personal information
that could result in the unauthorized disclosure, misuse, or other compromise of the
information and assess the sufficiency of any safeguards in place to control the risks.
new text end
new text begin
(d) The board shall not release data submitted under this section unless it is provided
with evidence, satisfactory to the board, that the person requesting the information is
entitled to receive the data.
new text end
new text begin
(e) The board shall not release the name of a prescriber without the written consent
of the prescriber or a valid search warrant or court order. The board shall provide a
mechanism for a prescriber to submit to the board a signed consent authorizing the release
of the prescriber's name when data containing the prescriber's name is requested.
new text end
new text begin
(f) The board shall maintain a log of all persons who access the data and shall ensure
that any permissible user complies with paragraph (c) prior to attaining direct access to
the data.
new text end
new text begin Subd. 7. new text end
new text begin Disciplinary action. new text end
new text begin
(a) A dispenser who knowingly fails to submit data to
the board as required under this section is subject to disciplinary action by the appropriate
health-related licensing board.
new text end
new text begin
(b) A prescriber or dispenser authorized to access the data who knowingly discloses
the data in violation of state or federal laws relating to the privacy of health care data
shall be subject to disciplinary action by the appropriate health-related licensing board,
and appropriate civil penalties.
new text end
new text begin Subd. 8. new text end
new text begin Evaluation and reporting. new text end
new text begin
(a) The board shall evaluate the prescription
electronic reporting system to determine if the system is cost-effective and whether it is
negatively impacting appropriate prescribing practices of controlled substances. The
board may contract with a vendor to design and conduct the evaluation.
new text end
new text begin
(b) The board shall submit the evaluation of the system to the legislature by January
15, 2010.
new text end
new text begin Subd. 9. new text end
new text begin Immunity from liability; no requirement to obtain information. new text end
new text begin
(a) A
pharmacist, prescriber, or other dispenser making a report to the program in good faith
under this section is immune from any civil, criminal, or administrative liability, which
might otherwise be incurred or imposed as a result of the report, or on the basis that the
pharmacist or prescriber did or did not seek or obtain or use information from the program.
new text end
new text begin
(b) Nothing in this section shall require a pharmacist, prescriber, or other dispenser
to obtain information about a patient from the program, and the pharmacist, prescriber,
or other dispenser, if acting in good faith, is immune from any civil, criminal, or
administrative liability that might otherwise be incurred or imposed for requesting,
receiving, or using information from the program.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2007, or upon receiving
sufficient nonstate funds to implement the prescription electronic reporting program,
whichever is later. In the event that nonstate funds are not secured by the Board of
Pharmacy to adequately fund the implementation of the prescription electronic reporting
program, the board is not required to implement this section without a subsequent
appropriation from the legislature.
new text end
Sec. 8.
Minnesota Statutes 2006, section 245.4874, is amended to read:
245.4874 DUTIES OF COUNTY BOARD.
(a) The county board must:
(1) develop a system of affordable and locally available children's mental health
services according to sections 245.487 to 245.4887;
(2) establish a mechanism providing for interagency coordination as specified in
section 245.4875, subdivision 6;
(3) consider the assessment of unmet needs in the county as reported by the local
children's mental health advisory council under section 245.4875, subdivision 5, paragraph
(b), clause (3). The county shall provide, upon request of the local children's mental health
advisory council, readily available data to assist in the determination of unmet needs;
(4) assure that parents and providers in the county receive information about how to
gain access to services provided according to sections 245.487 to 245.4887;
(5) coordinate the delivery of children's mental health services with services
provided by social services, education, corrections, health, and vocational agencies to
improve the availability of mental health services to children and the cost-effectiveness of
their delivery;
(6) assure that mental health services delivered according to sections 245.487
to 245.4887 are delivered expeditiously and are appropriate to the child's diagnostic
assessment and individual treatment plan;
(7) provide the community with information about predictors and symptoms of
emotional disturbances and how to access children's mental health services according to
sections 245.4877 and 245.4878;
(8) provide for case management services to each child with severe emotional
disturbance according to sections 245.486; 245.4871, subdivisions 3 and 4; and 245.4881,
subdivisions 1, 3, and 5;
(9) provide for screening of each child under section 245.4885 upon admission
to a residential treatment facility, acute care hospital inpatient treatment, or informal
admission to a regional treatment center;
(10) prudently administer grants and purchase-of-service contracts that the county
board determines are necessary to fulfill its responsibilities under sections 245.487 to
245.4887;
(11) assure that mental health professionals, mental health practitioners, and case
managers employed by or under contract to the county to provide mental health services
are qualified under section 245.4871;
(12) assure that children's mental health services are coordinated with adult mental
health services specified in sections 245.461 to 245.486 so that a continuum of mental
health services is available to serve persons with mental illness, regardless of the person's
age;
(13) assure that culturally informed mental health consultants are used as necessary
to assist the county board in assessing and providing appropriate treatment for children of
cultural or racial minority heritage; and
(14) consistent with section 245.486, arrange for or provide a children's mental
health screening to a child receiving child protective services or a child in out-of-home
placement, a child for whom parental rights have been terminated, a child found to be
delinquent, and a child found to have committed a juvenile petty offense for the third
or subsequent time, unless a screeningnew text begin or diagnostic assessmentnew text end has been performed
within the previous 180 days, or the child is currently under the care of a mental health
professional. The court or county agency must notify a parent or guardian whose
parental rights have not been terminated of the potential mental health screening and the
option to prevent the screening by notifying the court or county agency in writing. The
screening shall be conducted with a screening instrument approved by the commissioner
of human services according to criteria that are updated and issued annually to ensure
that approved screening instruments are valid and useful for child welfare and juvenile
justice populations, and shall be conducted by a mental health practitioner as defined in
section 245.4871, subdivision 26, or a probation officer or local social services agency
staff person who is trained in the use of the screening instrument. Training in the use of the
instrument shall include training in the administration of the instrument, the interpretation
of its validity given the child's current circumstances, the state and federal data practices
laws and confidentiality standards, the parental consent requirement, and providing respect
for families and cultural values. If the screen indicates a need for assessment, the child's
family, or if the family lacks mental health insurance, the local social services agency,
in consultation with the child's family, shall have conducted a diagnostic assessment,
including a functional assessment, as defined in section 245.4871. The administration of
the screening shall safeguard the privacy of children receiving the screening and their
families and shall comply with the Minnesota Government Data Practices Act, chapter
13, and the federal Health Insurance Portability and Accountability Act of 1996, Public
Law 104-191. Screening results shall be considered private data and the commissioner
shall not collect individual screening results.
(b) When the county board refers clients to providers of children's therapeutic
services and supports under section 256B.0943, the county board must clearly identify
the desired services components not covered under section 256B.0943 and identify the
reimbursement source for those requested services, the method of payment, and the
payment rate to the provider.
Sec. 9.
Minnesota Statutes 2006, section 253B.185, subdivision 2, is amended to read:
Subd. 2.
Transfer to correctional facility.
(a) If a person has been committed
under this section and later is committed to the custody of the commissioner of corrections
for any reason, including but not limited to, being sentenced for a crime or revocation of
the person's supervised release or conditional release under section 244.05deleted text begin , 609.108,
subdivision 6,deleted text end or 609.109, subdivision 7, the person shall be transferred to a facility
designated by the commissioner of corrections without regard to the procedures provided
in section 253B.18.
(b) If a person is committed under this section after a commitment to the
commissioner of corrections, the person shall first serve the sentence in a facility
designated by the commissioner of corrections. After the person has served the sentence,
the person shall be transferred to a treatment program designated by the commissioner
of human services.
Sec. 10.
Minnesota Statutes 2006, section 254A.03, subdivision 3, is amended to read:
Subd. 3.
Rules for chemical dependency care.
The commissioner of human
services shall establish by rule criteria to be used in determining the appropriate level
of chemical dependency caredeleted text begin , whether outpatient, inpatient or short-term treatment
programs,deleted text end for each recipient of public assistance seeking treatment for alcohol or other
drug dependency and abuse problems. deleted text begin The criteria shall address, at least, the family
relationship, past treatment history, medical or physical problems, arrest record, and
employment situation.
deleted text end
Sec. 11.
Minnesota Statutes 2006, section 254A.16, subdivision 2, is amended to read:
Subd. 2.
Program and service guidelines.
(a) The commissioner shall provide
program and service guidelines and technical assistance to the county boards in carrying
out services authorized under deleted text begin sectionsdeleted text end new text begin sectionnew text end 254A.08deleted text begin , 254A.12, 254A.14, and their
responsibilities under chapter 256Edeleted text end .
(b) The commissioner shall recommend to the governor means of improving
the efficiency and effectiveness of comprehensive program services in the state and
maximizing the use of nongovernmental funds for providing comprehensive programs.
Sec. 12.
Minnesota Statutes 2006, section 254B.02, subdivision 1, is amended to read:
Subdivision 1.
Chemical dependency treatment allocation.
The chemical
dependency funds appropriated for allocation shall be placed in a special revenue account.
The commissioner shall annually transfer funds from the chemical dependency fund to pay
for operation of the drug and alcohol abuse normative evaluation system and to pay for all
costs incurred by adding two positions for licensing of chemical dependency treatment
and rehabilitation programs located in hospitals for which funds are not otherwise
appropriated. deleted text begin For each year of the biennium ending June 30, 1999, the commissioner shall
allocate funds to the American Indian chemical dependency tribal account for treatment
of American Indians by eligible vendors under section 254B.05, equal to the amount
allocated in fiscal year 1997.deleted text end new text begin Six percent of the remaining money must be reserved for
tribal allocation under section 254B.09, subdivisions 4 and 5.new text end The commissioner shall
annually divide the money available in the chemical dependency fund that is not held
in reserve by counties from a previous allocation, or allocated to the American Indian
chemical dependency tribal account. Six percent of the remaining money must be
reserved for the nonreservation American Indian chemical dependency allocation for
treatment of American Indians by eligible vendors under section 254B.05, subdivision
1. The remainder of the money must be allocated among the counties according to the
following formula, using state demographer data and other data sources determined by
the commissioner:
(a) For purposes of this formula, American Indians and children under age 14 are
subtracted from the population of each county to determine the restricted population.
(b) The amount of chemical dependency fund expenditures for entitled persons for
services not covered by prepaid plans governed by section 256B.69 in the previous year is
divided by the amount of chemical dependency fund expenditures for entitled persons for
all services to determine the proportion of exempt service expenditures for each county.
(c) The prepaid plan months of eligibility is multiplied by the proportion of exempt
service expenditures to determine the adjusted prepaid plan months of eligibility for
each county.
(d) The adjusted prepaid plan months of eligibility is added to the number of
restricted population fee for service months of eligibility for the Minnesota family
investment program, general assistance, and medical assistance and divided by the county
restricted population to determine county per capita months of covered service eligibility.
(e) The number of adjusted prepaid plan months of eligibility for the state is added
to the number of fee for service months of eligibility for the Minnesota family investment
program, general assistance, and medical assistance for the state restricted population and
divided by the state restricted population to determine state per capita months of covered
service eligibility.
(f) The county per capita months of covered service eligibility is divided by the
state per capita months of covered service eligibility to determine the county welfare
caseload factor.
(g) The median married couple income for the most recent three-year period
available for the state is divided by the median married couple income for the same period
for each county to determine the income factor for each county.
(h) The county restricted population is multiplied by the sum of the county welfare
caseload factor and the county income factor to determine the adjusted population.
(i) $15,000 shall be allocated to each county.
(j) The remaining funds shall be allocated proportional to the county adjusted
population.
Sec. 13.
Minnesota Statutes 2006, section 254B.02, subdivision 5, is amended to read:
Subd. 5.
Administrative adjustment.
The commissioner may make payments to
local agencies from money allocated under this section to support administrative activities
under sections 254B.03 and 254B.04. The administrative payment must not exceed
five percent of the first $50,000, four percent of the next $50,000, and three percent of
the remaining payments for services from the allocation. deleted text begin Twenty-five percent of the
administrative allowance shall be advanced at the beginning of each quarter, based on
the payments for services made in the most recent quarter for which data is available.
Adjustment of any overestimate or underestimate based on actual expenditures shall be
made by the state agency by adjusting the administrative allowance for any succeeding
quarter.deleted text end
Sec. 14.
Minnesota Statutes 2006, section 254B.03, subdivision 1, is amended to read:
Subdivision 1.
Local agency duties.
(a) Every local agency shall provide chemical
dependency services to persons residing within its jurisdiction who meet criteria
established by the commissioner for placement in a chemical dependency residential or
nonresidential treatment service. Chemical dependency money must be administered
by the local agencies according to law and rules adopted by the commissioner under
sections 14.001 to 14.69.
(b) In order to contain costs, the county board shall, with the approval of the
commissioner of human services, select eligible vendors of chemical dependency services
who can provide economical and appropriate treatment. Unless the local agency is a social
services department directly administered by a county or human services board, the local
agency shall not be an eligible vendor under section 254B.05. The commissioner may
approve proposals from county boards to provide services in an economical manner or to
control utilization, with safeguards to ensure that necessary services are provided. If a
county implements a demonstration or experimental medical services funding plan, the
commissioner shall transfer the money as appropriate. If a county selects a vendor located
in another state, the county shall ensure that the vendor is in compliance with the rules
governing licensure of programs located in the state.
deleted text begin
(c) The calendar year 2002 rate for vendors may not increase more than three
percent above the rate approved in effect on January 1, 2001. The calendar year 2003
rate for vendors may not increase more than three percent above the rate in effect on
January 1, 2002. The calendar years 2004 and 2005 rates may not exceed the rate in
effect on January 1, 2003.
deleted text end
deleted text begin (d)deleted text end new text begin (c)new text end A culturally specific vendor that provides assessments under a variance under
Minnesota Rules, part 9530.6610, shall be allowed to provide assessment services to
persons not covered by the variance.
Sec. 15.
Minnesota Statutes 2006, section 254B.03, subdivision 3, is amended to read:
Subd. 3.
Local agencies to pay state for county share.
deleted text begin Local agencies shall submit
invoices to the state on forms supplied by the commissioner and according to procedures
established by the commissioner.deleted text end Local agencies shall pay the state for the county share
of the deleted text begin invoiceddeleted text end servicesnew text begin authorized by the local agencynew text end . deleted text begin Payments shall be made at the
beginning of each month for services provided in the previous month. The commissioner
shall bill the county monthly for services, based on the most recent month for which
expenditure information is available. Adjustment of any overestimate or underestimate
based on actual expenditures shall be made by the state agency by adjusting the estimate
for any succeeding month.
deleted text end
Sec. 16.
Minnesota Statutes 2006, section 254B.06, subdivision 3, is amended to read:
Subd. 3.
Payment; denial.
The commissioner shall pay eligible vendors for
placements made by local agencies under section 254B.03, subdivision 1, and placements
by tribal designated agencies according to section 254B.09. The commissioner may
reduce or deny payment of the state share when services are not provided according to the
placement criteria established by the commissioner. The commissioner may pay for all or
a portion of improper county chemical dependency placements and bill the county for the
entire payment made when the placement did not comply with criteria established by the
commissioner. The commissioner may make payments to vendors and charge the county
100 percent of the payments if documentation of a county approved placement is received
more than 30 working days, exclusive of weekends and holidays, after the date services
begandeleted text begin ; or if the county approved invoice is received by the commissioner more than 120
days after the last date of service provided.deleted text end The commissioner shall not pay vendors until
private insurance company claims have been settled.
Sec. 17.
Minnesota Statutes 2006, section 256B.0625, subdivision 23, is amended to
read:
Subd. 23.
Day treatment services.
Medical assistance covers day treatment
services as specified in sections 245.462, subdivision 8, and 245.4871, subdivision 10, that
are provided under contract with the county board. Notwithstanding Minnesota Rules,
part 9505.0323, subpart 15, the commissioner may set authorization thresholds for day
treatment for adults according to section 256B.0625, subdivision 25. new text begin Notwithstanding
Minnesota Rules, part 9505.0323, subpart 15, new text end effective July 1, 2004, medical assistance
covers day treatment services for children as specified under section 256B.0943.
Sec. 18.
Minnesota Statutes 2006, section 256B.0943, subdivision 6, is amended to
read:
Subd. 6.
Provider entity clinical infrastructure requirements.
(a) To be
an eligible provider entity under this section, a provider entity must have a clinical
infrastructure that utilizes diagnostic assessment, an individualized treatment plan,
service delivery, and individual treatment plan review that are culturally competent,
child-centered, and family-driven to achieve maximum benefit for the client. The provider
entity must review and update the clinical policies and procedures every three years and
must distribute the policies and procedures to staff initially and upon each subsequent
update.
(b) The clinical infrastructure written policies and procedures must include policies
and procedures for:
(1) providing or obtaining a client's diagnostic assessment that identifies acute and
chronic clinical disorders, co-occurring medical conditions, sources of psychological and
environmental problems, and a functional assessment. The functional assessment must
clearly summarize the client's individual strengths and needs;
(2) developing an individual treatment plan that is:
(i) based on the information in the client's diagnostic assessment;
(ii) developed no later than the end of the first psychotherapy session after the
completion of the client's diagnostic assessment by the mental health professional who
provides the client's psychotherapy;
(iii) developed through a child-centered, family-driven planning process that
identifies service needs and individualized, planned, and culturally appropriate
interventions that contain specific treatment goals and objectives for the client and the
client's family or foster family;
(iv) reviewed at least once every 90 days and revised, if necessary; and
(v) signed by the client or, if appropriate, by the client's parent or other person
authorized by statute to consent to mental health services for the client;
(3) developing an individual behavior plan that documents services to be provided
by the mental health behavioral aide. The individual behavior plan must include:
(i) detailed instructions on the service to be provided;
(ii) time allocated to each service;
(iii) methods of documenting the child's behavior;
(iv) methods of monitoring the child's progress in reaching objectives; and
(v) goals to increase or decrease targeted behavior as identified in the individual
treatment plan;
(4) clinical supervision of the mental health practitioner and mental health behavioral
aide. A mental health professional must document the clinical supervision the professional
provides by cosigning individual treatment plans and making entries in the client's record
on supervisory activities. Clinical supervision does not include the authority to make or
terminate court-ordered placements of the child. A clinical supervisor must be available
for urgent consultation as required by the individual client's needs or the situation. Clinical
supervision may occur individually or in a small group to discuss treatment and review
progress toward goals. The focus of clinical supervision must be the client's treatment
needs and progress and the mental health practitioner's or behavioral aide's ability to
provide services;
(4a) CTSS certified provider entities providing day treatment programs must meet
the conditions in items (i) to (iii):
(i) the deleted text begin providerdeleted text end new text begin supervisornew text end must be present and available on the premises more
than 50 percent of the time in a five-working-day period during which the supervisee is
providing a mental health service;
(ii) the diagnosis and the client's individual treatment plan or a change in the
diagnosis or individual treatment plan must be made by or reviewed, approved, and signed
by the deleted text begin providerdeleted text end new text begin supervisornew text end ; and
(iii) every 30 days, the supervisor must review and sign the record of the client's care
for all activities in the preceding 30-day period;
(4b) for all other services provided under CTSS, clinical supervision standards
provided in items (i) to (iii) must be used:
(i) medical assistance shall reimburse a mental health practitioner who maintains a
consulting relationship with a mental health professional who accepts full professional
responsibility and is present on site for at least one observation during the first 12 hours
in which the mental health practitioner provides the individual, family, or group skills
training to the child or the child's family;
(ii) thereafter, the mental health professional is required to be present on site for
observation as clinically appropriate when the mental health practitioner is providing
individual, family, or group skills training to the child or the child's family; and
(iii) the observation must be a minimum of one clinical unit. The on-site presence of
the mental health professional must be documented in the child's record and signed by the
mental health professional who accepts full professional responsibility;
(5) providing direction to a mental health behavioral aide. For entities that employ
mental health behavioral aides, the clinical supervisor must be employed by the provider
entity or other certified children's therapeutic supports and services provider entity to
ensure necessary and appropriate oversight for the client's treatment and continuity
of care. The mental health professional or mental health practitioner giving direction
must begin with the goals on the individualized treatment plan, and instruct the mental
health behavioral aide on how to construct therapeutic activities and interventions that
will lead to goal attainment. The professional or practitioner giving direction must also
instruct the mental health behavioral aide about the client's diagnosis, functional status,
and other characteristics that are likely to affect service delivery. Direction must also
include determining that the mental health behavioral aide has the skills to interact with
the client and the client's family in ways that convey personal and cultural respect and
that the aide actively solicits information relevant to treatment from the family. The aide
must be able to clearly explain the activities the aide is doing with the client and the
activities' relationship to treatment goals. Direction is more didactic than is supervision
and requires the professional or practitioner providing it to continuously evaluate the
mental health behavioral aide's ability to carry out the activities of the individualized
treatment plan and the individualized behavior plan. When providing direction, the
professional or practitioner must:
(i) review progress notes prepared by the mental health behavioral aide for accuracy
and consistency with diagnostic assessment, treatment plan, and behavior goals and the
professional or practitioner must approve and sign the progress notes;
(ii) identify changes in treatment strategies, revise the individual behavior plan,
and communicate treatment instructions and methodologies as appropriate to ensure
that treatment is implemented correctly;
(iii) demonstrate family-friendly behaviors that support healthy collaboration among
the child, the child's family, and providers as treatment is planned and implemented;
(iv) ensure that the mental health behavioral aide is able to effectively communicate
with the child, the child's family, and the provider; and
(v) record the results of any evaluation and corrective actions taken to modify the
work of the mental health behavioral aide;
(6) providing service delivery that implements the individual treatment plan and
meets the requirements under subdivision 9; and
(7) individual treatment plan review. The review must determine the extent to which
the services have met the goals and objectives in the previous treatment plan. The review
must assess the client's progress and ensure that services and treatment goals continue to
be necessary and appropriate to the client and the client's family or foster family. Revision
of the individual treatment plan does not require a new diagnostic assessment unless the
client's mental health status has changed markedly. The updated treatment plan must be
signed by the client, if appropriate, and by the client's parent or other person authorized by
statute to give consent to the mental health services for the child.
Sec. 19.
Minnesota Statutes 2006, section 256B.0943, subdivision 9, is amended to
read:
Subd. 9.
Service delivery criteria.
(a) In delivering services under this section, a
certified provider entity must ensure that:
(1) each individual provider's caseload size permits the provider to deliver services
to both clients with severe, complex needs and clients with less intensive needs. The
provider's caseload size should reasonably enable the provider to play an active role in
service planning, monitoring, and delivering services to meet the client's and client's
family's needs, as specified in each client's individual treatment plan;
(2) site-based programs, including day treatment and preschool programs, provide
staffing and facilities to ensure the client's health, safety, and protection of rights, and that
the programs are able to implement each client's individual treatment plan;
(3) a day treatment program is provided to a group of clients by a multidisciplinary
team under the clinical supervision of a mental health professional. The day treatment
program must be provided in and by: (i) an outpatient hospital accredited by the Joint
Commission on Accreditation of Health Organizations and licensed under sections
144.50 to 144.55; (ii) a community mental health center under section 245.62; and (iii)
an entity that is under contract with the county board to operate a program that meets
the requirements of sections 245.4712, subdivision 2, and 245.4884, subdivision 2,
and Minnesota Rules, parts 9505.0170 to 9505.0475. The day treatment program must
stabilize the client's mental health status while developing and improving the client's
independent living and socialization skills. The goal of the day treatment program must be
to reduce or relieve the effects of mental illness and provide training to enable the client
to live in the community. The program must be available at least one day a week for a
deleted text begin minimumdeleted text end three-hour time block. The three-hour time block must include at least one
hour, but no more than two hours, of individual or group psychotherapy. The remainder
of the three-hour time block may include recreation therapy, socialization therapy, or
independent living skills therapy, but only if the therapies are included in the client's
individual treatment plan. Day treatment programs are not part of inpatient or residential
treatment services; and
(4) a preschool program is a structured treatment program offered to a child who
is at least 33 months old, but who has not yet reached the first day of kindergarten, by a
preschool multidisciplinary team in a day program licensed under Minnesota Rules, parts
9503.0005 to 9503.0175. The program must be available at least one day a week for a
minimum two-hour time block. The structured treatment program may include individual
or group psychotherapy and recreation therapy, socialization therapy, or independent
living skills therapy, if included in the client's individual treatment plan.
(b) A provider entity must deliver the service components of children's therapeutic
services and supports in compliance with the following requirements:
(1) individual, family, and group psychotherapy must be delivered as specified in
Minnesota Rules, part 9505.0323;
(2) individual, family, or group skills training must be provided by a mental health
professional or a mental health practitioner who has a consulting relationship with a
mental health professional who accepts full professional responsibility for the training;
(3) crisis assistance must be time-limited and designed to resolve or stabilize crisis
through arrangements for direct intervention and support services to the child and the
child's family. Crisis assistance must utilize resources designed to address abrupt or
substantial changes in the functioning of the child or the child's family as evidenced by
a sudden change in behavior with negative consequences for well being, a loss of usual
coping mechanisms, or the presentation of danger to self or others;
(4) medically necessary services that are provided by a mental health behavioral
aide must be designed to improve the functioning of the child and support the family in
activities of daily and community living. A mental health behavioral aide must document
the delivery of services in written progress notes. The mental health behavioral aide
must implement goals in the treatment plan for the child's emotional disturbance that
allow the child to acquire developmentally and therapeutically appropriate daily living
skills, social skills, and leisure and recreational skills through targeted activities. These
activities may include:
(i) assisting a child as needed with skills development in dressing, eating, and
toileting;
(ii) assisting, monitoring, and guiding the child to complete tasks, including
facilitating the child's participation in medical appointments;
(iii) observing the child and intervening to redirect the child's inappropriate behavior;
(iv) assisting the child in using age-appropriate self-management skills as related
to the child's emotional disorder or mental illness, including problem solving, decision
making, communication, conflict resolution, anger management, social skills, and
recreational skills;
(v) implementing deescalation techniques as recommended by the mental health
professional;
(vi) implementing any other mental health service that the mental health professional
has approved as being within the scope of the behavioral aide's duties; or
(vii) assisting the parents to develop and use parenting skills that help the child
achieve the goals outlined in the child's individual treatment plan or individual behavioral
plan. Parenting skills must be directed exclusively to the child's treatment; and
(5) direction of a mental health behavioral aide must include the following:
(i) a total of one hour of on-site observation by a mental health professional during
the first 12 hours of service provided to a child;
(ii) ongoing on-site observation by a mental health professional or mental health
practitioner for at least a total of one hour during every 40 hours of service provided
to a child; and
(iii) immediate accessibility of the mental health professional or mental health
practitioner to the mental health behavioral aide during service provision.
Sec. 20.
Minnesota Statutes 2006, section 256B.0943, subdivision 11, is amended to
read:
Subd. 11.
Documentation and billing.
(a) A provider entity must document the
services it provides under this section. The provider entity must ensure that the entity's
documentation standards meet the requirements of federal and state laws. Services billed
under this section that are not documented according to this subdivision shall be subject to
monetary recovery by the commissioner.new text begin The provider entity may not bill for anything
other than direct service time.
new text end
(b) An individual mental health provider must promptly document the following
in a client's record after providing services to the client:
(1) each occurrence of the client's mental health service, including the date, type,
length, and scope of the service;
(2) the name of the person who gave the service;
(3) contact made with other persons interested in the client, including representatives
of the courts, corrections systems, or schools. The provider must document the name
and date of each contact;
(4) any contact made with the client's other mental health providers, case manager,
family members, primary caregiver, legal representative, or the reason the provider did
not contact the client's family members, primary caregiver, or legal representative, if
applicable; and
(5) required clinical supervision, as appropriate.
Sec. 21.
Minnesota Statutes 2006, section 256B.0943, subdivision 12, is amended to
read:
Subd. 12.
Excluded services.
The following services are not eligible for medical
assistance payment as children's therapeutic services and supports:
(1) service components of children's therapeutic services and supports
simultaneously provided by more than one provider entity unless prior authorization is
obtained;
(2) children's therapeutic services and supports provided in violation of medical
assistance policy in Minnesota Rules, part 9505.0220;
(3) mental health behavioral aide services provided by a personal care assistant who
is not qualified as a mental health behavioral aide and employed by a certified children's
therapeutic services and supports provider entity;
(4) service components of CTSS that are the responsibility of a residential or
program license holder, including foster care providers under the terms of a service
agreement or administrative rules governing licensure; deleted text begin and
deleted text end
(5) adjunctive activities that may be offered by a provider entity but are not
otherwise covered by medical assistance, including:
(i) a service that is primarily recreation oriented or that is provided in a setting that
is not medically supervised. This includes sports activities, exercise groups, activities
such as craft hours, leisure time, social hours, meal or snack time, trips to community
activities, and tours;
(ii) a social or educational service that does not have or cannot reasonably be
expected to have a therapeutic outcome related to the client's emotional disturbance;
(iii) consultation with other providers or service agency staff about the care or
progress of a client;
(iv) prevention or education programs provided to the community; and
(v) treatment for clients with primary diagnoses of alcohol or other drug abusedeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(6) activities that are not direct service time.
new text end
Sec. 22.
Minnesota Statutes 2006, section 256E.35, subdivision 2, is amended to read:
Subd. 2.
Definitions.
(a) The definitions in this subdivision apply to this section.
(b) "Family asset account" means a savings account opened by a household
participating in the Minnesota family assets for independence initiative.
(c) "Fiduciary organization" means:
(1) a community action agency that has obtained recognition under section ;
(2) a federal community development credit union serving the seven-county
metropolitan area; or
(3) a women-oriented economic development agency serving the seven-county
metropolitan area.
(d) "Financial institution" means a bank, bank and trust, savings bank, savings
association, or credit union, the deposits of which are insured by the Federal Deposit
Insurance Corporation or the National Credit Union Administration.
(e) "Permissible use" means:
(1) postsecondary educational expenses at an accredited public postsecondary
institution including books, supplies, and equipment required for courses of instruction;
(2) acquisition costs of acquiring, constructing, or reconstructing a residence,
including any usual or reasonable settlement, financing, or other closing costs;
(3) business capitalization expenses for expenditures on capital, plant, equipment,
working capital, and inventory expenses of a legitimate business pursuant to a business
plan approved by the fiduciary organization; and
(4) acquisition costs of a principal residence within the meaning of section 1034 of
the Internal Revenue Code of 1986 which do not exceed 100 percent of the average area
purchase price applicable to the residence determined according to section 143(e)(2) and
(3) of the Internal Revenue Code of 1986.
(f) "Household" means all individuals who share use of a dwelling unit as primary
quarters for living and eating separate from other individuals.
Sec. 23.
Laws 2005, chapter 98, article 3, section 25, is amended to read:
Sec. 25. REPEALER.
Minnesota Statutes 2004, sections 245.713, deleted text begin subdivisions 2 anddeleted text end new text begin subdivisionnew text end 4;
245.716; and 626.5551, subdivision 4, are repealed.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective retroactively from August 1, 2005.
new text end
Sec. 24. new text begin FEDERAL GRANTS.
new text end
new text begin
The Board of Pharmacy shall apply for any applicable federal grants or other nonstate
funds to establish and fully implement the prescription electronic reporting system.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 25. new text begin BOARD OF PHARMACY.
new text end
new text begin
The Board of Pharmacy shall not increase the license fees of pharmacists or
pharmacies in order to adequately fund the prescription electronic reporting system under
Minnesota Statutes, section 152.126, without specific authority from the legislature.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 26. new text begin BOARD OF MEDICAL PRACTICE.
new text end
new text begin
The Board of Medical Practice shall convene a work group to discuss the appropriate
prescribing of controlled substances listed in Minnesota Statutes, section 152.02,
subdivisions 3 and 4, and those substances defined by the Board of Pharmacy under
Minnesota Statutes, section 152.02, subdivisions 7, 8, and 12, for pain management, and
shall report to the legislature by December 15, 2007.
new text end
Sec. 27. new text begin REPEALER.
new text end
new text begin
(a) Minnesota Statutes 2006, sections 254A.02, subdivisions 7, 9, 12, 14, 15, and 16;
254A.085; 254A.086; 254A.12; 254A.14; 254A.15; 254A.16, subdivision 5; 254A.175;
254A.18; 256J.561, subdivision 1; 256J.62, subdivision 9; and 256J.65,
new text end
new text begin
are repealed.
new text end
new text begin
(b)
new text end
new text begin
Minnesota Rules, part 9503.0035, subpart 2,
new text end
new text begin
is repealed.
new text end
ARTICLE 12
MISCELLANEOUS
Section 1.
Minnesota Statutes 2006, section 43A.23, subdivision 1, is amended to read:
Subdivision 1.
General.
new text begin (a) new text end The commissioner is authorized to request bids and
to enter into contracts with parties which in the judgment of the commissioner are best
qualified to provide service to the benefit plans. Contracts entered into are not subject
to the requirements of sections 16C.16 to 16C.19. The commissioner may negotiate
premium rates and coverage. Contracts to underwrite the benefit plans must be bid or
negotiated separately from contracts to service the benefit plans, which may be awarded
only on the basis of competitive bids. The commissioner shall consider the cost of the
plans, conversion options relating to the contracts, service capabilities, character, financial
position, and reputation of the carriers, and any other factors which the commissioner
deems appropriate. Each benefit contract must be for a uniform term of at least one year,
but may be made automatically renewable from term to term in the absence of notice of
termination by either party. A carrier licensed under chapter 62A is exempt from the taxes
imposed by chapter 297I on premiums paid to it by the state.
new text begin (b) new text end All self-insured hospital and medical service products must comply with coverage
mandates, data reporting, and consumer protection requirements applicable to the licensed
carrier administering the product, had the product been insured, including chapters 62J,
62M, and 62Q. Any self-insured products that limit coverage to a network of providers
or provide different levels of coverage between network and nonnetwork providers shall
comply with section 62D.123 and geographic access standards for health maintenance
organizations adopted by the commissioner of health in rule under chapter 62D.
new text begin
(c) Notwithstanding paragraph (b), a self-insured hospital and medical product
offered under sections 43A.22 to 43A.30 is not required to extend dependent coverage to
an eligible employee's unmarried child under the age of 25 to the full extent required under
chapters 62A and 62L. Dependent coverage must, at a minimum, extend to an eligible
employee's unmarried child who is under the age of 19 or an unmarried child under the
age of 25 who is a full-time student. The definition of "full-time student" for purposes
of this paragraph includes any student who by reason of illness, injury, or physical or
mental disability as documented by a physician is unable to carry what the educational
institution considers a full-time course load so long as the student's course load is at least
60 percent of what otherwise is considered by the institution to be a full-time course load.
Any notice regarding termination of coverage due to attainment of the limiting age must
include information about this definition of "full-time student."
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2008.
new text end
Sec. 2.
Minnesota Statutes 2006, section 62E.02, subdivision 7, is amended to read:
Subd. 7.
Dependent.
"Dependent" means a spouse or unmarried child deleted text begin under the
age of 19 years, a dependent child who is a studentdeleted text end under the age of 25, or a dependent
child of any age who is disabled.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2008, and applies to
coverage offered, sold, issued, or renewed on or after that date.
new text end
Sec. 3.
Minnesota Statutes 2006, section 62H.02, is amended to read:
62H.02 REQUIRED PROVISIONS.
new text begin (a) new text end A joint self-insurance plan must include aggregate excess stop-loss coverage and
individual excess stop-loss coverage provided by an insurance company licensed by the
state of Minnesota.
new text begin (b) new text end Aggregate excess stop-loss coverage must include provisions to cover incurred,
unpaid claim liability in the event of plan termination. deleted text begin In addition,
deleted text end
new text begin (c)new text end The plan of self-insurance must have participating employers fund an amount at
least equal to the point at which the excess or stop-loss insurer has contracted to assume
100 percent of additional liability.
new text begin (d) new text end A joint self-insurance plan must submit its proposed excess or stop-loss insurance
contract to the commissioner of commerce at least 30 days prior to the proposed plan's
effective date and at least 30 days subsequent to any renewal date. The commissioner shall
review the contract to determine if they meet the standards established by sections 62H.01
to 62H.08 and respond within a 30-day period.
new text begin (e) new text end Any excess or stop-loss insurance plan must contain a provision that the excess
or stop-loss insurer will give the plan and the commissioner of commerce a minimum of
180 days' notice of termination or nonrenewal. If the plan fails to secure replacement
coverage within 60 days after receipt of the notice of cancellation or nonrenewal, the
commissioner shall issue an order providing for the orderly termination of the plan.
new text begin (f) new text end The commissioner may waive the requirements of this section and of any rule
relating to the requirements of this section, if the commissioner determines that a joint
self-insurance plan has established alternative arrangements that fully fund the plan's
liability or incurred but unpaid claims. The commissioner may not waive the requirement
that a joint self-insurance plan have excess stop-loss coverage.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 4.
Minnesota Statutes 2006, section 62J.07, subdivision 1, is amended to read:
Subdivision 1.
Legislative oversight.
The Legislative Commission on Health
Care Access deleted text begin reviews the activities of the commissioner of health, the Health Technology
Advisory Committee, and all other state agencies involved in the implementation and
administration of this chapter, including efforts to obtain federal approval through waivers
and other meansdeleted text end new text begin shall make recommendations to the legislature on how to achieve the
goal of universal health coverage as described in section 62Q.165. The recommendations
shall include a timetable in which measurable progress must be achieved toward this goal.
The commission shall submit to the legislature by January 15, 2008, the recommendations
and corresponding timetablenew text end .
Sec. 5.
Minnesota Statutes 2006, section 62J.07, subdivision 3, is amended to read:
Subd. 3.
Reports to the commission.
The deleted text begin commissionerdeleted text end new text begin commissioners new text end of
healthnew text begin , human services, commerce,new text end and deleted text begin the Health Technology Advisory Committee shall
report on their activities annually and at other times at the request of the Legislative
Commission on Health Care Access. The commissioners of health, commerce, and human
services shall provide periodic reports to the legislative commission on the progress of
rulemaking that is authorized or required under this chapter and shall notify members
of the commission when a draft of a proposed rule has been completed and scheduled
for publication in the State Register. At the request of a member of the commission,
a commissioner shall provide a description and a copy of a proposed ruledeleted text end new text begin other state
agencies shall provide assistance and technical support to the commission at the request
of the commission. The commission may convene subcommittees to provide additional
assistance and advice to the commissionnew text end .
Sec. 6.
Minnesota Statutes 2006, section 62L.02, subdivision 11, is amended to read:
Subd. 11.
Dependent.
"Dependent" means an eligible employee's spouse,
unmarried child who is deleted text begin under the age of 19 years, unmarried childdeleted text end under the age of 25
years deleted text begin who is a full-time student as defined in section 62A.301deleted text end , dependent child of any age
who is disabled and who meets the eligibility criteria in section 62A.14, subdivision 2,
or any other person whom state or federal law requires to be treated as a dependent for
purposes of health plans. For the purpose of this definition, a child includes a child for
whom the employee or the employee's spouse has been appointed legal guardian and an
adoptive child as provided in section 62A.27.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2008, and applies to
coverage offered, sold, issued, and renewed on or after that date.
new text end
Sec. 7.
Minnesota Statutes 2006, section 151.37, subdivision 2, is amended to read:
Subd. 2.
Prescribing and filing.
(a) A licensed practitioner in the course of
professional practice only, may prescribe, administer, and dispense a legend drug, and may
cause the same to be administered by a nurse, a physician assistant, or medical student or
resident under the practitioner's direction and supervision, and may cause a person who
is an appropriately certified, registered, or licensed health care professional to prescribe,
dispense, and administer the same within the expressed legal scope of the person's practice
as defined in Minnesota Statutes. A licensed practitioner may prescribe a legend drug,
without reference to a specific patient, by directing a nurse, pursuant to section 148.235,
subdivisions 8 and 9, physician assistant, or medical student or resident to adhere to
a particular practice guideline or protocol when treating patients whose condition falls
within such guideline or protocol, and when such guideline or protocol specifies the
circumstances under which the legend drug is to be prescribed and administered. An
individual who verbally, electronically, or otherwise transmits a written, oral, or electronic
order, as an agent of a prescriber, shall not be deemed to have prescribed the legend drug.
This paragraph applies to a physician assistant only if the physician assistant meets the
requirements of section 147A.18.
(b) A licensed practitioner that dispenses for profit a legend drug that is to be
administered orally, is ordinarily dispensed by a pharmacist, and is not a vaccine, must
file with the practitioner's licensing board a statement indicating that the practitioner
dispenses legend drugs for profit, the general circumstances under which the practitioner
dispenses for profit, and the types of legend drugs generally dispensed. It is unlawful to
dispense legend drugs for profit after July 31, 1990, unless the statement has been filed
with the appropriate licensing board. For purposes of this paragraph, "profit" means (1)
any amount received by the practitioner in excess of the acquisition cost of a legend drug
for legend drugs that are purchased in prepackaged form, or (2) any amount received
by the practitioner in excess of the acquisition cost of a legend drug plus the cost of
making the drug available if the legend drug requires compounding, packaging, or other
treatment. The statement filed under this paragraph is public data under section 13.03.
This paragraph does not apply to a licensed doctor of veterinary medicine or a registered
pharmacist. Any person other than a licensed practitioner with the authority to prescribe,
dispense, and administer a legend drug under paragraph (a) shall not dispense for profit.
To dispense for profit does not include dispensing by a community health clinic when the
profit from dispensing is used to meet operating expenses.
new text begin
(c) A prescription or drug order for a legend drug is not valid if it is based solely
on an online questionnaire, unless it can be established that the prescription or order was
based on a documented patient evaluation adequate to establish a diagnosis and identify
underlying conditions and contraindications to treatment.
new text end
Sec. 8.
Minnesota Statutes 2006, section 152.11, is amended by adding a subdivision to
read:
new text begin Subd. 2d. new text end
new text begin
Identification requirement for schedule II or III controlled substance.
new text end
new text begin
(a) No person may dispense a controlled substance included in schedule II or III without
requiring the person purchasing the controlled substance, who need not be the person for
whom the controlled substance prescription is written, to present valid photographic
identification, unless the person purchasing the controlled substance, or if applicable the
person for whom the controlled substance prescription is written, is known to the dispenser.
new text end
new text begin
(b) This subdivision applies only to purchases of controlled substances that are not
covered, in whole or in part, by a health plan company or other third-party payor. The
Board of Pharmacy shall report to the legislature by July 1, 2009, on the effect of this
subdivision. The board shall include in the report the incidence of complaints, if any,
generated by the requirements of this subdivision and whether this subdivision is creating
barriers to pharmaceutical access.
new text end
Sec. 9.
Minnesota Statutes 2006, section 169A.70, subdivision 4, is amended to read:
Subd. 4.
Assessor standards; rules; assessment time limits.
A chemical use
assessment required by this section must be conducted by an assessor appointed by the
court. The assessor must meet the training and qualification requirements of rules adopted
by the commissioner of human services under section 254A.03, subdivision 3 (chemical
dependency treatment rules). Notwithstanding section 13.82 (law enforcement data), the
assessor shall have access to any police reports, laboratory test results, and other law
enforcement data relating to the current offense or previous offenses that are necessary
to complete the evaluation. An assessor providing an assessment under this section may
not have any direct or shared financial interest or referral relationship resulting in shared
financial gain with a treatment providernew text begin , except as authorized under section 254A.20,
subdivision 3new text end . If an independent assessor is not available, the court may use the services
of an assessor authorized to perform assessments for the county social services agency
under a variance granted under rules adopted by the commissioner of human services
under section 254A.03, subdivision 3. An appointment for the defendant to undergo the
assessment must be made by the court, a court services probation officer, or the court
administrator as soon as possible but in no case more than one week after the defendant's
court appearance. The assessment must be completed no later than three weeks after the
defendant's court appearance. If the assessment is not performed within this time limit, the
county where the defendant is to be sentenced shall perform the assessment. The county
of financial responsibility must be determined under chapter 256G.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 10.
new text begin
[254A.20] CHEMICAL USE ASSESSMENTS.
new text end
new text begin Subdivision 1. new text end
new text begin Persons arrested outside of home county. new text end
new text begin
When a chemical use
assessment is required under Minnesota Rules, parts 9530.6600 to 9530.6655, for a person
who is arrested and taken into custody by a peace officer outside of the person's county
of residence, the assessment must be completed by the person's county of residence no
later than three weeks after the assessment is initially requested. If the assessment is
not performed within this time limit, the county where the person is to be sentenced
shall perform the assessment. The county of financial responsibility is determined under
chapter 256G.
new text end
new text begin Subd. 2. new text end
new text begin Probation officer as contact. new text end
new text begin
When a chemical use assessment is required
under Minnesota Rules, parts 9530.6600 to 9530.6655, for a person who is on probation
or under other correctional supervision, the assessor, either orally or in writing, shall
contact the person's probation officer to verify or supplement the information provided
by the person.
new text end
new text begin Subd. 3. new text end
new text begin Financial conflicts of interest. new text end
new text begin
(a) Except as provided in paragraph (b), an
assessor conducting a chemical use assessment under Minnesota Rules, parts 9530.6600
to 9530.6655, may not have any direct or shared financial interest or referral relationship
resulting in shared financial gain with a treatment provider.
new text end
new text begin
(b) A county may contract with an assessor having a conflict described in paragraph
(a) if the county documents that:
new text end
new text begin
(1) the assessor is employed by a culturally specific service provider or a service
provider with a program designed to treat individuals of a specific age, sex, or sexual
preference;
new text end
new text begin
(2) the county does not employ a sufficient number of qualified assessors and the
only qualified assessors available in the county have a direct or shared financial interest or
a referral relationship resulting in shared financial gain with a treatment provider; or
new text end
new text begin
(3) the county social service agency has an existing relationship with an assessor
or service provider and elects to enter into a contract with that assessor to provide both
assessment and treatment under circumstances specified in the county's contract, provided
the county retains responsibility for making placement decisions.
new text end
new text begin
An assessor under this paragraph may not place clients in treatment. The assessor
shall gather required information and provide it to the county along with any required
documentation. The county shall make all placement decisions for clients assessed by
assessors under this paragraph.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2007, except for subdivision
3, which is effective the day following final enactment.
new text end
Sec. 11.
new text begin
[256B.0636] CONTROLLED SUBSTANCE PRESCRIPTIONS; ABUSE
PREVENTION.
new text end
new text begin
The commissioner of human services shall develop and implement a plan to:
new text end
new text begin
(1) review utilization patterns of Minnesota health care program enrollees for
controlled substances listed in section 152.02, subdivisions 3 and 4, and those substances
defined by the Board of Pharmacy under section 152.02, subdivisions 8 and 12;
new text end
new text begin
(2) develop a mechanism to address abuses both for fee-for-service Minnesota health
care program enrollees and those enrolled in managed care plans; and
new text end
new text begin
(3) provide education to Minnesota health care program enrollees on the proper use
of controlled substances.
new text end
new text begin
For purposes of this section, "Minnesota health care program" means medical
assistance, MinnesotaCare, or general assistance medical care.
new text end
Sec. 12.
Minnesota Statutes 2006, section 609.115, subdivision 8, is amended to read:
Subd. 8.
Chemical use assessment required.
(a) If a person is convicted of a
felony, the probation officer shall determine in the report prepared under subdivision 1
whether or not alcohol or drug use was a contributing factor to the commission of the
offense. If so, the report shall contain the results of a chemical use assessment conducted
in accordance with this subdivision. The probation officer shall make an appointment for
the defendant to undergo the chemical use assessment if so indicated.
(b) The chemical use assessment report must include a recommended level of
care for the defendant in accordance with the criteria contained in rules adopted by the
commissioner of human services under section 254A.03, subdivision 3. The assessment
must be conducted by an assessor qualified under rules adopted by the commissioner of
human services under section 254A.03, subdivision 3. An assessor providing a chemical
use assessment may not have any direct or shared financial interest or referral relationship
resulting in shared financial gain with a treatment providernew text begin , except as authorized under
section 254A.20, subdivision 3new text end . If an independent assessor is not available, the probation
officer may use the services of an assessor authorized to perform assessments for the
county social services agency under a variance granted under rules adopted by the
commissioner of human services under section 254A.03, subdivision 3.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 13. new text begin INTERPRETER SERVICES WORK GROUP.
new text end
new text begin
(a) The commissioner of health shall convene a work group of interested parties to
discuss the provision of interpreter services to patients in medical and dental care settings.
new text end
new text begin
(b) The work group shall develop findings and recommendations on the following:
new text end
new text begin
(1) ensuring access to interpreter services;
new text end
new text begin
(2) compliance with requirements of federal law and guidance;
new text end
new text begin
(3) developing a quality assurance program to ensure the quality of health care
interpreting services, including requirements for training and establishing a certification
process; and
new text end
new text begin
(4) identifying broad-based funding mechanisms for interpreter services.
new text end
new text begin
(c) The work group shall report findings and recommendations to the commissioner
of health and to the chairs of the health policy and finance committees in the house and
senate by January 15, 2008.
new text end
new text begin
(d) The work group expires the day following the submission of the report required
by paragraph (c).
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 14. new text begin AGRICULTURAL COOPERATIVE HEALTH PLAN FOR FARMERS.
new text end
new text begin Subdivision 1. new text end
new text begin Pilot project requirements. new text end
new text begin
Notwithstanding contrary provisions of
Minnesota Statutes, chapter 62H, the following apply to a joint self-insurance pilot project
administered by a trust sponsored by one or more agricultural cooperatives organized
under Minnesota Statutes, chapter 308A, or under a federal charter for the purpose of
offering health coverage to members of the cooperatives and their families, provided the
project satisfies the other requirements of Minnesota Statutes, chapter 62H:
new text end
new text begin
(1) Minnesota Statutes, section 62H.02, paragraph (b), does not apply;
new text end
new text begin
(2) the notice period required under Minnesota Statutes, section 62H.02, paragraph
(e), is 90 days;
new text end
new text begin
(3) a joint self-insurance plan may elect to treat the sale of a health plan to or for
an employer that has only one eligible employee who has not waived coverage as the
sale of an individual health plan as allowed under Minnesota Statutes, section 62L.02,
subdivision 26;
new text end
new text begin
(4) Minnesota Statutes, section 297I.05, subdivision 12, paragraph (c), applies; and
new text end
new text begin
(5) the trust must pay the assessment for the Minnesota Comprehensive Health
Association as provided under Minnesota Statutes, section 62E.11.
new text end
new text begin Subd. 2. new text end
new text begin Evaluation and renewal. new text end
new text begin
The pilot project authorized under this section
is for a period of four years from the date of initial enrollment. The commissioner of
commerce shall grant an extension of four additional years if the trust provides evidence
that it remains in compliance with the requirements of this section and other applicable
laws and rules. If the commissioner determines that the operation of the trust has not
improved access, expanded health plan choices, or improved the affordability of health
coverage for farm families, or that it has significantly damaged access, choice, or
affordability for other consumers not enrolled in the trust, the commissioner shall provide
at least 180 days' advance written notice to the trust and to the chairs of the senate and
house finance and policy committees with jurisdiction over health and insurance of the
commissioner's intention not to renew the pilot project at the expiration of a four-year
period.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 15. new text begin HEALTH PLAN PURCHASING POOL STUDY GROUP.
new text end
new text begin Subdivision 1. new text end
new text begin Creation; membership. new text end
new text begin
(a) A health plan purchasing pool study
group is created to study and make recommendations regarding the creation of a voluntary,
statewide health plan purchasing pool that would contract directly with providers to
provide affordable health coverage to eligible Minnesota residents. The study group is
composed of:
new text end
new text begin
(1) three members of the senate appointed by the Subcommittee on Committees of
the Committee on Rules and Administration, including one member of the minority;
new text end
new text begin
(2) three members of the house of representatives, two from the majority party
appointed by the speaker of the house of representatives, and one from the minority party
appointed by the minority leader of the house of representatives;
new text end
new text begin
(3) the attorney general or the attorney general's designated representative;
new text end
new text begin
(4) three representatives of health care providers appointed as follows:
new text end
new text begin
(i) one member appointed by the governor;
new text end
new text begin
(ii) one member appointed by the speaker of the house; and
new text end
new text begin
(iii) one member appointed by the Subcommittee on Committees of the senate
Committee on Rules and Administration;
new text end
new text begin
(5) one member selected by the American Federation of State, County, and
Municipal employees;
new text end
new text begin
(6) one member selected by the Minnesota Association of Professional Employees;
new text end
new text begin
(7) one member selected by Education Minnesota;
new text end
new text begin
(8) one member selected by the Minnesota Business Partnership; and
new text end
new text begin
(9) one member selected by the Metropolitan Interdependent Business Organization.
new text end
new text begin
All appointments made under this subdivision must be made within 30 days of the
effective date of this act.
new text end
new text begin
(b) The attorney general or the attorney general's designee shall convene the first
meeting of the study group. The study group shall select its chair at the first meeting.
new text end
new text begin Subd. 2. new text end
new text begin Study; report. new text end
new text begin
The study group shall study and make recommendations
on the following issues related to the creation, maintenance, and funding of a voluntary,
statewide health plan purchasing pool to provide comprehensive, cost-effective, and
medically appropriate health coverage to all public and private employees in Minnesota
and all Minnesota residents:
new text end
new text begin
(1) the creation of an independent public entity to administer the pool;
new text end
new text begin
(2) eligibility and participation requirements for existing public and private health
care purchasing pools, public and private employers, and residents of this state;
new text end
new text begin
(3) how to contract directly with providers to provide comprehensive coverage for
preventive, mental health, dental and other medical services, and comprehensive drug
benefits to enrollees and maximize the cost savings and other efficiencies that a large
purchasing pool would be expected to generate without the need for a public subsidy;
new text end
new text begin
(4) provisions that allow the pool to contract directly with health care providers
to provide coverage to enrollees;
new text end
new text begin
(5) incentives designed to attract and retain the maximum number of enrollees;
new text end
new text begin
(6) recommendations for the administration of the pool and the plans that will be
available to enrollees including, but not limited to, recommendations to keep the pool
solvent and profitable so that public subsidies are not necessary; and
new text end
new text begin
(7) other elements the study group concludes are necessary or desirable for the
pool to possess.
new text end
new text begin
The study group shall submit its report and the draft legislation necessary to
implement its recommendations to the chairs of the legislative committees and divisions
with jurisdiction over health care policy and finance, the Health Care Access Commission,
and the governor by February 1, 2008.
new text end
new text begin Subd. 3. new text end
new text begin Staffing. new text end
new text begin
State agencies shall assist the study group with any requests for
information the study group considers necessary to complete the study and report under
subdivision 2.
new text end
new text begin Subd. 4. new text end
new text begin Removal; vacancies; expenses. new text end
new text begin
Removal of members, vacancies, and
expenses for members shall be as provided in Minnesota Statutes, section 15.059.
new text end
new text begin Subd. 5. new text end
new text begin Expiration. new text end
new text begin
This section expires after the submission of the report as
required in subdivision 2.
new text end
Sec. 16. new text begin REPEALER.
new text end
new text begin
Minnesota Statutes 2006, section 62A.301,
new text end
new text begin
is repealed, effective January 1, 2008.
new text end
ARTICLE 13
CHILDREN'S HEALTH PROGRAMS; MINNESOTACARE
Section 1.
Minnesota Statutes 2006, section 256B.057, is amended by adding a
subdivision to read:
new text begin Subd. 2c. new text end
new text begin Extended coverage for children. new text end
new text begin
A child receiving medical assistance
under subdivision 2, who becomes ineligible due to excess income, is eligible for two
additional months of medical assistance. Eligibility under this section is effective
following any coverage available under section 256B.0625.
new text end
new text begin
A child eligible for extended coverage under this section is deemed automatically
eligible for MinnesotaCare until renewal. MinnesotaCare coverage begins in accordance
with section 256L.05, subdivision 3.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective October 1, 2008, or upon federal
approval, whichever is later.
new text end
Sec. 2.
Minnesota Statutes 2006, section 256L.04, subdivision 1, is amended to read:
Subdivision 1.
Families with children.
(a) Families with children with family
income equal to or less than 275 percent of the federal poverty guidelines for the
applicable family size shall be eligible for MinnesotaCare according to this section. All
other provisions of sections 256L.01 to 256L.18, including the insurance-related barriers
to enrollment under section 256L.07, shall apply unless otherwise specified.
(b) Parents who enroll in the MinnesotaCare program must also enroll their children,
if the children are eligible. Children may be enrolled separately without enrollment by
parents. However, if one parent in the household enrolls, both parents must enroll, unless
other insurance is available. If one child from a family is enrolled, all children must
be enrolled, unless other insurance is available. If one spouse in a household enrolls,
the other spouse in the household must also enroll, unless other insurance is available.
Families cannot choose to enroll only certain uninsured members.
(c) Beginning October 1, 2003, the dependent sibling definition no longer applies
to the MinnesotaCare program. These persons are no longer counted in the parental
household and may apply as a separate household.
(d) Beginning July 1, 2003, or upon federal approval, whichever is later, parents are
not eligible for MinnesotaCare if their gross income exceeds $50,000.
new text begin
(e) Children formerly enrolled in medical assistance and automatically deemed
eligible for MinnesotaCare according to section 256B.057, subdivision 2c, are exempt
from the requirements of this section until renewal.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective October 1, 2008, or upon federal
approval, whichever is later.
new text end
Sec. 3.
Minnesota Statutes 2006, section 256L.07, is amended by adding a subdivision
to read:
new text begin Subd. 7. new text end
new text begin Exception for certain children. new text end
new text begin
Children formerly enrolled in medical
assistance and automatically deemed eligible for MinnesotaCare according to section
256B.057, subdivision 2c, are exempt from the requirements of this section until renewal.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective October 1, 2008, or upon federal
approval, whichever is later.
new text end
Sec. 4.
new text begin
[256L.22] DEFINITION; CHILDREN'S HEALTH PROGRAM.
new text end
new text begin
For purposes of sections 256L.22 to 256L.28, "children's health program" means
the medical assistance and MinnesotaCare programs to the extent medical assistance and
MinnesotaCare provide health coverage to children.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective October 1, 2008, or upon federal
approval, whichever is later.
new text end
Sec. 5.
new text begin
[256L.24] HEALTH CARE ELIGIBILITY FOR CHILDREN.
new text end
new text begin Subdivision 1. new text end
new text begin Applicability. new text end
new text begin
This section applies to children who are enrolled in a
children's health program.
new text end
new text begin Subd. 2. new text end
new text begin Application procedure. new text end
new text begin
The commissioner shall develop an application
form for children's health programs for children that is easily understandable and does not
exceed four pages in length. The provisions of section 256L.05, subdivision 1, apply.
new text end
new text begin Subd. 3. new text end
new text begin Premiums. new text end
new text begin
Children enrolled in MinnesotaCare shall pay premiums
as provided in section 256L.15.
new text end
new text begin Subd. 4. new text end
new text begin Eligibility renewal. new text end
new text begin
The commissioner shall require children enrolled in
MinnesotaCare to renew eligibility every 12 months.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective October 1, 2008, or upon federal
approval, whichever is later.
new text end
Sec. 6.
new text begin
[256L.26] ASSISTANCE TO APPLICANTS.
new text end
new text begin
The commissioner shall assist children in choosing a managed care organization
to receive services under a children's health program, by:
new text end
new text begin
(1) establishing a Web site to provide information about managed care organizations
and to allow online enrollment;
new text end
new text begin
(2) making applications and information on managed care organizations available
to applicants and enrollees according to Title VI of the Civil Rights Act and federal
regulations adopted under that law or any guidance from the United States Department of
Health and Human Services; and
new text end
new text begin
(3) making benefit educators available to assist applicants in choosing a managed
care organization.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective October 1, 2008, or upon federal
approval, whichever is later.
new text end
Sec. 7.
new text begin
[256L.28] FEDERAL APPROVAL.
new text end
new text begin
The commissioner shall seek all federal waivers and approvals necessary to
implement sections 256L.22 to 256L.28, including, but not limited to, waivers and
approvals necessary to:
new text end
new text begin
(1) coordinate medical assistance and MinnesotaCare coverage for children; and
new text end
new text begin
(2) maximize receipt of the federal medical assistance match for covered children,
by increasing income standards through the use of more liberal income methodologies as
provided under United States Code, title 42, sections 1396a and 1396u-1.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective October 1, 2008, or upon federal
approval, whichever is later.
new text end
ARTICLE 14
HEALTH CARE REFORM POLICY
Section 1.
Minnesota Statutes 2006, section 62J.82, is amended to read:
62J.82 HOSPITAL deleted text begin CHARGEdeleted text end new text begin INFORMATION REPORTING new text end DISCLOSURE.
new text begin Subdivision 1. new text end
new text begin Required information. new text end
The Minnesota Hospital Association shall
develop a Web-based system, available to the public free of charge, for reporting deleted text begin charge
informationdeleted text end new text begin the followingnew text end , for Minnesota residentsdeleted text begin ,deleted text end new text begin :
new text end
new text begin
(1) hospital-specific performance on the measures of care developed under section
256B.072 for acute myocardial infarction, heart failure, and pneumonia;
new text end
new text begin
(2) by January 1, 2009, hospital-specific performance on the public reporting
measures for hospital-acquired infections as published by the National Quality Forum
and collected by the Minnesota Hospital Association and Stratis Health in collaboration
with infection control practitioners; and
new text end
new text begin (3) charge information, new text end including, but not limited to, number of discharges, average
length of stay, average charge, average charge per day, and median charge, for each of the
50 most common inpatient diagnosis-related groups and the 25 most common outpatient
surgical procedures as specified by the Minnesota Hospital Association.
new text begin Subd. 2. new text end
new text begin Web site. new text end
The Web site must provide information that compares
hospital-specific data to hospital statewide data. The Web site must be deleted text begin established by
October 1, 2006, and must bedeleted text end updated annually. new text begin The commissioner shall provide a link to
this reporting information on the department's Web site.
new text end
new text begin Subd. 3. new text end
new text begin Enforcement. new text end
new text begin The commissioner shall provide a link to this information
on the department's Web site. new text end If a hospital does not provide this information to the
Minnesota Hospital Association, the commissioner new text begin of health new text end may require the hospital to
do sonew text begin in accordance with section 144.55, subdivision 6new text end . deleted text begin The commissioner shall provide a
link to this information on the department's Web site.
deleted text end
ARTICLE 15
HEALTH CARE REFORM
Section 1.
new text begin
[62J.431] EVIDENCE-BASED HEALTH CARE GUIDELINES.
new text end
new text begin
Evidence-based guidelines must meet the following criteria:
new text end
new text begin
(1) the scope and application are clear;
new text end
new text begin
(2) authorship is stated and any conflicts of interest disclosed;
new text end
new text begin
(3) authors represent all pertinent clinical fields or other means of input have been
used;
new text end
new text begin
(4) the development process is explicitly stated;
new text end
new text begin
(5) the guideline is grounded in evidence;
new text end
new text begin
(6) the evidence is cited and grated;
new text end
new text begin
(7) the document itself is clear and practical;
new text end
new text begin
(8) the document is flexible in use, with exceptions noted or provided for with
general statements;
new text end
new text begin
(9) measures are included for use in systems improvement; and
new text end
new text begin
(10) the guideline has scheduled reviews and updating.
new text end
Sec. 2.
Minnesota Statutes 2006, section 62J.495, is amended to read:
62J.495 HEALTH INFORMATION TECHNOLOGY AND
INFRASTRUCTURE deleted text begin ADVISORY COMMITTEEdeleted text end .
Subdivision 1.
deleted text begin Establishment; members; dutiesdeleted text end new text begin Implementationnew text end .
new text begin
By January
1, 2015, all hospitals and health care providers must have in place an interoperable
electronic health records system within their hospital system or clinical practice setting.
The commissioner of health, in consultation with the Health Information Technology and
Infrastructure Advisory Committee, shall develop a statewide plan to meet this goal,
including uniform standards to be used for the interoperable system for sharing and
synchronizing patient data across systems. The standards must be compatible with federal
efforts. The uniform standards must be developed by January 1, 2009, with a status report
on the development of these standards submitted to the legislature by January 15, 2008.
new text end
new text begin Subd. 2. new text end
new text begin
Health Information Technology and Infrastructure Advisory
Committee.
new text end
(a) The commissioner shall establish a Health Information Technology
and Infrastructure Advisory Committee governed by section 15.059 to advise the
commissioner on the following matters:
(1) assessment of the use of health information technology by the state, licensed
health care providers and facilities, and local public health agencies;
(2) recommendations for implementing a statewide interoperable health information
infrastructure, to include estimates of necessary resources, and for determining standards
for administrative data exchange, clinical support programs, patient privacy requirements,
and maintenance of the security and confidentiality of individual patient data; deleted text begin and
deleted text end
(3) new text begin recommendations for encouraging use of innovative health care applications
using information technology and systems to improve patient care and reduce the cost
of care, including applications relating to disease management and personal health
management that enable remote monitoring of patients' conditions, especially those with
chronic conditions; and
new text end
new text begin (4) new text end other related issues as requested by the commissioner.
(b) The members of the Health Information Technology and Infrastructure Advisory
Committee shall include the commissioners, or commissioners' designees, of health,
human services, administration, and commerce and additional members to be appointed
by the commissioner to include persons representing Minnesota's local public health
agencies, licensed hospitals and other licensed facilities and providers, private purchasers,
the medical and nursing professions, health insurers and health plans, the state quality
improvement organization, academic and research institutions, consumer advisory
organizations with an interest and expertise in health information technology, and other
stakeholders as identified by the Health Information Technology and Infrastructure
Advisory Committee.
deleted text begin Subd. 2. deleted text end
deleted text begin Annual report. deleted text end
new text begin (c) new text end The commissioner shall prepare and issue an annual
report not later than January 30 of each year outlining progress to date in implementing a
statewide health information infrastructure and recommending future projects.
deleted text begin Subd. 3. deleted text end
deleted text begin Expiration. deleted text end
new text begin (d) new text end Notwithstanding section 15.059, this deleted text begin sectiondeleted text end new text begin subdivision
new text end expires June 30, deleted text begin 2009deleted text end new text begin 2015new text end .
Sec. 3.
new text begin
[62J.496] ELECTRONIC HEALTH RECORD SYSTEM REVOLVING
ACCOUNT AND LOAN PROGRAM.
new text end
new text begin Subdivision 1. new text end
new text begin Account establishment. new text end
new text begin
An account is established to provide loans
to eligible borrowers to assist in financing the installation or support of an interoperable
health record system. The system must provide for the interoperable exchange of health
care information between the applicant and, at a minimum, a hospital system, pharmacy,
and a health care clinic or other physician group.
new text end
new text begin Subd. 2. new text end
new text begin Eligibility. new text end
new text begin
(a) "Eligible borrower" means one of the following:
new text end
new text begin
(1) community clinics, as defined under section 145.9268;
new text end
new text begin
(2) hospitals eligible for rural hospital capital improvement grants, as defined
in section 144.148;
new text end
new text begin
(3) physician clinics located in a community with a population of less than 50,000
according to United States Census Bureau statistics and outside the seven-county
metropolitan area;
new text end
new text begin
(4) nursing facilities licensed under sections 144A.01 to 144A.27; and
new text end
new text begin
(5) other providers of health or health care services approved by the commissioner
for which interoperable electronic health record capability would improve quality of
care, patient safety, or community health.
new text end
new text begin
(b) To be eligible for a loan under this section, the applicant must submit a loan
application to the commissioner of health on forms prescribed by the commissioner. The
application must include, at a minimum:
new text end
new text begin
(1) the amount of the loan requested and a description of the purpose or project
for which the loan proceeds will be used;
new text end
new text begin
(2) a quote from a vendor;
new text end
new text begin
(3) a description of the health care entities and other groups participating in the
project;
new text end
new text begin
(4) evidence of financial stability and a demonstrated ability to repay the loan; and
new text end
new text begin
(5) a description of how the system to be financed interconnects or plans in the
future to interconnect with other health care entities and provider groups located in the
same geographical area.
new text end
new text begin Subd. 3. new text end
new text begin Loans. new text end
new text begin
(a) The commissioner of health may make a no interest loan
to a provider or provider group who is eligible under subdivision 2 on a first-come,
first-served basis provided that the applicant is able to comply with this section. The total
accumulative loan principal must not exceed $1,500,000 per loan. The commissioner of
health has discretion over the size and number of loans made.
new text end
new text begin
(b) The commissioner of health may prescribe forms and establish an application
process and, notwithstanding section 16A.1283, may impose a reasonable nonrefundable
application fee to cover the cost of administering the loan program. Any application
fees imposed and collected under the electronic health records system revolving account
and loan program in this section are appropriated to the commissioner of health for the
duration of the loan program.
new text end
new text begin
(c) The borrower must begin repaying the principal no later than two years from the
date of the loan. Loans must be amortized no later than six years from the date of the loan.
new text end
new text begin
(d) Repayments must be credited to the account.
new text end
new text begin Subd. 4. new text end
new text begin Data classification. new text end
new text begin
Data collected by the commissioner of health on the
application to determine eligibility under subdivision 2 and to monitor borrowers' default
risk or collect payments owed under subdivision 3 are (1) private data on individuals as
defined in section 13.02, subdivision 12; and (2) nonpublic data as defined in section
13.02, subdivision 9. The names of borrowers and the amounts of the loans granted are
public data.
new text end
Sec. 4.
new text begin
[62J.536] UNIFORM ELECTRONIC TRANSACTIONS AND
IMPLEMENTATION GUIDE STANDARDS.
new text end
new text begin Subdivision 1. new text end
new text begin Electronic claims and eligibility transactions required. new text end
new text begin
(a)
Beginning January 15, 2009, all group purchasers must accept from health care providers
the eligibility for a health plan transaction described under Code of Federal Regulations,
title 45, part 162, subpart L. Beginning July 15, 2009, all group purchasers must accept
from health care providers the health care claims or equivalent encounter information
transaction described under Code of Federal Regulations, title 45, part 162, subpart K.
new text end
new text begin
(b) Beginning January 15, 2009, all group purchasers must transmit to providers the
eligibility for a health plan transaction described under Code of Federal Regulations, title
45, part 162, subpart L. Beginning December 1, 2009, all group purchasers must transmit
to providers the health care payment and remittance advice transaction described under
Code of Federal Regulations, title 45, part 162, subpart P.
new text end
new text begin
(c) Beginning January 15, 2009, all health care providers must submit to group
purchasers the eligibility for a health plan transaction described under Code of Federal
Regulations, title 45, part 162, subpart L. Beginning July 15, 2009, all health care
providers must submit to group purchasers the health care claims or equivalent encounter
information transaction described under Code of Federal Regulations, title 45, part 162,
subpart K.
new text end
new text begin
(d) Beginning January 15, 2009, all health care providers must accept from group
purchasers the eligibility for a health plan transaction described under Code of Federal
Regulations, title 45, part 162, subpart L. Beginning December 15, 2009, all health care
providers must accept from group purchasers the health care payment and remittance
advice transaction described under Code of Federal Regulations, title 45, part 162, subpart
P.
new text end
new text begin
(e) Each of the transactions described in paragraphs (a) to (d) shall require the use
of a single, uniform companion guide to the implementation guides described under
Code of Federal Regulations, title 45, part 162. The companion guides will be developed
pursuant to subdivision 2.
new text end
new text begin
(f) Notwithstanding any other provisions in sections 62J.50 to 62J.61, all group
purchasers and health care providers must exchange claims and eligibility information
electronically using the transactions, companion guides, implementation guides, and
timelines required under this subdivision. Group purchasers may not impose any fee on
providers for the use of the transactions prescribed in this subdivision.
new text end
new text begin
(g) Nothing in this subdivision shall prohibit group purchasers and health care
providers from using a direct data entry, Web-based methodology for complying with
the requirements of this subdivision. Any direct data entry method for conducting
the transactions specified in this subdivision must be consistent with the data content
component of the single, uniform companion guides required in paragraph (e) and the
implementation guides described under Code of Federal Regulations, title 45, part 162.
new text end
new text begin Subd. 2. new text end
new text begin Establishing uniform, standard companion guides. new text end
new text begin
(a) At least 12
months prior to the timelines required in subdivision 1, the commissioner of health shall
promulgate rules pursuant to section 62J.61 establishing and requiring group purchasers
and health care providers to use the transactions and the uniform, standard companion
guides required under subdivision 1, paragraph (e).
new text end
new text begin
(b) The commissioner of health must consult with the Minnesota Administrative
Uniformity Committee on the development of the single, uniform companion guides
required under subdivision 1, paragraph (e), for each of the transactions in subdivision 1.
The single uniform companion guides required under subdivision 1, paragraph (e), must
specify uniform billing and coding standards. The commissioner of health shall base the
companion guides required under subdivision 1, paragraph (e), billing and coding rules,
and standards on the Medicare program, with modifications that the commissioner deems
appropriate after consulting the Minnesota Administrative Uniformity Committee.
new text end
new text begin
(c) No group purchaser or health care provider may add to or modify the single,
uniform companion guides defined in subdivision 1, paragraph (e), through additional
companion guides or other requirements.
new text end
new text begin
(d) In promulgating the rules in paragraph (a), the commissioner shall not require
data content that is not essential to accomplish the purpose of the transactions in
subdivision 1.
new text end
new text begin Subd. 3. new text end
new text begin Definition. new text end
new text begin
Notwithstanding section 62J.03, subdivision 8, for purposes of
this section, "health care provider" includes licensed nursing homes, licensed boarding
care homes, and licensed home care providers.
new text end
Sec. 5.
Minnesota Statutes 2006, section 62J.692, subdivision 1, is amended to read:
Subdivision 1.
Definitions.
For purposes of this section, the following definitions
apply:
(a) "Accredited clinical training" means the clinical training provided by a
medical education program that is accredited through an organization recognized by the
Department of Education, the Centers for Medicare and Medicaid Services, or another
national body who reviews the accrediting organizations for multiple disciplines and
whose standards for recognizing accrediting organizations are reviewed and approved by
the commissioner of health in consultation with the Medical Education and Research
Advisory Committee.
(b) "Commissioner" means the commissioner of health.
(c) "Clinical medical education program" means the accredited clinical training of
physicians (medical students and residents), doctor of pharmacy practitioners, doctors
of chiropractic, dentists, advanced practice nurses (clinical nurse specialists, certified
registered nurse anesthetists, nurse practitioners, and certified nurse midwives), and
physician assistants.
(d) "Sponsoring institution" means a hospital, school, or consortium located in
Minnesota that sponsors and maintains primary organizational and financial responsibility
for a clinical medical education program in Minnesota and which is accountable to the
accrediting body.
(e) "Teaching institution" means a hospital, medical center, clinic, or other
organization that conducts a clinical medical education program in Minnesota.
(f) "Trainee" means a student or resident involved in a clinical medical education
program.
(g) "Eligible trainee deleted text begin FTEsdeleted text end new text begin FTE'snew text end " means the number of trainees, as measured by
full-time equivalent counts, that are at training sites located in Minnesota with deleted text begin adeleted text end new text begin currently
active new text end medical assistance deleted text begin provider numberdeleted text end new text begin enrollment status and a National Provider
Identification (NPI) number new text end where training occurs in either an inpatient or ambulatory
patient care setting and where the training is funded, in part, by patient care revenues.new text begin
Training that occurs in nursing facility settings is not eligible for funding under this section.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2008.
new text end
Sec. 6.
Minnesota Statutes 2006, section 62J.692, subdivision 4, is amended to read:
Subd. 4.
Distribution of funds.
(a) new text begin Following the distribution described under
paragraph (b), new text end the commissioner shall annually distribute deleted text begin 90 percent ofdeleted text end new text begin the new text end available
medical education funds to all qualifying applicants based on a distribution formula that
reflects a summation of two factors:
(1)deleted text begin an education factor, which is determined by the total number of eligible trainee
FTEs and the total statewide average costs per trainee, by type of trainee, in each clinical
medical education program; and
deleted text end
deleted text begin (2)deleted text end a public program volume factor, which is determined by the total volume of
public program revenue received by each training site as a percentage of all public
program revenue received by all training sites in the fund poolnew text begin ; and
new text end
new text begin (2) a supplemental public program volume factor, which is determined by providing
a supplemental payment of 20 percent of each training site's grant to training sites whose
public program revenue accounted for at least 0.98 percent of the total public program
revenue received by all eligible training sites. Grants to training sites whose public
program revenue accounted for less than 0.98 percent of the total public program revenue
received by all eligible training sites shall be reduced by an amount equal to the total
value of the supplemental paymentnew text end .
deleted text begin
In this formula, the education factor is weighted at 67 percent and the public program
volume factor is weighted at 33 percent.
deleted text end
Public program revenue for the distribution formula includes revenue from medical
assistance, prepaid medical assistance, general assistance medical care, and prepaid
general assistance medical care. Training sites that receive no public program revenue
are ineligible for funds available under this deleted text begin paragraphdeleted text end new text begin subdivisionnew text end . new text begin For purposes of
determining training-site level grants to be distributed under paragraph (a), new text end total statewide
average costs per trainee for medical residents is based on audited clinical training costs
per trainee in primary care clinical medical education programs for medical residents.
Total statewide average costs per trainee for dental residents is based on audited clinical
training costs per trainee in clinical medical education programs for dental students. Total
statewide average costs per trainee for pharmacy residents is based on audited clinical
training costs per trainee in clinical medical education programs for pharmacy students.
(b) deleted text begin The commissioner shall annually distribute ten percent of total available medical
education funds to all qualifying applicants based on the percentage received by each
applicant under paragraph (a). These funds are to be used to offset clinical education
costs at eligible clinical training sites based on criteria developed by the clinical medical
education program. Applicants may choose to distribute funds allocated under this
paragraph based on the distribution formula described in paragraph (a).deleted text end new text begin $5,350,000 of the
available medical education funds shall be distributed as follows:
new text end
new text begin
(1) $1,475,000 to the University of Minnesota Medical Center-Fairview;
new text end
new text begin
(2) $2,075,000 to the University of Minnesota School of Dentistry; and
new text end
new text begin
(3) $1,800,000 to the Academic Health Center.
new text end
(c) Funds distributed shall not be used to displace current funding appropriations
from federal or state sources.
(d) Funds shall be distributed to the sponsoring institutions indicating the amount
to be distributed to each of the sponsor's clinical medical education programs based on
the criteria in this subdivision and in accordance with the commissioner's approval letter.
Each clinical medical education program must distribute funds allocated under paragraph
(a) to the training sites as specified in the commissioner's approval letter. Sponsoring
institutions, which are accredited through an organization recognized by the Department
of Education or the Centers for Medicare and Medicaid Services, may contract directly
with training sites to provide clinical training. To ensure the quality of clinical training,
those accredited sponsoring institutions must:
(1) develop contracts specifying the terms, expectations, and outcomes of the clinical
training conducted at sites; and
(2) take necessary action if the contract requirements are not met. Action may
include the withholding of payments under this section or the removal of students from
the site.
(e) Any funds not distributed in accordance with the commissioner's approval letter
must be returned to the medical education and research fund within 30 days of receiving
notice from the commissioner. The commissioner shall distribute returned funds to the
appropriate training sites in accordance with the commissioner's approval letter.
(f) deleted text begin The commissioner shall distribute by June 30 of each year an amount equal to
the funds transferred under subdivision 10, plus five percent interest to the University of
Minnesota Board of Regents for the instructional costs of health professional programs
at the Academic Health Center and for interdisciplinary academic initiatives within the
Academic Health Center.
deleted text end
deleted text begin (g)deleted text end A maximum of $150,000 of the funds dedicated to the commissioner under
section 297F.10, subdivision 1, deleted text begin paragraph (b),deleted text end clause (2), may be used by the commissioner
for administrative expenses associated with implementing this section.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2008.
new text end
Sec. 7.
Minnesota Statutes 2006, section 62J.692, subdivision 5, is amended to read:
Subd. 5.
Report.
(a) Sponsoring institutions receiving funds under this section
must sign and submit a medical education grant verification report (GVR) to verify that
the correct grant amount was forwarded to each eligible training site. If the sponsoring
institution fails to submit the GVR by the stated deadline, or to request and meet
the deadline for an extension, the sponsoring institution is required to return the full
amount of funds received to the commissioner within 30 days of receiving notice from
the commissioner. The commissioner shall distribute returned funds to the appropriate
training sites in accordance with the commissioner's approval letter.
(b) The reports must provide verification of the distribution of the funds and must
include:
(1) the total number of eligible trainee FTEs in each clinical medical education
program;
(2) the name of each funded program and, for each program, the dollar amount
distributed to each training site;
(3) documentation of any discrepancies between the initial grant distribution notice
included in the commissioner's approval letter and the actual distribution;
(4)deleted text begin a statement by the sponsoring institution describing the distribution of funds
allocated under subdivision 4, paragraph (b), including information on which clinical
training sites received funding and the rationale used for determining funding priorities;
deleted text end
deleted text begin (5)deleted text end a statement by the sponsoring institution stating that the completed grant
verification report is valid and accurate; and
deleted text begin (6)deleted text end new text begin (5) new text end other information the commissioner, with advice from the advisory
committee, deems appropriate to evaluate the effectiveness of the use of funds for medical
education.
(c) By February 15 of each year, the commissioner, with advice from the
advisory committee, shall provide an annual summary report to the legislature on the
implementation of this section.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2008.
new text end
Sec. 8.
Minnesota Statutes 2006, section 62J.692, subdivision 8, is amended to read:
Subd. 8.
Federal financial participation.
deleted text begin (a)deleted text end The commissioner of human
services shall seek to maximize federal financial participation in payments for medical
education and research costs. deleted text begin If the commissioner of human services determines that
federal financial participation is available for the medical education and research, the
commissioner of health shall transfer to the commissioner of human services the amount
of state funds necessary to maximize the federal funds available. The amount transferred
to the commissioner of human services, plus the amount of federal financial participation,
shall be distributed to medical assistance providers in accordance with the distribution
methodology described in subdivision 4.
deleted text end
deleted text begin (b) For the purposes of paragraph (a),deleted text end The commissioner shall use physician clinic
rates where possible to maximize federal financial participation.new text begin Any additional funds that
become available must be distributed under subdivision 4, paragraph (a).
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2008.
new text end
Sec. 9.
Minnesota Statutes 2006, section 62J.81, subdivision 1, is amended to read:
Subdivision 1.
Required disclosure of estimated payment.
(a) A health care
provider, as defined in section 62J.03, subdivision 8, or the provider's designee as agreed
to by that designee, shall, at the request of a consumer, new text begin and at no cost to the consumer
or the consumer's employer, new text end provide that consumer with a good faith estimate of the
deleted text begin reimbursementdeleted text end new text begin allowable payment new text end the provider deleted text begin expects to receive from the health plan
company in which the consumer is enrolleddeleted text end new text begin has agreed to accept from the consumer's
health plan company for the services specified by the consumer, specifying the amount of
the allowable payment due from the health plan companynew text end . Health plan companies must
allow contracted providers, or their designee, to release this information. deleted text begin A good faith
estimate must also be made available at the request of a consumer who is not enrolled in
a health plan company.deleted text end new text begin If a consumer has no applicable public or private coverage, the
health care provider must give the consumer, and at no cost to the consumer, a good faith
estimate of the average allowable reimbursement the provider accepts as payment from
private third-party payers for the services specified by the consumer and the estimated
amount the noncovered consumer will be required to pay. new text end Payment information provided
by a provider, or by the provider's designee as agreed to by that designee, to a patient
pursuant to this subdivision does not constitute a legally binding estimate of the new text begin allowable
charge for or new text end cost new text begin to the consumer new text end of services.
(b) A health plan company, as defined in section 62J.03, subdivision 10, shall, at
the request of an enrollee or the enrollee's designee, provide that enrollee with a good
faith estimate of the deleted text begin reimbursementdeleted text end new text begin allowable amount new text end the health plan company deleted text begin would
expect to pay todeleted text end new text begin has contracted for with new text end a specified provider within the network new text begin as total
payment new text end for a health care service specified by the enrolleenew text begin and the portion of the allowable
amount due from the enrollee and the enrollee's out-of-pocket costsnew text end . deleted text begin If requested by the
enrollee, the health plan company shall also provide to the enrollee a good faith estimate
of the enrollee's out-of-pocket cost for the health care service.deleted text end An estimate provided to
an enrollee under this paragraph is not a legally binding estimate of the deleted text begin reimbursementdeleted text end
new text begin allowable amount new text end or new text begin enrollee's new text end out-of-pocket cost.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2007.
new text end
Sec. 10.
new text begin
[62Q.101] EVALUATION OF PROVIDER PERFORMANCE.
new text end
new text begin
A health plan company, or a vendor of risk management services as defined under
section 60A.23, subdivision 8, shall, in evaluating the performance of a health care
provider:
new text end
new text begin
(1) conduct the evaluation using a bona fide baseline based upon practice experience
of the provider group; and
new text end
new text begin
(2) disclose the baseline to the health care provider in writing and prior to the
beginning of the time period used for the evaluation.
new text end
Sec. 11.
Minnesota Statutes 2006, section 62Q.165, subdivision 1, is amended to read:
Subdivision 1.
Definition.
It is the commitment of the state to achieve universal
health coverage for all Minnesotansnew text begin by the year 2011new text end . Universal coverage is achieved
when:
(1) every Minnesotan has access to a full range of quality health care services;
(2) every Minnesotan is able to obtain affordable health coverage which pays for the
full range of services, including preventive and primary care; and
(3) every Minnesotan pays into the health care system according to that person's
ability.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2007.
new text end
Sec. 12.
Minnesota Statutes 2006, section 62Q.165, subdivision 2, is amended to read:
Subd. 2.
Goal.
It is the goal of the state to make continuous progress toward
reducing the number of Minnesotans who do not have health coverage so that by January
1, deleted text begin 2000, fewer than four percent of the state's population will be without health coveragedeleted text end new text begin
2011, all Minnesota residents have access to affordable health carenew text end . The goal will be
achieved by improving access to private health coverage through insurance reforms and
market reforms, by making health coverage more affordable for low-income Minnesotans
through purchasing pools and state subsidies, and by reducing the cost of health coverage
through cost containment programs and methods of ensuring that all Minnesotans are
paying into the system according to their ability.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2007.
new text end
Sec. 13.
Minnesota Statutes 2006, section 144.698, subdivision 1, is amended to read:
Subdivision 1.
Yearly reports.
Each hospital and each outpatient surgical center,
which has not filed the financial information required by this section with a voluntary,
nonprofit reporting organization pursuant to section 144.702, shall file annually with the
commissioner of health after the close of the fiscal year:
(1) a balance sheet detailing the assets, liabilities, and net worth of the hospital or
outpatient surgical center;
(2) a detailed statement of income and expenses;
(3) a copy of its most recent cost report, if any, filed pursuant to requirements of
Title XVIII of the United States Social Security Act;
(4) a copy of all changes to articles of incorporation or bylaws;
(5) information on services provided to benefit the community, including services
provided at no cost or for a reduced fee to patients unable to pay, teaching and research
activities, or other community or charitable activities;
(6) information required on the revenue and expense report form set in effect on
July 1, 1989, or as amended by the commissioner in rule;
(7) information on changes in ownership or control; deleted text begin and
deleted text end
(8) other information required by the commissioner in ruledeleted text begin .deleted text end new text begin ;
new text end
new text begin
(9) information on the number of available hospital beds that are dedicated to certain
specialized services, as designated by the commissioner, and annual occupancy rates for
those beds, separately for adult and pediatric care;
new text end
new text begin
(10) from outpatient surgical centers, the total number of surgeries; and
new text end
new text begin
(11) a report on health care capital expenditures during the previous year, as required
by section 62J.17.
new text end
Sec. 14.
new text begin
[145.985] HEALTH PROMOTION AND WELLNESS.
new text end
new text begin
Community health boards as defined in section 145A.02, subdivision 5, may work
with schools, health care providers, and others to coordinate health and wellness programs
in their communities. In order to meet the requirements of this section, community
health boards may:
new text end
new text begin
(1) provide instruction, technical assistance, and recommendations on how to
evaluate project outcomes;
new text end
new text begin
(2) assist with on-site health and wellness programs utilizing volunteers and others
addressing health and wellness topics including smoking, nutrition, obesity, and others; and
new text end
new text begin
(3) encourage health and wellness programs consistent with the Centers for Disease
Control and Prevention's Community Guide and goals consistent with the Centers for
Disease Control and Prevention's Healthy People 2010 initiative.
new text end
Sec. 15.
Minnesota Statutes 2006, section 256.01, subdivision 2b, is amended to read:
Subd. 2b.
Performance payments.
new text begin (a) new text end The commissioner shall develop and
implement a pay-for-performance system to provide performance payments to new text begin eligiblenew text end
medical groupsnew text begin and clinicsnew text end that demonstrate optimum care in serving individuals
with chronic diseases who are enrolled in health care programs administered by the
commissioner under chapters 256B, 256D, and 256L. new text begin The commissioner may receive any
federal matching money that is made available through the medical assistance program
for managed care oversight contracted through vendors, including consumer surveys,
studies, and external quality reviews as required by the federal Balanced Budget Act of
1997, Code of Federal Regulations, title 42, part 438-managed care, subpart E-external
quality review. Any federal money received for managed care oversight is appropriated
to the commissioner for this purpose. The commissioner may expend the federal money
received in either year of the biennium.
new text end
new text begin
(b) Effective July 1, 2009, or upon federal approval, whichever is later, the
commissioner shall develop and implement a patient incentive health program to provide
incentives and rewards to patients who are enrolled in health care programs administered
by the commissioner under chapters 256B, 256D, and 256L, and who have agreed to and
have met personal health goals established with the patients' primary care providers to
manage a chronic disease or condition, including but not limited to diabetes, high blood
pressure, and coronary artery disease.
new text end
Sec. 16.
Minnesota Statutes 2006, section 256B.0625, is amended by adding a
subdivision to read:
new text begin Subd. 49. new text end
new text begin Provider-directed care coordination services. new text end
new text begin
The commissioner
shall develop and implement a provider-directed care coordination program for medical
assistance recipients who are not enrolled in the prepaid medical assistance program and
who are receiving services on a fee-for-service basis. This program provides payment
to primary care clinics for care coordination for people who have complex and chronic
medical conditions. Clinics must meet certain criteria such as the capacity to develop care
plans; have a dedicated care coordinator; and have an adequate number of fee-for-service
clients, evaluation mechanisms, and quality improvement processes to qualify for
reimbursement. For purposes of this subdivision, a primary care clinic is a medical clinic
designated as the patient's first point of contact for medical care, available 24 hours a
day, seven days a week, that provides or arranges for the patient's comprehensive health
care needs, and provides overall integration, coordination and continuity over time and
referrals for specialty care.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2008.
new text end
Sec. 17. new text begin HEALTH CARE PAYMENT SYSTEM REFORM.
new text end
new text begin Subdivision 1. new text end
new text begin Payment reform plan. new text end
new text begin
The commissioners of employee relations,
human services, commerce, and health shall develop a plan for promoting and facilitating
changes in payment rates and methods for paying for health care services, drugs, devices,
supplies, and equipment in order to:
new text end
new text begin
(1) reward the provision of cost-effective primary and preventive care;
new text end
new text begin
(2) reward the use of evidence-based care;
new text end
new text begin
(3) discourage underutilization, overuse, and misuse;
new text end
new text begin
(4) reward the use of the most cost-effective settings, drugs, devices, providers,
and treatments; and
new text end
new text begin
(5) encourage consumers to maintain good health and use the health care system
appropriately.
new text end
new text begin
In developing the plan, the commissioners shall analyze existing data to determine
specific services and health conditions for which changes in payment rates and methods
would lead to significant improvements in quality of care. The commissioners shall
include a definition of the term "quality" for uniform understanding of the plan's impact.
new text end
new text begin Subd. 2. new text end
new text begin Report. new text end
new text begin
The commissioners shall submit a report to the legislature by
December 15, 2007, describing the payment reform plan. The report must include
proposed legislation for implementing those components of the plan requiring legislative
action or appropriations of money.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2007.
new text end
Sec. 18. new text begin COMMUNITY INITIATIVES TO COVER UNINSURED AND
UNDERINSURED.
new text end
new text begin Subdivision 1. new text end
new text begin Community partnerships. new text end
new text begin
The commissioner of health shall
provide planning grants to up to three community partnerships that satisfy the requirements
in this section. A community partnership is eligible for a grant if the community
partnership includes:
new text end
new text begin
(1) at least one county;
new text end
new text begin
(2) at least one local hospital;
new text end
new text begin
(3) at least one local employer who collectively provides at least 300 jobs in the
community;
new text end
new text begin
(4) at least one school system;
new text end
new text begin
(5) at least one of the following:
new text end
new text begin
(i) one or more integrated health care clinics or physician groups. For purposes of
this section, "integrated health care" means integrated mental health and primary care; or
new text end
new text begin
(ii) one or more health care clinics or physician groups and one or more mental
health clinics; and
new text end
new text begin
(6) a third-party payer, which may include a county-based purchasing plan, an
employer, or a health plan company.
new text end
new text begin Subd. 2 new text end
new text begin Proposal requirements. new text end
new text begin
The planning grants shall be used by community
partnerships to develop a comprehensive proposal to provide affordable health care
services to uninsured and underinsured individuals with chronic health conditions through
an integrated community partnership system. A community partnership requesting a
planning grant must submit to the commissioner a planning proposal that includes:
new text end
new text begin
(1) methods for identifying potential uninsured or underinsured individuals and
patients who have or who are at risk of developing a chronic health condition;
new text end
new text begin
(2) methods to integrate and coordinate medical, mental health, and chemical health
services with services provided through county social services, corrections, public health,
school districts, and health care providers;
new text end
new text begin
(3) providing early intervention and prevention activities; and
new text end
new text begin
(4) methods to identify and support accountability across public and private systems,
including means to measure outcomes and economic savings from providing services
through an integrated system.
new text end
new text begin Subd. 3. new text end
new text begin Planning grant criteria. new text end
new text begin
(a) Proposals for planning grants shall be
submitted to the commissioner. Preference shall be given to planning proposals that:
new text end
new text begin
(1) have broad community support from local business, providers, counties, and
other public and private organizations;
new text end
new text begin
(2) propose to provide services to uninsured or underinsured individuals of every
age who have or are at risk of developing multiple, co-occurring chronic conditions;
new text end
new text begin
(3) integrate or coordinate resources from multiple sources; and
new text end
new text begin
(4) demonstrate how administrative costs for health plan companies and providers
can be reduced through greater simplification, coordination, consolidation, standardization,
reducing billing errors, or other methods.
new text end
new text begin
(b) Community partnerships receiving a planning grant under this section shall
submit their proposed initiatives to the commissioner by December 15, 2007.
new text end
new text begin
(c) The commissioner shall submit a report to the legislature by February 15, 2008,
that:
new text end
new text begin
(1) identifies the community partnerships that received a planning grant under this
section; and
new text end
new text begin
(2) summarizes the planned initiatives submitted to the commissioner based on
the requirements in this section.
new text end
Sec. 19. new text begin CARE COORDINATION PILOT PROJECTS.
new text end
new text begin Subdivision 1. new text end
new text begin Pilot projects. new text end
new text begin
(a) The commissioner of human services shall
develop and administer up to four pilot projects for children and adults with complex
health care needs who are enrolled in fee-for-service medical assistance, to the extent
permitted by federal requirements. At least two of the grantees must focus on children
with autism or children with complex/multi-diagnoses physical conditions. The purpose
of the projects is to pilot primary care clinic models of care delivery focused on care
coordination and family involvement in order to:
new text end
new text begin
(1) incent and support the provision of cost-effective primary and preventive care;
new text end
new text begin
(2) reward the use of evidence-based care;
new text end
new text begin
(3) reward coordination of care for patients with chronic conditions;
new text end
new text begin
(4) discourage overuse and misuse of high cost services;
new text end
new text begin
(5) reward the use of the most cost-effective settings, drugs, devices, providers,
and treatments; and
new text end
new text begin
(6) encourage consumers to maintain good health and use the health care system
appropriately.
new text end
new text begin
(b) The pilot projects must involve the use of designated care professionals or
clinics to serve as a patient's medical home and be responsible for coordinating health
care services across the continuum of care.
new text end
new text begin Subd. 2. new text end
new text begin Requirements. new text end
new text begin
In order to be designated a pilot project, health care
professionals or clinics must demonstrate the ability to:
new text end
new text begin
(1) be the patient's first point of contact by telephone or other means, 24 hours per
day, seven days a week;
new text end
new text begin
(2) provide or arrange for patients' comprehensive health care needs, including the
ability to structure planned chronic disease visits and train and support the caregivers to
effectively monitor and manage the person's health condition;
new text end
new text begin
(3) coordinate patients' care when care must be provided outside the medical home;
new text end
new text begin
(4) provide longitudinal care, not just episodic care, including meeting long-term
and unique personal needs; and
new text end
new text begin
(5) systematically improve quality of care using, among other inputs, patient
feedback.
new text end
new text begin Subd. 3. new text end
new text begin Evaluation. new text end
new text begin
Pilot projects must be evaluated based on patient satisfaction,
provider satisfaction, clinical process and outcome measures, program costs and savings,
and economic impact on health care providers. Pilot projects must be evaluated based
on the extent to which the medical home:
new text end
new text begin
(1) coordinated health care services across the continuum of care and thereby
reduced duplication of services and enhanced communication across providers;
new text end
new text begin
(2) provided safe and high-quality care by increasing utilization of effective
treatments, reduced use of ineffective treatments, reduced barriers to essential care and
services, and eliminated barriers to access;
new text end
new text begin
(3) reduced unnecessary hospitalizations and emergency room visits and increased
use of cost-effective care and settings;
new text end
new text begin
(4) encouraged long-term patient and provider relationships by shifting from
episodic care to consistent, coordinated communication and care with a specified team of
providers or individual providers;
new text end
new text begin
(5) engaged and educated consumers by encouraging shared patient and provider
responsibility and accountability for disease prevention, health promotion, chronic
disease management, acute care, and overall well-being, encouraging informed medical
decision-making, ensuring the availability of accurate medical information, and facilitated
the transfer of accurate medical information;
new text end
new text begin
(6) fostered the expansion of a technology infrastructure that supports collaboration;
and
new text end
new text begin
(7) reduced overall health care costs as compared to conventional payment methods
for similar patient populations.
new text end
new text begin Subd. 4. new text end
new text begin Rulemaking. new text end
new text begin
The commissioner is exempt from administrative rulemaking
under chapter 14 for purposes of developing, administering, contracting for, and evaluating
pilot projects under this section. The commissioner shall publish a proposed request for
proposals in the State Register and allow 30 days for comment before issuing the final
request for proposals.
new text end
new text begin Subd. 5. new text end
new text begin Care coordination payments. new text end
new text begin
Grantees under this section are not eligible
for care coordination payments under Minnesota Statutes, section 256B.0625, subdivision
49.
new text end
Sec. 20. new text begin MERC DISTRIBUTION FORMULA.
new text end
new text begin
The commissioner of health shall evaluate the effect of the 2007 revisions to the
medical education and research costs (MERC) distribution formula adopted in this act
on sponsoring institutions and clinical training sites with low numbers of eligible trainee
full-time equivalents. The commissioner shall present to the legislature, by January 15,
2009, any recommendations for changes in the MERC distribution formula necessary to
ensure the financial viability of clinical medical education at these sponsoring institutions
and clinical training sites.
new text end
Sec. 21. new text begin HEALTH CARE TRANSFORMATION TASK FORCE.
new text end
new text begin Subdivision 1. new text end
new text begin Task force. new text end
new text begin
(a) The governor shall convene a Health Care
Transformation Task Force to advise and assist the governor regarding activities to
transform the health care system, and to develop a statewide action plan as provided under
subdivision 3. The task force shall consist of:
new text end
new text begin
(1) two legislators from the house of representatives appointed by the speaker, and
two legislators from the senate appointed by the Subcommittee on Committees of the
Committee on Rules and Administration;
new text end
new text begin
(2) two representatives of the governor and state agencies, appointed by the governor;
new text end
new text begin
(3) three persons appointed by the governor who have demonstrated leadership in
health care organizations, health improvement initiatives, health care trade or professional
associations, or other collaborative health system improvement activities;
new text end
new text begin
(4) three persons appointed by the governor who have demonstrated leadership in
employer and group purchaser activities related to health system improvement, at least
two of which must be from a labor organization; and
new text end
new text begin
(5) five persons appointed by the governor who have demonstrated public or private
sector leadership and innovation.
new text end
new text begin
The governor is exempt from the requirements of the open appointments process for
purposes of appointing task force members.
new text end
new text begin
(b) The Department of Health shall provide staff support to the task force. The task
force may accept outside resources to help support its efforts.
new text end
new text begin Subd. 2. new text end
new text begin Public and stakeholder engagement. new text end
new text begin
The commissioner of health shall
review available research to determine Minnesotans' values, preferences, opinions, and
perceptions related to health care and to the issues confronting the task force, and shall
report the findings to the task force.
new text end
new text begin Subd. 3. new text end
new text begin Duties. new text end
new text begin
(a) By February 1, 2008, the task force shall develop and present to
the legislature and the governor a statewide action plan for transforming the health care
system to improve affordability, quality, access, and the health status of Minnesotans. The
plan may consist of legislative actions, administrative actions of governmental entities,
collaborative actions, and actions of individuals and individual organizations. Among
other things, the action plan must include the following, with specific and measurable
goals and deadlines for each:
new text end
new text begin
(1) actions that will reduce health care expenditures by 20 percent by January 2011,
and limit the rate of growth in health care spending to no greater than the percentage
increase in the Consumer Price Index for all urban consumers plus two percentage points
each year thereafter;
new text end
new text begin
(2) actions that will increase the affordable health coverage options for all
Minnesotans and other strategies that will ensure all Minnesotans will have health
coverage by January 2011;
new text end
new text begin
(3) actions to improve the quality and safety of health care and reduce racial and
ethnic disparities in access and quality;
new text end
new text begin
(4) actions that will improve the health status of Minnesotans and reduce the rate of
preventable chronic illness;
new text end
new text begin
(5) proposed changes to state health care purchasing and payment strategies that will
promote higher quality, lower cost health care;
new text end
new text begin
(6) actions that will promote the appropriate and cost-effective investment in new
facilities, technologies, and drugs;
new text end
new text begin
(7) options for serving small employers and their employees, and self-employed
individuals; and
new text end
new text begin
(8) actions to reduce administrative costs.
new text end
Sec. 22. new text begin REPEALER.
new text end
new text begin
(a)
new text end
new text begin
Minnesota Statutes 2006, section 62J.052, subdivision 1,
new text end
new text begin
is repealed effective
August 1, 2007.
new text end
new text begin
(b)
new text end
new text begin
Minnesota Statutes 2006, section 62J.692, subdivision 10,
new text end
new text begin
is repealed effective
January 1, 2008.
new text end
ARTICLE 16
PUBLIC HEALTH POLICY
Section 1.
Minnesota Statutes 2006, section 16B.61, is amended by adding a
subdivision to read:
new text begin Subd. 3b. new text end
new text begin Window fall prevention device code. new text end
new text begin
The commissioner of labor and
industry shall adopt rules for window fall prevention devices as part of the state Building
Code. Window fall prevention devices include, but are not limited to, safety screens,
hardware, guards, and other devices that comply with the standards established by the
commissioner of labor and industry. The rules shall require compliance with standards
for window fall prevention devices developed by ASTM International, contained in the
International Building Code as the model language with amendments deemed necessary to
coordinate with the other adopted building codes in Minnesota. The rules shall establish a
scope that includes the applicable building occupancies, and the types, locations, and sizes
of windows that will require the installation of fall devices. The rules will be effective July
1, 2009. The commissioner shall report to the legislature on the status of the rulemaking
on or before February 15, 2008.
new text end
Sec. 2.
Minnesota Statutes 2006, section 103I.101, subdivision 6, is amended to read:
Subd. 6.
Fees for variances.
The commissioner shall charge a nonrefundable
application fee of deleted text begin $175deleted text end new text begin $215new text end to cover the administrative cost of processing a request for a
variance or modification of rules adopted by the commissioner under this chapter.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2008.
new text end
Sec. 3.
Minnesota Statutes 2006, section 103I.208, subdivision 1, is amended to read:
Subdivision 1.
Well notification fee.
The well notification fee to be paid by a
property owner is:
(1) for a new water supply well, deleted text begin $175deleted text end new text begin $215new text end , which includes the state core function
fee;
(2) for a well sealing, deleted text begin $35deleted text end new text begin $50new text end for each well, which includes the state core function
fee, except that for monitoring wells constructed on a single property, having depths
within a 25 foot range, and sealed within 48 hours of start of construction, a single fee of
deleted text begin $35deleted text end new text begin $50new text end ; and
(3) for construction of a dewatering well, deleted text begin $175deleted text end new text begin $215new text end , which includes the state core
function fee, for each dewatering well except a dewatering project comprising five or
more dewatering wells shall be assessed a single fee of deleted text begin $875deleted text end new text begin $1,075new text end for the dewatering
wells recorded on the notification.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2008.
new text end
Sec. 4.
Minnesota Statutes 2006, section 103I.208, subdivision 2, is amended to read:
Subd. 2.
Permit fee.
The permit fee to be paid by a property owner is:
(1) for a water supply well that is not in use under a maintenance permit, deleted text begin $150deleted text end new text begin $175new text end
annually;
(2) for construction of a monitoring well, deleted text begin $175deleted text end new text begin $215new text end , which includes the state
core function fee;
(3) for a monitoring well that is unsealed under a maintenance permit, deleted text begin $150deleted text end new text begin $175new text end
annually;
(4) for monitoring wells used as a leak detection device at a single motor fuel retail
outlet, a single petroleum bulk storage site excluding tank farms, or a single agricultural
chemical facility site, the construction permit fee is deleted text begin $175deleted text end new text begin $215new text end , which includes the state
core function fee, per site regardless of the number of wells constructed on the site, and
the annual fee for a maintenance permit for unsealed monitoring wells is deleted text begin $150deleted text end new text begin $175new text end per
site regardless of the number of monitoring wells located on site;
(5) for a groundwater thermal exchange device, in addition to the notification fee for
water supply wells, deleted text begin $175deleted text end new text begin $215new text end , which includes the state core function fee;
(6) for a vertical heat exchanger, deleted text begin $175deleted text end new text begin $215new text end ;
(7) for a dewatering well that is unsealed under a maintenance permit, deleted text begin $150deleted text end new text begin $175new text end
annually for each dewatering well, except a dewatering project comprising more than five
dewatering wells shall be issued a single permit for deleted text begin $750deleted text end new text begin $875new text end annually for dewatering
wells recorded on the permit; and
(8) for an elevator boring, deleted text begin $175deleted text end new text begin $215new text end for each boring.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2008.
new text end
Sec. 5.
Minnesota Statutes 2006, section 103I.235, subdivision 1, is amended to read:
Subdivision 1.
Disclosure of wells to buyer.
(a) Before signing an agreement to
sell or transfer real property, the seller must disclose in writing to the buyer information
about the status and location of all known wells on the property, by delivering to the buyer
either a statement by the seller that the seller does not know of any wells on the property,
or a disclosure statement indicating the legal description and county, and a map drawn
from available information showing the location of each well to the extent practicable.
In the disclosure statement, the seller must indicate, for each well, whether the well is in
use, not in use, or sealed.
(b) At the time of closing of the sale, the disclosure statement information, name and
mailing address of the buyer, and the quartile, section, township, and range in which each
well is located must be provided on a well disclosure certificate signed by the seller or a
person authorized to act on behalf of the seller.
(c) A well disclosure certificate need not be provided if the seller does not know
of any wells on the property and the deed or other instrument of conveyance contains
the statement: "The Seller certifies that the Seller does not know of any wells on the
described real property."
(d) If a deed is given pursuant to a contract for deed, the well disclosure certificate
required by this subdivision shall be signed by the buyer or a person authorized to act on
behalf of the buyer. If the buyer knows of no wells on the property, a well disclosure
certificate is not required if the following statement appears on the deed followed by the
signature of the grantee or, if there is more than one grantee, the signature of at least one
of the grantees: "The Grantee certifies that the Grantee does not know of any wells on the
described real property." The statement and signature of the grantee may be on the front
or back of the deed or on an attached sheet and an acknowledgment of the statement by
the grantee is not required for the deed to be recordable.
(e) This subdivision does not apply to the sale, exchange, or transfer of real property:
(1) that consists solely of a sale or transfer of severed mineral interests; or
(2) that consists of an individual condominium unit as described in chapters 515
and 515B.
(f) For an area owned in common under chapter 515 or 515B the association or other
responsible person must report to the commissioner by July 1, 1992, the location and
status of all wells in the common area. The association or other responsible person must
notify the commissioner within 30 days of any change in the reported status of wells.
(g) For real property sold by the state under section 92.67, the lessee at the time of
the sale is responsible for compliance with this subdivision.
(h) If the seller fails to provide a required well disclosure certificate, the buyer, or
a person authorized to act on behalf of the buyer, may sign a well disclosure certificate
based on the information provided on the disclosure statement required by this section
or based on other available information.
(i) A county recorder or registrar of titles may not record a deed or other instrument
of conveyance dated after October 31, 1990, for which a certificate of value is required
under section 272.115, or any deed or other instrument of conveyance dated after October
31, 1990, from a governmental body exempt from the payment of state deed tax, unless
the deed or other instrument of conveyance contains the statement made in accordance
with paragraph (c) or (d) or is accompanied by the well disclosure certificate containing all
the information required by paragraph (b) or (d). The county recorder or registrar of titles
must not accept a certificate unless it contains all the required information. The county
recorder or registrar of titles shall note on each deed or other instrument of conveyance
accompanied by a well disclosure certificate that the well disclosure certificate was
received. The notation must include the statement "No wells on property" if the disclosure
certificate states there are no wells on the property. The well disclosure certificate shall not
be filed or recorded in the records maintained by the county recorder or registrar of titles.
After noting "No wells on property" on the deed or other instrument of conveyance, the
county recorder or registrar of titles shall destroy or return to the buyer the well disclosure
certificate. The county recorder or registrar of titles shall collect from the buyer or the
person seeking to record a deed or other instrument of conveyance, a fee of deleted text begin $40deleted text end new text begin $45new text end
for receipt of a completed well disclosure certificate. By the tenth day of each month,
the county recorder or registrar of titles shall transmit the well disclosure certificates
to the commissioner of health. By the tenth day after the end of each calendar quarter,
the county recorder or registrar of titles shall transmit to the commissioner of health
deleted text begin $32.50deleted text end new text begin $37.50new text end of the fee for each well disclosure certificate received during the quarter.
The commissioner shall maintain the well disclosure certificate for at least six years. The
commissioner may store the certificate as an electronic image. A copy of that image
shall be as valid as the original.
(j) No new well disclosure certificate is required under this subdivision if the buyer
or seller, or a person authorized to act on behalf of the buyer or seller, certifies on the deed
or other instrument of conveyance that the status and number of wells on the property
have not changed since the last previously filed well disclosure certificate. The following
statement, if followed by the signature of the person making the statement, is sufficient
to comply with the certification requirement of this paragraph: "I am familiar with the
property described in this instrument and I certify that the status and number of wells on
the described real property have not changed since the last previously filed well disclosure
certificate." The certification and signature may be on the front or back of the deed or on
an attached sheet and an acknowledgment of the statement is not required for the deed or
other instrument of conveyance to be recordable.
(k) The commissioner in consultation with county recorders shall prescribe the form
for a well disclosure certificate and provide well disclosure certificate forms to county
recorders and registrars of titles and other interested persons.
(l) Failure to comply with a requirement of this subdivision does not impair:
(1) the validity of a deed or other instrument of conveyance as between the parties
to the deed or instrument or as to any other person who otherwise would be bound by
the deed or instrument; or
(2) the record, as notice, of any deed or other instrument of conveyance accepted for
filing or recording contrary to the provisions of this subdivision.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2008.
new text end
Sec. 6.
Minnesota Statutes 2006, section 144.123, is amended to read:
144.123 FEES FOR DIAGNOSTIC LABORATORY SERVICES;
EXCEPTIONS.
Subdivision 1.
Who must pay.
Except for the limitation contained in this section,
the commissioner of health shall charge a handling fee for each specimen submitted to
the Department of Health for analysis for diagnostic purposes by any hospital, private
laboratory, private clinic, or physician. No fee shall be charged to any entity which
receives direct or indirect financial assistance from state or federal funds administered by
the Department of Health, including any public health department, nonprofit community
clinic, deleted text begin venerealdeleted text end new text begin sexually transmittednew text end disease clinic, deleted text begin family planning clinic,deleted text end or similar
entity. new text begin No fee will be charged for any biological materials submitted to the Department
of Health as a requirement of Minnesota Rules, part 4605.7040, or for those biological
materials requested by the department to gather information for disease prevention or
control purposes. new text end The commissioner of health may establish deleted text begin by ruledeleted text end other exceptions to
the handling fee as may be necessary to deleted text begin gather information for epidemiologic purposesdeleted text end new text begin
protect the public's healthnew text end . All fees collected pursuant to this section shall be deposited in
the state treasury and credited to the state government special revenue fund.
Subd. 2.
deleted text begin Rules fordeleted text end Fee amounts.
The commissioner of health shall deleted text begin promulgate
rules, in accordance with chapter 14, which shall specify the amount of thedeleted text end new text begin charge anew text end
handling fee prescribed in subdivision 1. The fee shall approximate the costs to the
department of handling specimens including reporting, postage, specimen kit preparation,
and overhead costs. The fee prescribed in subdivision 1 shall be deleted text begin $15deleted text end new text begin $25new text end per specimen
deleted text begin until the commissioner promulgates rules pursuant to this subdivisiondeleted text end .
Sec. 7.
Minnesota Statutes 2006, section 144.125, is amended to read:
144.125 TESTS OF INFANTS FOR HERITABLE AND CONGENITAL
DISORDERS.
Subdivision 1.
Duty to perform testing.
It is the duty of (1) the administrative
officer or other person in charge of each institution caring for infants 28 days or less
of age, (2) the person required in pursuance of the provisions of section 144.215, to
register the birth of a child, or (3) the nurse midwife or midwife in attendance at the
birth, to arrange to have administered to every infant or child in its care tests for heritable
and congenital disorders according to subdivision 2 and rules prescribed by the state
commissioner of health. Testing and the recording and reporting of test results shall be
performed at the times and in the manner prescribed by the commissioner of health. The
commissioner shall charge deleted text begin laboratory service feesdeleted text end new text begin a feenew text end so that the total of fees collected
will approximate the costs of conducting the tests and implementing and maintaining a
system to follow-up infants with heritable or congenital disordersnew text begin , including hearing loss
detected through the early hearing detection and intervention program under section
144.966new text end . The deleted text begin laboratory servicedeleted text end fee is deleted text begin $61deleted text end new text begin $101new text end per specimen. Costs associated with
capital expenditures and the development of new procedures may be prorated over a
three-year period when calculating the amount of the fees.
Subd. 2.
Determination of tests to be administered.
The commissioner shall
periodically revise the list of tests to be administered for determining the presence of a
heritable or congenital disorder. Revisions to the list shall reflect advances in medical
science, new and improved testing methods, or other factors that will improve the public
health. In determining whether a test must be administered, the commissioner shall take
into consideration the adequacy of deleted text begin laboratorydeleted text end new text begin analyticalnew text end methods to detect the heritable
or congenital disorder, the ability to treat or prevent medical conditions caused by the
heritable or congenital disorder, and the severity of the medical conditions caused by the
heritable or congenital disorder. The list of tests to be performed may be revised if the
changes are recommended by the advisory committee established under section 144.1255,
approved by the commissioner, and published in the State Register. The revision is
exempt from the rulemaking requirements in chapter 14, and sections 14.385 and 14.386
do not apply.
Subd. 3.
Objection of parents to test.
Persons with a duty to perform testing under
subdivision 1 shall advise parents of infants (1) that the blood or tissue samples used to
perform testing thereunder as well as the results of such testing may be retained by the
Department of Health, (2) the benefit of retaining the blood or tissue sample, and (3) that
the following options are available to them with respect to the testing: (i) to decline to
have the tests, or (ii) to elect to have the tests but to require that all blood samples and
records of test results be destroyed within 24 months of the testing. If the parents of
an infant object in writing to testing for heritable and congenital disorders or elect to
require that blood samples and test results be destroyed, the objection or election shall
be recorded on a form that is signed by a parent or legal guardian and made part of the
infant's medical record. A written objection exempts an infant from the requirements of
this section and section 144.128.
Sec. 8.
Minnesota Statutes 2006, section 144.9507, is amended by adding a subdivision
to read:
new text begin Subd. 6. new text end
new text begin Medical assistance. new text end
new text begin
Medical assistance reimbursement for lead risk
assessment services under section 256B.0625, subdivision 49, shall not be used to replace
or decrease existing state or local funding for lead services and lead-related activities.
new text end
Sec. 9.
Minnesota Statutes 2006, section 144.9512, is amended to read:
144.9512 LEAD ABATEMENT PROGRAM.
Subdivision 1.
Definitions.
(a) The definitions in section 144.9501 and in this
subdivision apply to this section.
(b) deleted text begin "Eligible organization" means a lead contractor, city, board of health, community
health department, community action agency as defined in section 256E.30, or community
development corporation.
deleted text end
deleted text begin (c)deleted text end "Commissioner" means the commissioner of healthdeleted text begin , or the commissioner of the
Minnesota Housing Finance Agency as authorized by section 462A.05, subdivision 15cdeleted text end .
Subd. 2.
Grants; administration.
Within the limits of the available appropriation,
the commissioner deleted text begin must develop a swab team services program which maydeleted text end new text begin shallnew text end make
deleted text begin demonstration and trainingdeleted text end grants to deleted text begin eligible organizationsdeleted text end new text begin a nonprofit organization
currently operating the CLEARCorps lead hazard reduction project new text end to train workers to
provide swab team services deleted text begin and swab team servicesdeleted text end for residential property. deleted text begin Grants may
be awarded to nonprofit organizations to provide technical assistance and training to
ensure quality and consistency within the statewide program. Grants must be awarded to
help ensure full-time employment to workers providing swab team services and must be
awarded for a two-year period.
deleted text end
deleted text begin
Grants awarded under this section must be made in consultation with the
commissioner of the Housing Finance Agency and representatives of neighborhood
groups from areas at high risk for toxic lead exposure, a labor organization, the lead
coalition, community action agencies, and the legal aid society. The consulting team must
review grant applications and recommend awards to eligible organizations that meet
requirements for receiving a grant under this section.
deleted text end
deleted text begin Subd. 3. deleted text end
deleted text begin Applicants. deleted text end
deleted text begin
(a) Interested eligible organizations may apply to the
commissioner for grants under this section. Two or more eligible organizations may
jointly apply for a grant. Priority shall be given to community action agencies in greater
Minnesota and to either community action agencies or neighborhood based nonprofit
organizations in cities of the first class. Of the total annual appropriation, 12.5 percent may
be used for administrative purposes. The commissioner may deviate from this percentage
if a grantee can justify the need for a larger administrative allowance. Of this amount,
up to five percent may be used by the commissioner for state administrative purposes.
Applications must provide information requested by the commissioner, including at least
the information required to assess the factors listed in paragraph (d).
deleted text end
deleted text begin
(b) The commissioner must consult with boards of health to provide swab team
services for purposes of secondary prevention. The priority for swab teams created
by grants to eligible organizations under this section must be work assigned by the
commissioner of health, or by a board of health if so designated by the commissioner of
health, to provide secondary prevention swab team services to fulfill the requirements
of section deleted text begin 144.9504, subdivision 6deleted text end , in response to a lead order. Swab teams assigned
work under this section by the commissioner, that are not engaged daily in fulfilling the
requirements of section deleted text begin 144.9504, subdivision 6deleted text end , must deliver swab team services in
response to elevated blood lead levels as defined in section deleted text begin 144.9501, subdivision 9deleted text end ,
where lead orders were not issued, and for purposes of primary prevention in census
tracts known to be in areas at high risk for toxic lead exposure as described in section
deleted text begin 144.9503, subdivision 2deleted text end .
deleted text end
deleted text begin
(c) Any additional money must be used for grants to establish swab teams for
primary prevention under section , in census tracts in areas at high risk for toxic
lead exposure as determined under section deleted text begin 144.9503, subdivision 2deleted text end .
deleted text end
deleted text begin
(d) In evaluating grant applications, the commissioner must consider the following
criteria:
deleted text end
deleted text begin
(1) the use of lead contractors and lead workers for residential swab team services;
deleted text end
deleted text begin
(2) the participation of neighborhood groups and individuals, as swab team workers,
in areas at high risk for toxic lead exposure;
deleted text end
deleted text begin
(3) plans for the provision of swab team services for primary and secondary
prevention as required under subdivision 4;
deleted text end
deleted text begin
(4) plans for supervision, training, career development, and postprogram placement
of swab team members;
deleted text end
deleted text begin
(5) plans for resident and property owner education on lead safety;
deleted text end
deleted text begin
(6) plans for distributing cleaning supplies to area residents and educating residents
and property owners on cleaning techniques;
deleted text end
deleted text begin
(7) sources of other funding and cost estimates for training, lead inspections, swab
team services, equipment, monitoring, testing, and administration;
deleted text end
deleted text begin
(8) measures of program effectiveness;
deleted text end
deleted text begin
(9) coordination of program activities with other federal, state, and local public
health, job training, apprenticeship, and housing renovation programs including programs
under sections to ; and
deleted text end
deleted text begin
(10) prior experience in providing swab team services.
deleted text end
Subd. 4.
deleted text begin Lead supervisor or certified firmdeleted text end new text begin Eligible grant activitiesnew text end .
(a) deleted text begin Eligible
organizations and lead supervisors or certified firms may participate in the swab team
program. An eligible organizationdeleted text end new text begin The nonprofitnew text end receiving a grant under this section
must deleted text begin assuredeleted text end new text begin ensurenew text end that all participating lead supervisors or certified firms are licensed
and that all swab team workers are certified by the Department of Health under section
144.9505. deleted text begin Eligible organizations and lead supervisors or certified firms may distinguish
between interior and exterior services in assigning duties anddeleted text end new text begin The nonprofit organizationnew text end
may participate in the program by:
(1) providing on-the-job training for swab team workers;
(2) providing swab team services to meet the requirements of sections 144.9503,
subdivision 4, and 144.9504, subdivision 6;
(3) providing deleted text begin a removal and replacement component using skilled craft workers
under subdivision 7deleted text end new text begin lead hazard reduction to meet the requirements of section 144.9501,
subdivision 17new text end ;
deleted text begin
(4) providing lead testing according to subdivision 8;
deleted text end
deleted text begin (5)deleted text end new text begin (4)new text end providing lead dust deleted text begin cleaning suppliesdeleted text end new text begin cleanup equipment and materialsnew text end , as
described in section deleted text begin 144.9507deleted text end new text begin 144.9503new text end , subdivision deleted text begin 4deleted text end deleted text begin , paragraph (c)deleted text end new text begin 1new text end , to residents; deleted text begin ordeleted text end
deleted text begin (6)deleted text end new text begin (5)new text end having a swab team worker instruct residents and property owners on
appropriate lead control techniques, including the lead-safe directives developed by the
commissioner of healthdeleted text begin .deleted text end new text begin ;
new text end
new text begin
(6) conducting blood lead testing events including screening children and pregnant
women according to Department of Health screening guidelines;
new text end
new text begin
(7) performing case management services according to Department of Health case
management guidelines; or
new text end
new text begin
(8) conducting mandated risk assessments under Minnesota Statutes, section
144.9504, subdivision 2.
new text end
deleted text begin
(b) Participating lead supervisors or certified firms must:
deleted text end
deleted text begin
(1) demonstrate proof of workers' compensation and general liability insurance
coverage;
deleted text end
deleted text begin
(2) be knowledgeable about lead abatement requirements established by the
Department of Housing and Urban Development and the Occupational Safety and Health
Administration and lead hazard reduction requirements and lead-safe directives of the
commissioner of health;
deleted text end
deleted text begin
(3) demonstrate experience with on-the-job training programs;
deleted text end
deleted text begin
(4) demonstrate an ability to recruit employees from areas at high risk for toxic
lead exposure; and
deleted text end
deleted text begin
(5) demonstrate experience in working with low-income clients.
deleted text end
Subd. 5.
Swab team workers.
Each worker engaged in swab team services
established under this section must have blood lead concentrations below 15 micrograms
of lead per deciliter of whole blood as determined by a baseline blood lead screening.
deleted text begin Anydeleted text end new text begin The nonprofitnew text end organization receiving a grant under this section is responsible for lead
screening and must deleted text begin assuredeleted text end new text begin ensurenew text end that all swab team workers meet the standards established
in this subdivision. deleted text begin Granteesdeleted text end new text begin The nonprofit organizationnew text end must use appropriate workplace
procedures including following the lead-safe directives developed by the commissioner of
health to reduce risk of elevated blood lead levels. deleted text begin Granteesdeleted text end new text begin The nonprofit organizationnew text end
and participating contractors must report all employee blood lead levels that exceed 15
micrograms of lead per deciliter of whole blood to the commissioner of health.
deleted text begin Subd. 6. deleted text end
deleted text begin On-the-job training component. deleted text end
deleted text begin
(a) Programs established under this
section must provide on-the-job training for swab team workers.
deleted text end
deleted text begin
(b) Swab team workers must receive monetary compensation equal to the prevailing
wage as defined in section deleted text begin 177.42, subdivision 6deleted text end , for comparable jobs in the licensed
contractor's principal business.
deleted text end
deleted text begin Subd. 7. deleted text end
deleted text begin Removal and replacement component. deleted text end
deleted text begin
(a) Within the limits of the
available appropriation and if a need is identified by a lead inspector, the commissioner
may establish a component for removal and replacement of deteriorated paint in residential
properties according to the following criteria:
deleted text end
deleted text begin
(1) components within a residence must have both deteriorated lead-based paint and
substrate damage beyond repair or rotting wooden framework to be eligible for removal
and replacement;
deleted text end
deleted text begin
(2) all removal and replacement must be done using least-cost methods and
following lead-safe directives;
deleted text end
deleted text begin
(3) whenever windows and doors or other components covered with deteriorated
lead-based paint have sound substrate or are not rotting, those components should be
repaired, sent out for stripping, planed down to remove deteriorated lead-based paint, or
covered with protective guards instead of being replaced, provided that such an activity is
the least-cost method of providing the swab team service;
deleted text end
deleted text begin
(4) removal and replacement or repair must be done by lead contractors using skilled
craft workers or trained swab team members; and
deleted text end
deleted text begin
(5) all craft work that requires a state license must be supervised by a person with
a state license in the craft work being supervised. The grant recipient may contract for
this supervision.
deleted text end
deleted text begin
(b) The program design must:
deleted text end
deleted text begin
(1) identify the need for on-the-job training of swab team workers to be removal and
replacement workers; and
deleted text end
deleted text begin
(2) describe plans to involve appropriate groups in designing methods to meet the
need for training swab team workers.
deleted text end
deleted text begin Subd. 8. deleted text end
deleted text begin Testing and evaluation. deleted text end
deleted text begin
(a) Testing of the environment is not necessary
by swab teams whose work is assigned by the commissioner of health or a designated
board of health under section . The commissioner of health or designated board
of health must share the analytical testing data collected on each residence for purposes
of secondary prevention under section with the swab team workers in order to
provide constructive feedback on their work and to the commissioner for the purposes
set forth in paragraph (c).
deleted text end
deleted text begin
(b) For purposes of primary prevention evaluation, the following samples must be
collected: pretesting and posttesting of one noncarpeted floor dust lead sample and a
notation of the extent and location of bare soil and of deteriorated lead-based paint. The
analytical testing data collected on each residence for purposes of primary prevention
under section must be shared with the swab team workers in order to provide
constructive feedback on their work and to the commissioner for the purposes set forth in
paragraph (c).
deleted text end
deleted text begin
(c) The commissioner of health must establish a program to collect appropriate data
as required under paragraphs (a) and (b), in order to conduct an ongoing evaluation of
swab team services for primary and secondary prevention. Within the limits of available
appropriations, the commissioner of health must conduct on up to 1,000 residences which
have received primary or secondary prevention swab team services, a postremediation
evaluation, on at least a quarterly basis for a period of at least two years for each residence.
The evaluation must note the condition of the paint within the residence, the extent of bare
soil on the grounds, and collect and analyze one noncarpeted floor dust lead sample.
The data collected must be evaluated to determine the efficacy of providing swab team
services as a method of reducing lead exposure in young children. In evaluating this data,
the commissioner of health must consider city size, community location, historic traffic
flow, soil lead level of the property by area or census tract, distance to industrial point
sources that emit lead, season of the year, age of the housing, age and number of children
living at the residence, the presence of pets that move in and out of the residence, and
other relevant factors as the commissioner of health may determine.
deleted text end
Subd. 9.
Program benefits.
As a condition of providing swab team services under
this section, deleted text begin andeleted text end new text begin the nonprofitnew text end organization may require a property owner to not increase
rents on a property solely as a result of a substantial improvement made with public
funds under the programs in this section.
Subd. 10.
Requirements of deleted text begin organizations receiving grantsdeleted text end new text begin the nonprofit
organizationnew text end .
deleted text begin An eligibledeleted text end new text begin The nonprofitnew text end organization that is awarded a deleted text begin training and
demonstrationdeleted text end grant under this section must prepare and submit a quarterly progress report
to the commissioner beginning three months after receipt of the grant.
Sec. 10.
new text begin
[144.966] EARLY HEARING DETECTION AND INTERVENTION
PROGRAM.
new text end
new text begin Subdivision 1. new text end
new text begin Definitions. new text end
new text begin
(a) "Child" means a person 18 years of age or younger.
new text end
new text begin
(b) "False positive rate" means the proportion of infants identified as having a
significant hearing loss by the screening process who are ultimately found to not have a
significant hearing loss.
new text end
new text begin
(c) "False negative rate" means the proportion of infants not identified as having
a significant hearing loss by the screening process who are ultimately found to have a
significant hearing loss.
new text end
new text begin
(d) "Hearing screening test" means automated auditory brain stem response,
otoacoustic emissions, or another appropriate screening test approved by the Department
of Health.
new text end
new text begin
(e) "Hospital" means a birthing health care facility or birthing center licensed in
this state that provides obstetrical services.
new text end
new text begin
(f) "Infant" means a child who is not a newborn and has not attained the age of
one year.
new text end
new text begin
(g) "Newborn" means an infant 28 days of age or younger.
new text end
new text begin
(h) "Parent" means a natural parent, stepparent, adoptive parent, guardian, or
custodian of a newborn or infant.
new text end
new text begin Subd. 2. new text end
new text begin Newborn Hearing Screening Advisory Committee. new text end
new text begin
(a) The
commissioner of health shall establish a Newborn Hearing Screening Advisory Committee
to advise and assist the Department of Health and the Department of Education in:
new text end
new text begin
(1) developing protocols and timelines for screening, rescreening, and diagnostic
audiological assessment and early medical, audiological, and educational intervention
services for children who are deaf or hard-of-hearing;
new text end
new text begin
(2) designing protocols for tracking children from birth through age three that may
have passed newborn screening but are at risk for delayed or late onset of permanent
hearing loss;
new text end
new text begin
(3) designing a technical assistance program to support facilities implementing the
screening program and facilities conducting rescreening and diagnostic audiological
assessment;
new text end
new text begin
(4) designing implementation and evaluation of a system of follow-up and tracking;
and
new text end
new text begin
(5) evaluating program outcomes to increase effectiveness and efficiency and ensure
culturally appropriate services for children with a confirmed hearing loss and their families.
new text end
new text begin
(b) The commissioner of health shall appoint at least one member from each of the
following groups with no less than two of the members being deaf or hard-of-hearing:
new text end
new text begin
(1) a representative from a consumer organization representing culturally deaf
persons;
new text end
new text begin
(2) a parent with a child with hearing loss representing a parent organization;
new text end
new text begin
(3) a consumer from an organization representing oral communication options;
new text end
new text begin
(4) a consumer from an organization representing cued speech communication
options;
new text end
new text begin
(5) an audiologist who has experience in evaluation and intervention of infants
and young children;
new text end
new text begin
(6) a speech-language pathologist who has experience in evaluation and intervention
of infants and young children;
new text end
new text begin
(7) two primary care providers who have experience in the care of infants and young
children, one of which shall be a pediatrician;
new text end
new text begin
(8) a representative from the early hearing detection intervention teams;
new text end
new text begin
(9) a representative from the Department of Education resource center for the deaf
and hard-of-hearing or the representative's designee;
new text end
new text begin
(10) a representative of the Minnesota Commission Serving Deaf and Hard of
Hearing People;
new text end
new text begin
(11) a representative from the Department of Human Services Deaf and Hard of
Hearing Services Division;
new text end
new text begin
(12) one or more of the Part C coordinators from the Department of Education,
the Department of Health, or the Department of Human Services or the department's
designees;
new text end
new text begin
(13) the Department of Health early hearing detection and intervention coordinators;
new text end
new text begin
(14) two birth hospital representatives from one rural and one urban hospital;
new text end
new text begin
(15) a pediatric geneticist;
new text end
new text begin
(16) an otolaryngologist;
new text end
new text begin
(17) a representative from the Newborn Screening Advisory Committee under
this subdivision; and
new text end
new text begin
(18) a representative of the Department of Education regional low-incidence
facilitators.
new text end
new text begin
The commissioner must complete the appointments required under this subdivision by
September 1, 2007.
new text end
new text begin
(c) The Department of Health member shall chair the first meeting of the committee.
At the first meeting, the committee shall elect a chair from its membership. The committee
shall meet at the call of the chair, at least four times a year. The committee shall adopt
written bylaws to govern its activities. The Department of Health shall provide technical
and administrative support services as required by the committee. These services shall
include technical support from individuals qualified to administer infant hearing screening,
rescreening, and diagnostic audiological assessments.
new text end
new text begin
Members of the committee shall receive no compensation for their service, but
shall be reimbursed as provided in section 15.059 for expenses incurred as a result of
their duties as members of the committee.
new text end
new text begin
(d) This subdivision expires June 30, 2013.
new text end
new text begin Subd. 3. new text end
new text begin Early hearing detection and intervention programs. new text end
new text begin
All hospitals
shall establish an early hearing detection and intervention (EHDI) program. Each EHDI
program shall:
new text end
new text begin
(1) in advance of any hearing screening testing, provide to the newborn's or infant's
parents or parent information concerning the nature of the screening procedure, applicable
costs of the screening procedure, the potential risks and effects of hearing loss, and the
benefits of early detection and intervention;
new text end
new text begin
(2) comply with parental consent under section 144.125, subdivision 3;
new text end
new text begin
(3) develop policies and procedures for screening and rescreening based on
Department of Health recommendations;
new text end
new text begin
(4) provide appropriate training and monitoring of individuals responsible for
performing hearing screening tests as recommended by the Department of Health;
new text end
new text begin
(5) test the newborn's hearing prior to discharge, or, if the newborn is expected to
remain in the hospital for a prolonged period, testing shall be performed prior to three
months of age or when medically feasible;
new text end
new text begin
(6) develop and implement procedures for documenting the results of all hearing
screening tests;
new text end
new text begin
(7) inform the newborn's or infant's parents or parent, primary care physician, and
the Department of Health according to recommendations of the Department of Health of
the results of the hearing screening test or rescreening if conducted, or if the newborn or
infant was not successfully tested. The hospital that discharges the newborn or infant to
home is responsible for the screening; and
new text end
new text begin
(8) collect performance data specified by the Department of Health.
new text end
new text begin Subd. 4. new text end
new text begin Notification and information. new text end
new text begin
(a) Notification to the parents or parent,
primary care provider, and the Department of Health shall occur prior to discharge or no
later than ten days following the date of testing. Notification shall include information
recommended by the Department of Health.
new text end
new text begin
(b) A physician, nurse, midwife, or other health professional attending a birth outside
a hospital or institution shall provide information, orally and in writing, as established by
the Department of Health, to parents regarding places where the parents may have their
infant's hearing screened and the importance of the screening.
new text end
new text begin
(c) The professional conducting the diagnostic procedure to confirm the hearing loss
must report the results to the parents, primary care provider, and Department of Health
according to the Department of Health recommendations.
new text end
new text begin Subd. 5. new text end
new text begin Oversight responsibility. new text end
new text begin
The Department of Health shall exercise
oversight responsibility for EHDI programs, including establishing a performance data set
and reviewing performance data collected by each hospital.
new text end
new text begin Subd. 6. new text end
new text begin Civil and criminal immunity and penalties. new text end
new text begin
(a) No physician or hospital
shall be civilly or criminally liable for failure to conduct hearing screening testing.
new text end
new text begin
(b) No physician, midwife, nurse, other health professional, or hospital acting in
compliance with this section shall be civilly or criminally liable for any acts conforming
with this section, including furnishing information required according to this section.
new text end
new text begin Subd. 7. new text end
new text begin Fees. new text end
new text begin
The commissioner shall charge a fee so that the total of fees
collected will approximate the costs of implementing and maintaining a system to follow
up on infants and provide technical assistance, a tracking system, data management, and
evaluation. The fee shall be incorporated in the fee charged under section 144.125.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 11.
Minnesota Statutes 2006, section 144E.101, subdivision 6, is amended to read:
Subd. 6.
Basic life support.
(a) Except as provided in paragraph (e), a basic life
support ambulance shall be staffed by at least two ambulance service personnel, at least
one of which must be an EMT, who provide a level of care so as to ensure that:
(1) life-threatening situations and potentially serious injuries are recognized;
(2) patients are protected from additional hazards;
(3) basic treatment to reduce the seriousness of emergency situations is administered;
and
(4) patients are transported to an appropriate medical facility for treatment.
(b) A basic life support service shall provide basic airway management.
(c) By January 1, 2001, a basic life support service shall provide automatic
defibrillation, as provided in section 144E.103, subdivision 1, paragraph (b).
(d) A basic life support service licensee's medical director may authorize the
ambulance service personnel to carry and to use medical antishock trousers and to perform
intravenous infusion if the ambulance service personnel have been properly trained.
(e) Upon application from an ambulance service that includes evidence
demonstrating hardship, the board may grant a deleted text begin temporarydeleted text end variance from the staff
requirements in paragraph (a) and may authorize a basic life support ambulance to be
staffed by one EMT and one first responder. The variance shall apply to basic life support
ambulances operated by the ambulance service deleted text begin for up to one year from the date of the
variance's issuancedeleted text end new text begin until the ambulance service renews its licensenew text end . When a variance
expires, an ambulance service may apply for a new variance under this paragraph. For
purposes of this paragraph, "ambulance service" means either an ambulance service whose
primary service area is located outside the metropolitan counties listed in section 473.121,
subdivision 4, and outside the cities of Duluth, Mankato, Moorhead, Rochester, and St.
Cloud; or an ambulance service based in a community with a population of less than 1,000.
Sec. 12.
Minnesota Statutes 2006, section 144E.127, is amended to read:
144E.127 INTERHOSPITALnew text begin ; INTERFACILITYnew text end TRANSFER.
new text begin Subdivision 1. new text end
new text begin Interhospital transfers. new text end
When transporting a patient from one
licensed hospital to another, a licensee may substitute for one of the required ambulance
service personnel, a physician, a registered nurse, or physician's assistant who has been
trained to use the equipment in the ambulance and is knowledgeable of the licensee's
ambulance service protocols.
new text begin Subd. 2. new text end
new text begin Interfacility transfers. new text end
new text begin
In an interfacility transport, a licensee whose
primary service area is located outside the metropolitan counties listed in section 473.121,
subdivision 4, and outside the cities of Duluth, Mankato, Moorhead, Rochester, and St.
Cloud; or an ambulance service based in a community with a population of less than 1,000,
may substitute one EMT with a registered first responder if an EMT or EMT-paramedic,
physician, registered nurse, or physician's assistant is in the patient compartment. If using
a physician, registered nurse, or physician's assistant as the sole provider in the patient
compartment, the individual must be trained to use the equipment in the ambulance and be
knowledgeable of the ambulance service protocols.
new text end
Sec. 13.
Minnesota Statutes 2006, section 144E.35, subdivision 1, is amended to read:
Subdivision 1.
Repayment for volunteer training.
deleted text begin Any political subdivision, or
nonprofit hospital or nonprofit corporation operatingdeleted text end A licensed ambulance service shall
be reimbursed by the board for the necessary expense of the initial training of a volunteer
ambulance attendant upon successful completion by the attendant of a basic emergency
care course, or a continuing education course for basic emergency care, or both, which has
been approved by the board, pursuant to section 144E.285. Reimbursement may include
tuition, transportation, food, lodging, hourly payment for the time spent in the training
course, and other necessary expenditures, except that in no instance shall a volunteer
ambulance attendant be reimbursed more than deleted text begin $450deleted text end new text begin $600 new text end for successful completion of a
basic course, and deleted text begin $225deleted text end new text begin $275 new text end for successful completion of a continuing education course.
Sec. 14.
new text begin
[156.015] FEES.
new text end
new text begin Subdivision 1. new text end
new text begin Verification of licensure. new text end
new text begin
The board may charge a fee of $25 per
license verification to a licensee for verification of licensure status provided to other
veterinary licensing boards.
new text end
new text begin Subd. 2. new text end
new text begin Continuing education review. new text end
new text begin
The board may charge a fee of $50 per
submission to a sponsor for review and approval of individual continuing education
seminars, courses, wet labs, and lectures. This fee does not apply to continuing education
sponsors that already meet the criteria for preapproval under Minnesota Rules, part
9100.1000, subpart 3, item A.
new text end
Sec. 15.
Minnesota Statutes 2006, section 198.075, is amended to read:
198.075 MINNESOTA VETERANS HOME EMPLOYEES; EXCLUDED
FROM COMMISSARY PRIVILEGES.
new text begin Except as provided in this section, new text end no commissary privileges including food, laundry
service, janitorial service, and household supplies shall be furnished to any employee of
the Minnesota veterans homes.new text begin An employee of the Minnesota veterans homes who works
a second shift that is consecutive with a regularly scheduled shift may be allowed one free
meal at the veterans home on the day of that extra shift.
new text end
Sec. 16.
Minnesota Statutes 2006, section 256B.0625, is amended by adding a
subdivision to read:
new text begin Subd. 49. new text end
new text begin Lead risk assessments. new text end
new text begin
(a) Effective October 1, 2007, or six months after
federal approval, whichever is later, medical assistance covers lead risk assessments
provided by a lead risk assessor who is licensed by the commissioner of health under
section 144.9505 and employed by an assessing agency as defined in section 144.9501.
Medical assistance covers a onetime on-site investigation of a recipient's home or primary
residence to determine the existence of lead so long as the recipient is under the age
of 21 and has a venous blood lead level specified in section 144.9504, subdivision 2,
paragraph (a).
new text end
new text begin
(b) Medical assistance reimbursement covers the lead risk assessor's time to
complete the following activities:
new text end
new text begin
(1) gathering samples;
new text end
new text begin
(2) interviewing family members;
new text end
new text begin
(3) gathering data, including meter readings; and
new text end
new text begin
(4) providing a report with the results of the investigation and options for reducing
lead-based paint hazards.
new text end
new text begin
Medical assistance coverage of lead risk assessment does not include testing of
environmental substances such as water, paint, or soil or any other laboratory services.
Medical assistance coverage of lead risk assessments is not included in the capitated
services for children enrolled in health plans through the prepaid medical assistance
program and the MinnesotaCare program.
new text end
new text begin
(c) Payment for lead risk assessment must be cost-based and must meet the
criteria for federal financial participation under the Medicaid program. The rate must
be based on allowable expenditures from cost information gathered. Under section
144.9507, subdivision 5, federal medical assistance funds may not replace existing
funding for lead-related activities. The nonfederal share of costs for services provided
under this subdivision must be from state or local funds and is the responsibility of the
agency providing the risk assessment. When the risk assessment is conducted by the
commissioner of health, the state share must be from appropriations to the commissioner
of health for this purpose. Eligible expenditures for the nonfederal share of costs may not
be made from federal funds or funds used to match other federal funds. Any federal
disallowances are the responsibility of the agency providing risk assessment services.
new text end
Sec. 17.
Laws 2005, First Special Session chapter 4, article 9, section 3, subdivision 2,
is amended to read:
Subd. 2.Community and Family Health
|
||||||
| Summary by Fund |
||
| General |
40,413,000 |
40,382,000 |
| State Government Special Revenue |
141,000 |
128,000 |
| Health Care Access |
3,510,000 |
3,516,000 |
| Federal TANF |
6,000,000 |
6,000,000 |
deleted text begin
Family Planning Base Reduction. Base
level funding for the family planning
special projects grant program is reduced
by $1,877,000 each year of the biennium
beginning July 1, 2007, provided that
this reduction shall only take place
upon full implementation of the family
planning project section of the 1115 waiver.
Notwithstanding Minnesota Statutes, section
145.925, the commissioner shall give priority
to community health care clinics providing
family planning services that either serve a
high number of women who do not qualify
for medical assistance or are unable to
participate in the medical assistance program
as a medical assistance provider when
allocating the remaining appropriations.
Notwithstanding section 15, this paragraph
shall not expire.
deleted text end
Shaken Baby Video. Of the state
government special revenue fund
appropriation, $13,000 in 2006 is
appropriated to the commissioner of health
to provide a video to hospitals on shaken
baby syndrome. The commissioner of health
shall assess a fee to hospitals to cover the
cost of the approved shaken baby video and
the revenue received is to be deposited in the
state government special revenue fund.
Sec. 18. new text begin STUDY OF BLOOD LEAD TESTING METHODS.
new text end
new text begin
(a) The commissioner of health, in consultation with the commissioner of human
services, cities of the first class, health care providers, and other interested parties, shall
conduct a study to evaluate blood lead testing methods used to confirm elevated blood
lead status. The study shall examine:
new text end
new text begin
(1) the false positive rate of capillary tests for children who are younger than 72
months old;
new text end
new text begin
(2) current protocols for conducting capillary testing, including filter paper
methodology; and
new text end
new text begin
(3) existing guidelines and regulations from other states and federal agencies
regarding lead testing.
new text end
new text begin
(b) The commissioner shall make recommendations on:
new text end
new text begin
(1) the use of capillary tests to initiate environmental investigations and case
management, including number and timing of tests and fiscal implications for state and
local lead programs; and
new text end
new text begin
(2) reducing the state mandatory intervention to ten micrograms of lead per deciliter
of whole blood.
new text end
new text begin
(c) The commissioner shall submit the results of the study and recommendations,
including any necessary legislative changes, to the legislature by January 15, 2008.
new text end
Sec. 19. new text begin WINDOW SAFETY EDUCATION.
new text end
new text begin
The commissioner of health shall create in the department's current educational
safety program a component targeted at parents and caregivers of young children to
provide awareness of the need to take precautions to prevent children from falling
through open windows. The commissioner of health shall consult with representatives
of the residential building industry, the window products industry, the child safety
advocacy community, and the Department of Labor and Industry to create the window
safety program component. The program must include the gathering of data about
falls from windows that result in severe injury in order to measure the effectiveness of
the safety program. The commissioner of health may consult with other child safety
advocacy groups, experts, and interested parties in the development and implementation
of the window safety program. The commissioner of health shall prepare and submit
a final report on the window safety program to the legislature by March 1, 2011. The
commissioner shall prepare and submit a yearly progress report to the legislature by
March 1 of each year beginning in 2008 until the submission of the final report. The
final report must include a summary of the safety program, the impact of the program on
children falling from windows, and any recommendations for further study or action.
new text end
Sec. 20. new text begin REVISOR'S INSTRUCTION.
new text end
new text begin
The revisor of statutes shall change the range reference "144.9501 to 144.9509"
to "144.9501 to 144.9512" wherever the reference appears in Minnesota Statutes and
Minnesota Rules.
new text end
Sec. 21. new text begin REPEALER.
new text end
new text begin
Laws 2004, chapter 288, article 6, section 27,
new text end
new text begin
is repealed.
new text end
ARTICLE 17
PUBLIC HEALTH
Section 1.
Minnesota Statutes 2006, section 145A.17, is amended to read:
145A.17 FAMILY HOME VISITING PROGRAMS.
Subdivision 1.
Establishment; goals.
The commissioner shall establish a program
to fund family home visiting programs designed to foster deleted text begin adeleted text end healthy deleted text begin beginning for children
in families at or below 200 percent of the federal poverty guidelinesdeleted text end new text begin beginnings, improve
pregnancy outcomes, promote school readinessnew text end , prevent child abuse and neglect, reduce
juvenile delinquency, promote positive parenting and resiliency in children, and promote
family health and economic self-sufficiencynew text begin for children and families. The commissioner
shall promote partnerships, collaboration, and multidisciplinary visiting done by teams of
professionals and paraprofessionals from the fields of public health nursing, social work,
and early childhood educationnew text end . A program funded under this section must serve families
at or below 200 percent of the federal poverty guidelines, and other families determined
to be at risk, including but not limited to being at risk for child abuse, child neglect, or
juvenile delinquency. Programs must deleted text begin give priority for services to families considered to
be in need of services, including but not limited todeleted text end new text begin begin prenatally whenever possible and
must be targeted to new text end families with:
(1) adolescent parents;
(2) a history of alcohol or other drug abuse;
(3) a history of child abuse, domestic abuse, or other types of violence;
(4) a history of domestic abuse, rape, or other forms of victimization;
(5) reduced cognitive functioning;
(6) a lack of knowledge of child growth and development stages;
(7) low resiliency to adversities and environmental stresses; deleted text begin or
deleted text end
(8) insufficient financial resources to meet family needsnew text begin ;
new text end
new text begin
(9) a history of homelessness;
new text end
new text begin
(10) a risk of long-term welfare dependence or family instability due to employment
barriers; or
new text end
new text begin (11) other risk factors as determined by the commissionernew text end .
Subd. 3.
Requirements for programs; process.
(a) deleted text begin Before a community health
board or tribal government may receive an allocation under subdivision 2, a community
health board or tribal government must submit a proposal to the commissioner that
includes identification, based on a community assessment, of the populations at or below
200 percent of the federal poverty guidelines that will be served and the other populations
that will be served. Each program that receives funds mustdeleted text end new text begin Community health boards
and tribal governments that receive funding under this section must submit a plan to
the commissioner describing a multidisciplinary approach to targeted home visiting for
families. The plan must be submitted on forms provided by the commissioner. At a
minimum, the plan must include the followingnew text end :
new text begin
(1) a description of outreach strategies to families prenatally or at birth;
new text end
new text begin
(2) provisions for the seamless delivery of health, safety, and early learning services;
new text end
new text begin
(3) methods to promote continuity of services when families move within the state;
new text end
new text begin
(4) a description of the community demographics;
new text end
new text begin
(5) a plan for meeting outcome measures; and
new text end
new text begin
(6) a proposed work plan that includes:
new text end
new text begin
(i) coordination to ensure nonduplication of services for children and families;
new text end
new text begin
(ii) a description of the strategies to ensure that children and families at greatest risk
receive appropriate services; and
new text end
new text begin
(iii) collaboration with multidisciplinary partners including public health,
ECFE, Head Start, community health workers, social workers, community home
visiting programs, school districts, and other relevant partners. Letters of intent from
multidisciplinary partners must be submitted with the plan.
new text end
new text begin
(b) Each program that receives funds must accomplish the following program
requirements:
new text end
(1) use deleted text begin eitherdeleted text end a deleted text begin broaddeleted text end community-based deleted text begin or selective community-baseddeleted text end strategy to
provide preventive and early intervention home visiting services;
(2) offer a home visit by a trained home visitor. If a home visit is accepted, the first
home visit must occur prenatally or as soon after birth as possible and must include a
public health nursing assessment by a public health nurse;
(3) offer, at a minimum, information on infant care, child growth and development,
positive parenting, preventing diseases, preventing exposure to environmental hazards,
and support services available in the community;
(4) provide information on and referrals to health care services, if needed, including
information on new text begin and assistance in applying for new text end health care coverage for which the child or
family may be eligible; and provide information on preventive services, developmental
assessments, and the availability of public assistance programs as appropriate;
(5) provide youth development programsnew text begin when appropriatenew text end ;
(6) recruit home visitors who will represent, to the extent possible, the races,
cultures, and languages spoken by families that may be served;
(7) train and supervise home visitors in accordance with the requirements established
under subdivision 4;
(8) maximize resources and minimize duplication by coordinating deleted text begin activitiesdeleted text end new text begin or
contracting new text end with local social and human services organizations, education organizations,
and other appropriate governmental entities and community-based organizations and
agencies; deleted text begin and
deleted text end
(9) utilize appropriate racial and ethnic approaches to providing home visiting
servicesnew text begin ; and
new text end
new text begin (10) connect eligible families, as needed, to additional resources available in the
community, including, but not limited to, early care and education programs, health or
mental health services, family literacy programs, employment agencies, social services,
and child care resources and referral agenciesnew text end .
new text begin
(c) When available, programs that receive funds under this section must offer or
provide the family with a referral to center-based or group meetings that meet at least
once per month for those families identified with additional needs. The meetings must
focus on further enhancing the information, activities, and skill-building addressed during
home visitation; offering opportunities for parents to meet with and support each other;
and offering infants and toddlers a safe, nurturing, and stimulating environment for
socialization and supervised play with qualified teachers.
new text end
deleted text begin (b)deleted text end new text begin (d) new text end Funds available under this section shall not be used for medical services. The
commissioner shall establish an administrative cost limit for recipients of funds. The
outcome measures established under subdivision 6 must be specified to recipients of
funds at the time the funds are distributed.
deleted text begin (c)deleted text end new text begin (e) new text end Data collected on individuals served by the home visiting programs must
remain confidential and must not be disclosed by providers of home visiting services
without a specific informed written consent that identifies disclosures to be made.
Upon request, agencies providing home visiting services must provide recipients with
information on disclosures, including the names of entities and individuals receiving the
information and the general purpose of the disclosure. Prospective and current recipients
of home visiting services must be told and informed in writing that written consent for
disclosure of data is not required for access to home visiting services.
Subd. 4.
Training.
The commissioner shall establish training requirements for
home visitors and minimum requirements for supervision deleted text begin by a public health nursedeleted text end . The
requirements for nurses must be consistent with chapter 148. new text begin The commissioner must
provide training for home visitors. new text end Training must include deleted text begin child development, positive
parenting techniques, screening and referrals for child abuse and neglect, and diverse
cultural practices in child rearing and family systemsdeleted text end new text begin the following:
new text end
new text begin
(1) effective relationships for engaging and retaining families and ensuring family
health, safety, and early learning;
new text end
new text begin
(2) effective methods of implementing parent education, conducting home visiting,
and promoting quality early childhood development;
new text end
new text begin
(3) early childhood development from birth to age five;
new text end
new text begin
(4) diverse cultural practices in child rearing and family systems;
new text end
new text begin
(5) recruiting, supervising, and retaining qualified staff;
new text end
new text begin
(6) increasing services for underserved populations; and
new text end
new text begin (7) relevant issues related to child welfare and protective services, with information
provided being consistent with state child welfare agency trainingnew text end .
Subd. 5.
Technical assistance.
The commissioner shall provide administrative
and technical assistance to each program, including assistance in data collection and
other activities related to conducting short- and long-term evaluations of the programs
as required under subdivision 7. The commissioner may request research and evaluation
support from the University of Minnesota.
Subd. 6.
Outcome new text begin and performance new text end measures.
The commissioner shall establish
deleted text begin outcomesdeleted text end new text begin measures new text end to determine the impact of family home visiting programs funded
under this section on the following areas:
(1) appropriate utilization of preventive health care;
(2) rates of substantiated child abuse and neglect;
(3) rates of unintentional child injuries;
(4) rates of children who are screened and who pass early childhood screening; deleted text begin and
deleted text end
(5) new text begin rates of children accessing early care and educational services;
new text end
new text begin
(6) program retention rates;
new text end
new text begin
(7) number of home visits provided compared to the number of home visits planned;
new text end
new text begin
(8) participant satisfaction;
new text end
new text begin
(9) rates of at-risk populations reached; and
new text end
new text begin (10) new text end any additional qualitative goals and quantitative measures established by the
commissioner.
Subd. 7.
Evaluation.
Using the qualitative goals and quantitative outcome new text begin and
performance new text end measures established under subdivisions 1 and 6, the commissioner shall
conduct ongoing evaluations of the programs funded under this section. Community
health boards and tribal governments shall cooperate with the commissioner in the
evaluations and shall provide the commissioner with the information necessary to conduct
the evaluations. As part of the ongoing evaluations, the commissioner shall rate the impact
of the programs on the outcome measures listed in subdivision 6, and shall periodically
determine whether home visiting programs are the best way to achieve the qualitative
goals established under subdivisions 1 and 6. If the commissioner determines that home
visiting programs are not the best way to achieve these goals, the commissioner shall
provide the legislature with alternative methods for achieving them.
Subd. 8.
Report.
By January 15, 2002, and January 15 of each even-numbered
year thereafter, the commissioner shall submit a report to the legislature on the family
home visiting programs funded under this section and on the results of the evaluations
conducted under subdivision 7.
Subd. 9.
No supplanting of existing funds.
Funding available under this section
may be used only to supplement, not to replace, nonstate funds being used for home
visiting services as of July 1, 2001.
Sec. 2. new text begin WATER LEVEL STANDARDS.
new text end
new text begin
(a) Until the commissioner of health adopts rules setting the health risk limits
required in paragraph (b), the health risk limit for all contaminants in private domestic
wells must be the more stringent of the state standards or the federal standards determined
by the United States Environmental Protection Agency.
new text end
new text begin
(b) By March 1, 2008, the commissioner of health must publish in the State Register
notice of intent to adopt rules relating to health risk limits for commonly detected
contaminants. The commissioner of health shall review current scientific information to
establish health risk limits for commonly detected contaminants in groundwater that
provides a reasonable margin of safety to adequately protect the health of developing
fetuses, infants, and children, in accordance with the requirements of Minnesota Statutes,
section 144.0751. Nothing in paragraph (a) prohibits the commissioner from setting
standards that are stricter than the federal standards.
new text end
new text begin
(c) By March 1, 2009, the commissioner shall adopt rules relating to health risk
limits for the ten most commonly detected contaminants.
new text end
new text begin
(d) By February 1, 2008, the commissioner shall report to the legislature on the
implications for public health and the costs to enforce the more stringent of health risk
limits or maximum contaminant levels for public water systems.
new text end
Sec. 3. new text begin FUNDING FOR ENVIRONMENTAL JUSTICE MAPPING.
new text end
new text begin
The commissioner of health, in conjunction with the commissioner of the Pollution
Control Agency, shall apply for federal funding to renew and expand the state's
environmental justice mapping capacity in order to promote public health tracking. If
implemented, the commissioner of health shall coordinate the project with the Pollution
Control Agency and the Department of Agriculture in order to explore possible links
between environmental health and toxic exposures and to help create a system for
environmental public health tracking and make recommendations to the legislature for
additional sources of funding within the state.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 4. new text begin FRAGRANCE-FREE SCHOOLS EDUCATION PILOT PROJECT.
new text end
new text begin Subdivision 1. new text end
new text begin Purpose. new text end
new text begin
Recognizing that scented products may trigger asthma or
chemical sensitivity reactions in students and school staff, which can contribute to learning
and breathing problems, the commissioner of health shall develop a fragrance-free schools
education pilot project.
new text end
new text begin Subd. 2. new text end
new text begin Education. new text end
new text begin
The commissioner of health, in collaboration with the
Minneapolis Board of Education, shall establish a working group composed of at least
three students, two teachers, one school administrator, and one member of the Minneapolis
Board of Education to recommend an education campaign in Minneapolis public schools
to inform students and parents about the potentially harmful effects of the use of fragrance
products on sensitive students and school personnel in Minneapolis schools. The
commissioner shall report findings to the legislature by February 1, 2008.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 5. new text begin MEDICAL ASSISTANCE COVERAGE FOR ARSENIC TESTING.
new text end
new text begin
The commissioner of human services shall inform providers that testing for arsenic
under Minnesota Statutes, section 144.967, is covered under medical assistance.
new text end
ARTICLE 18
HUMAN SERVICES FORECAST ADJUSTMENTS
Section 1. new text begin SUMMARY OF APPROPRIATIONS; DEPARTMENT OF HUMAN
|
new text begin
The dollar amounts shown are added to or, if shown in parentheses, are subtracted
from the appropriations in Laws 2006, chapter 282, from the general fund, or any other
fund named, to the Department of Human Services for the purposes specified in this
article, to be available for the fiscal year indicated for each purpose. The figure "2007"
used in this article means that the appropriation or appropriations listed are available
for the fiscal year ending June 30, 2007.
new text end
|
new text begin
2007 new text end |
||||||
|
new text begin
General Fund new text end |
new text begin
$ new text end |
new text begin
(25,226,000) new text end |
||||
|
new text begin
Health Care Access new text end |
new text begin
$ new text end |
new text begin
(53,980,000) new text end |
||||
|
new text begin
TANF new text end |
new text begin
$ new text end |
new text begin
(24,805,000) new text end |
||||
|
new text begin
Total new text end |
new text begin
$ new text end |
new text begin
(104,011,000) new text end |
Sec. 2. new text begin COMMISSIONER OF HUMAN
|
||||||
new text begin Subdivision 1. new text end
new text begin
Total Appropriation
|
new text begin
$ new text end |
new text begin
(104,011,000) new text end |
||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
2007 new text end |
||
|
new text begin
General new text end |
new text begin
(25,226,000) new text end |
|
|
new text begin
Health Care Access new text end |
new text begin
(53,980,000) new text end |
|
|
new text begin
TANF new text end |
new text begin
(24,805,000) new text end |
|
new text begin Subd. 2. new text end
new text begin
Revenue and Pass Through
|
||||||
|
new text begin
TANF new text end |
new text begin
(106,000) new text end |
|||||
new text begin Subd. 3. new text end
new text begin
Children and Economic Assistance
|
||||||
|
new text begin
General new text end |
new text begin
3,221,000 new text end |
|||||
|
new text begin
TANF new text end |
new text begin
(24,699,000) new text end |
|||||
new text begin
The amounts that may be spent from this
appropriation for each purpose are as follows:
new text end
|
new text begin
(a) MFIP/DWP Grants new text end |
||||||
|
new text begin
General new text end |
new text begin
13,827,000 new text end |
|||||
|
new text begin
TANF new text end |
new text begin
(24,699,000) new text end |
|||||
|
new text begin
(b) MFIP Child Care Assistance Grants new text end |
||||||
|
new text begin
General new text end |
new text begin
(4,733,000) new text end |
|||||
|
new text begin
(c) General Assistance Grants new text end |
||||||
|
new text begin
General new text end |
new text begin
1,081,000 new text end |
|||||
|
new text begin
(d) Minnesota Supplemental Aid Grants new text end |
||||||
|
new text begin
General new text end |
new text begin
(1,099,000) new text end |
|||||
|
new text begin
(e) Group Residential Housing Grants new text end |
||||||
|
new text begin
General new text end |
new text begin
(5,855,000) new text end |
|||||
new text begin Subd. 4. new text end
new text begin
Basic Health Care Grants
|
||||||
|
new text begin
General new text end |
new text begin
17,592,000 new text end |
|||||
|
new text begin
Health Care Access new text end |
new text begin
(53,980,000) new text end |
|||||
new text begin
The amounts that may be spent from this
appropriation for each purpose are as follows:
new text end
|
new text begin
(a) MinnesotaCare Health Care Access new text end |
new text begin
(53,980,000) new text end |
|||||
|
new text begin
(b) MA Basic Health Care - Families and Children new text end |
||||||
|
new text begin
General new text end |
new text begin
15,729,000 new text end |
|||||
|
new text begin
(c) MA Basic Health Care - Elderly and Disabled new text end |
||||||
|
new text begin
General new text end |
new text begin
(4,540,000) new text end |
|||||
|
new text begin
(d) General Assistance Medical Care new text end |
||||||
|
new text begin
General new text end |
new text begin
6,403,000 new text end |
|||||
new text begin Subd. 5. new text end
new text begin
Continuing Care Grants
|
||||||
|
new text begin
General new text end |
new text begin
(46,039,000) new text end |
|||||
new text begin
The amounts that may be spent from this
appropriation for each purpose are as follows:
new text end
|
new text begin
(a) MA Long-Term Care Facilities new text end |
||||||
|
new text begin
General new text end |
new text begin
(15,028,000) new text end |
|||||
|
new text begin
(b) MA Long-Term Care Waivers new text end |
||||||
|
new text begin
General new text end |
new text begin
(20,677,000) new text end |
|||||
|
new text begin
(c) Chemical Dependency Entitlement Grants new text end |
||||||
|
new text begin
General new text end |
new text begin
(10,334,000) new text end |
|||||
Sec. 3. new text begin EFFECTIVE DATE.
new text end
new text begin
Sections 1 and 2 are effective the day following final enactment.
new text end
ARTICLE 19
HUMAN SERVICES APPROPRIATIONS
Section 1. new text begin SUMMARY OF APPROPRIATIONS.
|
new text begin
The amounts shown in this section summarize direct appropriations, by fund, made
in this article.
new text end
|
new text begin
2008 new text end |
new text begin
2009 new text end |
new text begin
Total new text end |
||||
|
new text begin
General new text end |
new text begin
$ new text end |
new text begin
4,749,084,000 new text end |
new text begin
$ new text end |
new text begin
5,070,979,000 new text end |
new text begin
$ new text end |
new text begin
9,820,063,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
59,686,000 new text end |
new text begin
58,595,000 new text end |
new text begin
118,281,000 new text end |
|||
|
new text begin
Health Care Access new text end |
new text begin
441,426,000 new text end |
new text begin
506,894,000 new text end |
new text begin
948,320,000 new text end |
|||
|
new text begin
Federal TANF new text end |
new text begin
261,955,000 new text end |
new text begin
271,784,000 new text end |
new text begin
533,739,000 new text end |
|||
|
new text begin
Lottery Prize Fund new text end |
new text begin
2,185,000 new text end |
new text begin
1,790,000 new text end |
new text begin
3,975,000 new text end |
|||
|
new text begin
Total new text end |
new text begin
$ new text end |
new text begin
5,514,336,000 new text end |
new text begin
$ new text end |
new text begin
5,910,042,000 new text end |
new text begin
$ new text end |
new text begin
11,424,378,000 new text end |
Sec. 2. new text begin HEALTH AND HUMAN SERVICES APPROPRIATIONS.
|
new text begin
The sums shown in the columns marked "Appropriations" are appropriated to the
agencies and for the purposes specified in this article. The appropriations are from the
general fund, or another named fund, and are available for the fiscal years indicated
for each purpose. The figures "2008" and "2009" used in this article mean that the
appropriations listed under them are available for the fiscal year ending June 30, 2008, or
June 30, 2009, respectively. "The first year" is fiscal year 2008. "The second year" is fiscal
year 2009. "The biennium" is fiscal years 2008 and 2009. Appropriations for the fiscal
year ending June 30, 2007, are effective the day following final enactment.
new text end
|
new text begin
APPROPRIATIONS new text end |
||||||
|
new text begin
Available for the Year new text end |
||||||
|
new text begin
Ending June 30 new text end |
||||||
|
new text begin
2008 new text end |
new text begin
2009 new text end |
|||||
Sec. 3. new text begin HUMAN SERVICES
|
||||||
new text begin Subdivision 1. new text end
new text begin
Total Appropriation
|
new text begin
$ new text end |
new text begin
5,294,627,000 new text end |
new text begin
$ new text end |
new text begin
5,695,458,000 new text end |
||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
2008 new text end |
new text begin
2009 new text end |
|
|
new text begin
General new text end |
new text begin
4,614,727,000 new text end |
new text begin
4,940,293,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
549,000 new text end |
new text begin
565,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
426,628,000 new text end |
new text begin
492,759,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
250,537,000 new text end |
new text begin
260,051,000 new text end |
|
new text begin
Lottery Prize Fund new text end |
new text begin
2,185,000 new text end |
new text begin
1,790,000 new text end |
new text begin
The amounts that may be spent for each
purpose are specified in the following
subdivisions.
new text end
new text begin
Receipts for Systems Projects.
Appropriations and federal receipts for
information system projects for MAXIS,
PRISM, MMIS, and SSIS must be deposited
in the state system account authorized in
Minnesota Statutes, section 256.014. Money
appropriated for computer projects approved
by the Minnesota Office of Enterprise
Technology, funded by the legislature, and
approved by the commissioner of finance,
may be transferred from one project to
another and from development to operations
as the commissioner of human services
considers necessary. Any unexpended
balance in the appropriation for these
projects does not cancel but is available for
ongoing development and operations.
new text end
new text begin
Pay for Performance. (a) Of the general
fund appropriation, $272,000 each year
is available to the commissioner of
human services only under the following
circumstances:
new text end
new text begin
(1) $272,000 shall be made available by the
commissioner of finance on January 1, 2009,
only after notification by the commissioner
of human services to the commissioner of
finance and to the chairs of the relevant house
of representatives and senate finance and
policy committees that the average number
of days from the receipt of a MinnesotaCare
application at the state processing unit until
the initial eligibility determination of the
application was 30 days or less during the
period October 1, 2007, to September 30,
2008. Applications transferred from counties
to the state processing unit are excluded from
this calculation; and
new text end
new text begin
(2) $272,000 shall be made available by the
commissioner of finance on January 1, 2009,
only after notification by the commissioner
of human services to the commissioner of
finance and to the chairs of the relevant
house of representatives and senate finance
and policy committees that the commissioner
initiated a separate treatment program for
persons in the Minnesota sex offenders
program who are between the ages of 18 and
25 by January 1, 2008.
new text end
new text begin
(b) Regardless of whether these
appropriations are made available to
the commissioner of human services, they
shall be part of base level funding for the
biennium beginning July 1, 2009.
new text end
new text begin
Purchasing Alliance Fund Transfer.
On September 1, 2007, any remaining
balance in the purchasing alliance stop-loss
fund account established under Minnesota
Statutes, section 256.956, shall transfer to
the general fund.
new text end
new text begin
Nonfederal Share Transfers. The
nonfederal share of activities for which
federal administrative reimbursement is
appropriated to the commissioner may be
transferred to the special revenue fund.
new text end
new text begin
TANF Maintenance of Effort. (a) In order
to meet the basic MOE requirements of the
TANF block grant specified under Code
of Federal Regulations, title 45, section
263.1, the commissioner may only report
nonfederal money expended for allowable
activities listed in the following clauses as
TANF/MOE expenditures:
new text end
new text begin
(1) MFIP cash, diversionary work program,
and food assistance benefits under Minnesota
Statutes, chapter 256J;
new text end
new text begin
(2) the child care assistance programs
under Minnesota Statutes, sections 119B.03
and 119B.05, and county child care
administrative costs under Minnesota
Statutes, section 119B.15;
new text end
new text begin
(3) state and county MFIP administrative
costs under Minnesota Statutes, chapters
256J and 256K;
new text end
new text begin
(4) state, county, and tribal MFIP
employment services under Minnesota
Statutes, chapters 256J and 256K;
new text end
new text begin
(5) expenditures made on behalf of
noncitizen MFIP recipients who qualify
for the medical assistance without federal
financial participation program under
Minnesota Statutes, section 256B.06,
subdivision 4, paragraphs (d), (e), and (j);
and
new text end
new text begin
(6) qualifying working family credit
expenditures under Minnesota Statutes,
section 290.0671.
new text end
new text begin
(b) The commissioner shall ensure that
sufficient qualified nonfederal expenditures
are made each year to meet the state's
TANF/MOE requirements. For the activities
listed in paragraph (a), clauses (2) to
(6), the commissioner may only report
expenditures that are excluded from the
definition of assistance under Code of
Federal Regulations, title 45, section 260.31.
new text end
new text begin
(c) The commissioner shall ensure that the
MOE used by the commissioner of finance
for the February and November forecasts
required under Minnesota Statutes, section
16A.103, contains expenditures under
paragraph (a), clause (1), equal to at least 16
percent of the total required under Code of
Federal Regulations, title 45, section 263.1.
new text end
new text begin
(d) Minnesota Statutes, section 256.011,
subdivision 3, which requires that federal
grants or aids secured or obtained under that
subdivision be used to reduce any direct
appropriations provided by law, does not
apply if the grants or aids are federal TANF
funds.
new text end
new text begin
(e) Notwithstanding any contrary provision
in this article, this rider expires June 30,
2011.
new text end
new text begin
Working Family Credit Expenditures as
TANF/MOE. The commissioner may claim
as TANF/MOE up to $6,707,000 per year
for fiscal year 2008 through fiscal year 2011.
Notwithstanding any contrary provision in
this article, this rider expires June 30, 2011.
new text end
new text begin
Additional Working Family Credit
Expenditures to be Claimed for
TANF/MOE. In addition to the amounts
provided in this section, the commissioner
may count the following amounts of working
family credit expenditure as TANF/MOE:
new text end
new text begin
(1) fiscal year 2008, $11,097,000;
new text end
new text begin
(2) fiscal year 2009, $25,401,000;
new text end
new text begin
(3) fiscal year 2010, $20,398,000; and
new text end
new text begin
(4) fiscal year 2011, $19,841,000.
new text end
new text begin
Notwithstanding any contrary provision in
this article, this rider expires June 30, 2011.
new text end
new text begin
Capitation Rate Increase. Of the health care
access fund appropriations to the University
of Minnesota in the higher education
omnibus appropriation bill, $2,157,000 in
fiscal year 2008 and $2,157,000 in fiscal year
2009 are to be used to increase the capitation
payments under Minnesota Statutes, section
256B.69.
new text end
new text begin Subd. 2. new text end
new text begin
Agency Management
|
||||||
new text begin
The amounts that may be spent from the
appropriation for each purpose are as follows:
new text end
|
new text begin
(a) Financial Operations new text end |
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
7,165,000 new text end |
new text begin
7,652,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
799,000 new text end |
new text begin
804,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
122,000 new text end |
new text begin
122,000 new text end |
|
new text begin
(b) Legal and Regulation Operations new text end |
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
12,337,000 new text end |
new text begin
12,424,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
427,000 new text end |
new text begin
440,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
900,000 new text end |
new text begin
926,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
100,000 new text end |
new text begin
100,000 new text end |
new text begin
Base Adjustment. The general fund base
is $12,361,000 for each of fiscal years 2010
and 2011.
new text end
|
new text begin
(c) Management Operations new text end |
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
4,332,000 new text end |
new text begin
4,419,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
236,000 new text end |
new text begin
243,000 new text end |
|
new text begin
(d) Information Technology Operations new text end |
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
23,949,000 new text end |
new text begin
23,922,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
6,015,000 new text end |
new text begin
5,972,000 new text end |
new text begin Subd. 3. new text end
new text begin
Revenue and Pass-Through
|
||||||
|
new text begin
Federal TANF new text end |
new text begin
57,896,000 new text end |
new text begin
59,900,000 new text end |
new text begin
TANF Transfer to Federal Child Care
and Development Fund. The following
TANF fund amounts are appropriated to the
commissioner for the purposes of MFIP and
transition year child care under Minnesota
Statutes, section 119B.05:
new text end
new text begin
(1) fiscal year 2008, $1,387,000;
new text end
new text begin
(2) fiscal year 2009, $3,003,000;
new text end
new text begin
(3) fiscal year 2010, $4,944,000; and
new text end
new text begin
(4) fiscal year 2011, $6,893,000.
new text end
new text begin
The commissioner shall authorize transfer
of sufficient TANF funds to the federal
child care and development fund to meet
this appropriation and shall ensure that all
transferred funds are expended according
the federal child care and development fund
regulations.
new text end
new text begin Subd. 4. new text end
new text begin
Children and Economic Assistance
|
||||||
new text begin
The amounts that may be spent from this
appropriation for each purpose are as follows:
new text end
|
new text begin
(a) MFIP/DWP Grants new text end |
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
62,069,000 new text end |
new text begin
62,405,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
75,904,000 new text end |
new text begin
80,841,000 new text end |
|
new text begin
(b) Support Services Grants new text end |
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
8,715,000 new text end |
new text begin
8,715,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
113,429,000 new text end |
new text begin
115,902,000 new text end |
new text begin
TANF Prior Appropriation Cancellation.
Notwithstanding Laws 2001, First Special
Session chapter 9, article 17, section
2, subdivision 11, paragraph (b), any
unexpended TANF funds appropriated to the
commissioner to contract with the Board of
Trustees of Minnesota State Colleges and
Universities, to provide tuition waivers to
employees of health care and human service
providers that are members of qualifying
consortia operating under Minnesota
Statutes, sections 116L.10 to 116L.15, must
cancel at the end of fiscal year 2007.
new text end
new text begin
MFIP Pilot Program.
new text end
new text begin
Of the TANF
appropriation, $100,000 in fiscal year 2008
and $750,000 in fiscal year 2009 are for a
grant to the Stearns-Benton Employment and
Training Council for the Workforce U pilot
program. Base level funding for this program
shall be $750,000 in 2010 and $0 in 2011.
new text end
new text begin
Supported Work. (1) Of the TANF
appropriation, $5,468,000 in fiscal year
2008 and $7,291,000 in fiscal year
2009 are for supported work for MFIP
participants, to be allocated to counties
and tribes based on the criteria under
clauses (2) and (3). Paid transitional work
experience and other supported employment
under this rider provides a continuum of
employment assistance, including outreach
and recruitment, program orientation
and intake, testing and assessment, job
development and marketing, preworksite
training, supported worksite experience, job
coaching, and postplacement follow-up, in
addition to extensive case management and
referral services.
new text end
new text begin
(2) A county or tribe is eligible to receive an
allocation under this rider if:
new text end
new text begin
(i) the county or tribe is not meeting the
federal work participation rate;
new text end
new text begin
(ii) the county or tribe has participants who
are required to perform work activities under
Minnesota Statutes, chapter 256J, but are not
meeting hourly work requirements; and
new text end
new text begin
(iii) the county or tribe has assessed
participants who have completed six weeks
of job search or are required to perform
work activities and are not meeting the
hourly requirements, and the county or tribe
has determined that the participant would
benefit from working in a supported work
environment.
new text end
new text begin
(3) A county or tribe may also be eligible for
funds in order to contract for supplemental
hours of paid work at the participant's child's
place of education, child care location, or the
child's physical or mental health treatment
facility or office. This grant to counties and
tribes is specifically for MFIP participants
who need to work up to five hours more
per week in order to meet the hourly work
requirement, and the participant's employer
cannot or will not offer more hours to the
participant.
new text end
new text begin
Work Study. Of the TANF appropriation,
$750,000 each year are to the commissioner
to contract with the Minnesota Office of
Higher Education for the biennium beginning
July 1, 2007, for work study grants under
Minnesota Statutes, section 136A.233,
specifically for low-income individuals who
receive assistance under Minnesota Statutes,
chapter 256J, and for grants to opportunities
industrialization centers.
new text end
new text begin
Integrated Service Projects. $2,500,000
in fiscal year 2008 and $2,500,000 in fiscal
year 2009 are appropriated from the TANF
fund to the commissioner to continue to
fund the existing integrated services projects
for MFIP families, and if funding allows,
additional similar projects.
new text end
new text begin
Base Adjustment. The TANF base for fiscal
year 2010 is $115,902,000 and for fiscal year
2011 is $115,152,000.
new text end
|
new text begin
(c) MFIP Child Care Assistance Grants new text end |
||||||
|
new text begin
General new text end |
new text begin
74,654,000 new text end |
new text begin
71,951,000 new text end |
|
new text begin
(d) Basic Sliding Fee Child Care Assistance Grants new text end |
||||||
|
new text begin
General new text end |
new text begin
42,995,000 new text end |
new text begin
45,008,000 new text end |
new text begin
Base Adjustment. The general fund base
is $44,881,000 for fiscal year 2010 and
$44,852,000 for fiscal year 2011.
new text end
new text begin
At-Home Infant Care Program. No
funding shall be allocated to or spent on
the at-home infant care program under
Minnesota Statutes, section 119B.035.
new text end
|
new text begin
(e) new text begin Child Care Development Grants new text end new text end |
||||||
|
new text begin
General new text end |
new text begin
4,390,000 new text end |
new text begin
6,390,000 new text end |
new text begin
Prekindergarten Exploratory Projects. Of
the general fund appropriation, $2,000,000
the first year and $4,000,000 the second
year are for grants to the city of St. Paul,
Hennepin County, and Blue Earth County to
establish scholarship demonstration projects
to be conducted in partnership with the
Minnesota Early Learning Foundation to
promote children's school readiness. This
appropriation is available until June 30, 2009.
new text end
new text begin
Child Care Services Grants. Of this
appropriation, $500,000 each year are for
the purpose of providing child care services
grants under Minnesota Statutes, section
119B.21, subdivision 5. This appropriation
is for the 2008-2009 biennium only, and does
not increase the base funding.
new text end
new text begin
Early Childhood Professional
Development System. Of this appropriation,
$500,000 each year are for purposes of the
early childhood professional development
system, which increases the quality and
continuum of professional development
opportunities for child care practitioners.
This appropriation is for the 2008-2009
biennium only, and does not increase the
base funding.
new text end
new text begin
Base Adjustment. The general fund base
is $1,515,000 for each of fiscal years 2010
and 2011.
new text end
|
new text begin
(f) Child Support Enforcement Grants new text end |
||||||
|
new text begin
General new text end |
new text begin
11,038,000 new text end |
new text begin
3,705,000 new text end |
new text begin
Child Support Enforcement. $7,333,000
for fiscal year 2008 is to make grants to
counties for child support enforcement
programs to make up for the loss under the
2005 federal Deficit Reduction Act of federal
matching funds for federal incentive funds
passed on to the counties by the state.
new text end
new text begin
This appropriation is available until June 30,
2009.
new text end
|
new text begin
(g) Children's Services Grants new text end |
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
63,647,000 new text end |
new text begin
71,147,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
250,000 new text end |
new text begin
-0- new text end |
|
new text begin
TANF new text end |
new text begin
240,000 new text end |
new text begin
340,000 new text end |
new text begin
Grants for Programs Serving Young
Parents. Of the TANF fund appropriation,
$140,000 each year is for a grant to a program
or programs that provide comprehensive
services through a private, nonprofit agency
to young parents in Hennepin County who
have dropped out of school and are receiving
public assistance. The program administrator
shall report annually to the commissioner on
skills development, education, job training,
and job placement outcomes for program
participants.
new text end
new text begin
County Allocations for Rate Increases.
County Children and Community Services
Act allocations shall be increased by
$197,000 effective October 1, 2007, and
$696,000 effective October 1, 2008, to help
counties pay for the rate adjustments to
day training and habilitation providers for
participants paid by county social service
funds. Notwithstanding the provisions of
Minnesota Statutes, section 256M.40, the
allocation to a county shall be based on
the county's proportion of social services
spending for day training and habilitation
services as determined in the most recent
social services expenditure and grant
reconciliation report.
new text end
new text begin
Privatized Adoption Grants. Federal
reimbursement for privatized adoption grant
and foster care recruitment grant expenditures
is appropriated to the commissioner for
adoption grants and foster care and adoption
administrative purposes.
new text end
new text begin
Adoption Assistance Incentive Grants.
Federal funds available during fiscal year
2008 and fiscal year 2009 for the adoption
incentive grants are appropriated to the
commissioner for these purposes.
new text end
new text begin
Adoption Assistance and Relative Custody
Assistance. The commissioner may transfer
unencumbered appropriation balances for
adoption assistance and relative custody
assistance between fiscal years and between
programs.
new text end
new text begin
Children's Mental Health Grants. Of the
general fund appropriation, $5,913,000 in
fiscal year 2008 and $6,825,000 in fiscal year
2009 are for children's mental health grants.
The purpose of these grants is to increase and
maintain the state's children's mental health
service capacity, especially for school-based
mental health services. The commissioner
shall require grantees to utilize all available
third party reimbursement sources as a
condition of using state grant funds. At
least 15 percent of these funds shall be
used to encourage efficiencies through early
intervention services. At least another 15
percent shall be used to provide respite care
services for children with severe emotional
disturbance at risk of out-of-home placement.
new text end
new text begin
Mental Health Crisis Services. Of the
general fund appropriation, $2,528,000 in
fiscal year 2008 and $2,850,000 in fiscal year
2009 are for statewide funding of children's
mental health crisis services. Providers must
utilize all available funding streams.
new text end
new text begin
Children's Mental Health Evidence-Based
and Best Practices. Of the general fund
appropriation, $375,000 in fiscal year 2008
and $750,000 in fiscal year 2009 are for
children's mental health evidence-based and
best practices including, but not limited
to: Adolescent Integrated Dual Diagnosis
Treatment services; school-based mental
health services; co-location of mental
health and physical health care, and; the
use of technological resources to better
inform diagnosis and development of
treatment plan development by mental
health professionals. The commissioner
shall require grantees to utilize all available
third-party reimbursement sources as a
condition of using state grant funds.
new text end
new text begin
Culturally Specific Mental Health
Treatment Grants. Of the general fund
appropriation, $75,000 in fiscal year 2008
and $300,000 in fiscal year 2009 are for
children's mental health grants to support
increased availability of mental health
services for persons from cultural and
ethnic minorities within the state. The
commissioner shall use at least 20 percent
of these funds to help members of cultural
and ethnic minority communities to become
qualified mental health professionals and
practitioners. The commissioner shall assist
grantees to meet third-party credentialing
requirements and require them to utilize all
available third-party reimbursement sources
as a condition of using state grant funds.
new text end
new text begin
Mental Health Services for Children with
Special Treatment Needs. Of the general
fund appropriation, $50,000 in fiscal year
2008 and $200,000 in fiscal year 2009 are
for children's mental health grants to support
increased availability of mental health
services for children with special treatment
needs. These shall include, but not be limited
to: victims of trauma, including children
subjected to abuse or neglect, veterans and
their families, and refugee populations;
persons with complex treatment needs, such
as eating disorders; and those with low
incidence disorders.
new text end
new text begin
MFIP and Children's Mental Health
Pilot Project. Of the TANF appropriation,
$100,000 in fiscal year 2008 and $200,000
in fiscal year 2009 are to fund the MFIP
and children's mental health pilot project.
Of these amounts, up to $100,000 may be
expended on evaluation of this pilot.
new text end
new text begin
Prenatal Alcohol or Drug Use. Of the
general fund appropriation, $75,000 each
year is to award grants beginning July 1,
2007, to programs that provide services
under Minnesota Statutes, section 254A.171,
in Pine, Kanabec, and Carlton Counties. This
appropriation shall become part of the base
appropriation.
new text end
new text begin
Base Adjustment. The general fund base
is $62,572,000 in fiscal year 2010 and
$62,575,000 in fiscal year 2011.
new text end
|
new text begin
(h) Children and Community Services Grants new text end |
||||||
|
new text begin
General new text end |
new text begin
101,369,000 new text end |
new text begin
69,208,000 new text end |
new text begin
Base Adjustment. The general fund base
is $69,274,000 in each of fiscal years 2010
and 2011.
new text end
new text begin
Targeted Case Management Temporary
Funding. (a) Of the general fund
appropriation, $32,667,000 in fiscal year
2008 is transferred to the targeted case
management contingency reserve account in
the general fund to be allocated to counties
and tribes affected by reductions in targeted
case management federal Medicaid revenue
as a result of the provisions in the federal
Deficit Reduction Act of 2005, Public Law
109-171.
new text end
new text begin
(b) Contingent upon (1) publication by the
federal Centers for Medicare and Medicaid
Services of final regulations implementing
the targeted case management provisions
of the federal Deficit Reduction Act of
2005, Public Law 109-171, or (2) the
issuance of a finding by the Centers for
Medicare and Medicaid Services of federal
Medicaid overpayments for targeted case
management expenditures, up to $32,667,000
is appropriated to the commissioner of human
services. Prior to distribution of funds, the
commissioner shall estimate and certify the
amount by which the federal regulations or
federal disallowance will reduce targeted
case management Medicaid revenue over the
2008-2009 biennium.
new text end
new text begin
(c) Within 60 days of a contingency described
in paragraph (b), the commissioner shall
distribute the grants proportionate to each
affected county or tribe's targeted case
management federal earnings for calendar
year 2005, not to exceed the lower of (1) the
amount of the estimated reduction in federal
revenue or (2) $32,667,000.
new text end
new text begin
(d) These funds are available in either year of
the biennium. Counties and tribes shall use
these funds to pay for social service-related
costs, but the funds are not subject to
provisions of the Children and Community
Services Act grant under Minnesota Statutes,
chapter 256M.
new text end
new text begin
(e) This appropriation shall be available to
pay counties and tribes for expenses incurred
on or after July 1, 2007. The appropriation
shall be available until expended.
new text end
|
new text begin
(i) General Assistance Grants new text end |
||||||
|
new text begin
General new text end |
new text begin
37,876,000 new text end |
new text begin
38,253,000 new text end |
new text begin
General Assistance Standard. The
commissioner shall set the monthly standard
of assistance for general assistance units
consisting of an adult recipient who is
childless and unmarried or living apart
from parents or a legal guardian at $203.
The commissioner may reduce this amount
according to Laws 1997, chapter 85, article
3, section 54.
new text end
new text begin
Emergency General Assistance. The
amount appropriated for emergency general
assistance funds is limited to no more
than $7,889,812 in fiscal year 2008 and
$7,889,812 in fiscal year 2009. Funds
to counties must be allocated by the
commissioner using the allocation method
specified in Minnesota Statutes, section
256D.06.
new text end
|
new text begin
(j) Minnesota Supplemental Aid Grants new text end |
||||||
|
new text begin
General new text end |
new text begin
30,505,000 new text end |
new text begin
30,812,000 new text end |
new text begin
Emergency Minnesota Supplemental
Aid Funds. The amount appropriated for
emergency Minnesota supplemental aid
funds is limited to no more than $1,100,000
in fiscal year 2008 and $1,100,000 in fiscal
year 2009. Funds to counties must be
allocated by the commissioner using the
allocation method specified in Minnesota
Statutes, section 256D.46.
new text end
|
new text begin
(k) Group Residential Housing Grants new text end |
||||||
|
new text begin
General new text end |
new text begin
91,069,000 new text end |
new text begin
98,671,000 new text end |
new text begin
People Incorporated. Of the general fund
appropriation, $460,000 each year is to
augment community support and mental
health services provided to individuals
residing in facilities under Minnesota
Statutes, section 256I.05, subdivision 1m.
new text end
|
new text begin
(l) Other Children and Economic Assistance Grants new text end |
||||||
|
new text begin
General new text end |
new text begin
20,183,000 new text end |
new text begin
16,333,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
1,500,000 new text end |
new text begin
1,500,000 new text end |
new text begin
Base Adjustment. The general fund base
shall be $16,033,000 in fiscal year 2010 and
$15,533,000 in fiscal year 2011. The TANF
base shall be $1,500,000 in fiscal year 2010
and $1,181,000 in fiscal year 2011.
new text end
new text begin
Homeless and Runaway Youth. Of the
general fund appropriation, $500,000 each
year are for the Runaway and Homeless
Youth Act under Minnesota Statutes, section
256K.45. Funds shall be spent in each area
of the continuum of care to ensure that
programs are meeting the greatest need. This
is a onetime appropriation.
new text end
new text begin
Long-Term Homelessness. Of the general
fund appropriation, $1,500,000 each year are
for implementation of programs to address
long-term homelessness. This is a onetime
appropriation.
new text end
new text begin
Minnesota Community Action Grants. (a)
Of the general fund appropriation, $250,000
each year is for the purposes of Minnesota
community action grants under Minnesota
Statutes, sections 256E.30 to 256E.32. This
is a onetime appropriation.
new text end
new text begin
(b) Of the TANF appropriation, $1,500,000
each year is for community action agencies
for auto repairs, auto loans, and auto purchase
grants to individuals who are eligible to
receive benefits under Minnesota Statutes,
chapter 256J, or who have lost eligibility
for benefits under Minnesota Statutes,
chapter 256J, due to earnings in the prior 12
months. Base level funding for this activity
shall be $1,500,000 in fiscal year 2010 and
$1,181,000 in fiscal year 2011.
new text end
new text begin
(c) Money appropriated under paragraphs (a)
and (b) that is not spent in the first year does
not cancel but is available for the second
year.
new text end
new text begin Subd. 5. new text end
new text begin
Children and Economic Assistance
|
||||||
new text begin
The amounts that may be spent from the
appropriation for each purpose are as follows:
new text end
|
new text begin
(a) Children and Economic Assistance Administration new text end |
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
9,326,000 new text end |
new text begin
9,381,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
1,196,000 new text end |
new text begin
1,196,000 new text end |
new text begin
Base Adjustment. The general fund base is
$9,343,000 in each of the fiscal years 2010
and 2011.
new text end
|
new text begin
(b) Children and Economic Assistance Operations new text end |
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
35,667,000 new text end |
new text begin
35,989,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
350,000 new text end |
new text begin
361,000 new text end |
new text begin
Financial Institution Data Match and
Payment of Fees. The commissioner is
authorized to allocate up to $310,000 each
year in fiscal years 2008 and 2009 from the
PRISM special revenue account to make
payments to financial institutions in exchange
for performing data matches between account
information held by financial institutions
and the public authority's database of child
support obligors as authorized by Minnesota
Statutes, section 13B.06, subdivision 7.
new text end
new text begin
Base Adjustment. The general fund base
is $35,967,000 in each of fiscal years 2010
and 2011.
new text end
new text begin Subd. 6. new text end
new text begin
Basic Health Care Grants
|
||||||
new text begin
The amounts that may be spent from the
appropriation for each purpose are as follows:
new text end
|
new text begin
(a) MinnesotaCare Grants new text end |
||||||
|
new text begin
Health Care Access new text end |
new text begin
389,760,000 new text end |
new text begin
458,401,000 new text end |
new text begin
HealthMatch Delay. Of this appropriation,
$2,560,000 the first year and $21,735,000
the second year are for the MinnesotaCare
program costs related to a seven-month
delay in implementation of the HealthMatch
program.
new text end
new text begin
Health Match Enrollment Shift. In fiscal
year 2009, $6,178,000 shall be transferred
from the health care access fund to the
general fund to pay for the Health Match
program-related enrollment shift. In the
event no systematic enrollment shift of
MinnesotaCare families and children to
medical assistance occurs prior to June 30,
2009, except as required under Minnesota
Statutes, section 256L.04, subdivision 8, this
transfer shall not occur.
new text end
|
new text begin
(b) MA Basic Health Care - Families and Children new text end |
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
739,957,000 new text end |
new text begin
838,874,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
1,672,000 new text end |
new text begin
-0- new text end |
|
new text begin
(c) MA Basic Health Care - Elderly and Disabled new text end |
||||||
|
new text begin
General new text end |
new text begin
995,560,000 new text end |
new text begin
1,101,390,000 new text end |
new text begin
Treatment Foster Care Services Delay. (a)
Notwithstanding Minnesota Statutes, section
256B.0625, subdivision 47, effective July
1, 2009, and subject to federal approval,
medical assistance covers treatment foster
care services according to Minnesota
Statutes, section 256B.0946.
new text end
new text begin
(b) Of the general fund savings that result
from the delayed effective date in paragraph
(a):
new text end
new text begin
(1) The commissioner shall present to the
legislature, by February 1, 2008, a report
and recommendations on establishing a
health insurance exchange that would
provide individuals with greater access,
choice, portability, and affordability of
health insurance products. The report must
evaluate, identify options, and present
recommendations, on:
new text end
new text begin
(i) whether a health insurance exchange
would provide individuals with greater
access, choice, portability, and affordability
of health care products;
new text end
new text begin
(ii) the duties and powers of the exchange;
new text end
new text begin
(iii) the use of the exchange to receive and
process employee premiums on a pretax
basis through section 125 plans;
new text end
new text begin
(iv) eligibility criteria that enrollees and
health plan companies must meet to
participate in the exchange;
new text end
new text begin
(v) the types of health plans to be offered
through the exchange, and the extent to
which these plans should be available for
purchase only through the exchange;
new text end
new text begin
(vi) loss ratio requirements for health plans
offered through the exchange;
new text end
new text begin
(vii) the extent to which the operation of the
exchange will lower the cost of health care
insurance coverage;
new text end
new text begin
(viii) estimates of administrative costs of
operating the exchange, and methods for
funding these administrative costs; and
new text end
new text begin
(iv) other topics relevant to the design and
operation of the exchange if its establishment
is recommended.
new text end
new text begin
(2) $375,000 each year are for the family,
friend, and neighbor grant program in article
1, section 94. Any balance in the first year
does not cancel but is available in the second
year. This appropriation is for the 2008-2009
biennium only, and does not increase the
base funding.
new text end
new text begin
(3) $300,000 each year from the general fund
and $150,000 each year from the TANF fund
are to the commissioner for the purposes
of a program in Ramsey County that
provides early intervention efforts designed
to discourage pregnant women from using
alcohol and illegal drugs. The appropriation
shall not become part of base level funding
and is available until spent.
new text end
new text begin
(4) $750,000 the first year is for transitional
housing programs under Minnesota Statutes,
section 256E.33. Up to ten percent of this
appropriation may be used for housing and
services which extend beyond 24 months.
$600,000 the first year is for emergency
services grants under Laws 1997, chapter
162, article 3, section 7.
new text end
new text begin
(5) $50,000 each year is for a grant to HOME
Line for the tenant hotline services program.
This is a onetime appropriation.
new text end
new text begin
(6) $60,000 in fiscal year 2008 is to
the commissioner to contract with a
Minnesota-based, nonprofit quality
improvement organization that collaborates
with providers and consumers in health
improvement activities, for the purpose
of conducting an independent analysis
of the reimbursement methodologies for
home health services provided to enrollees
in the Minnesota senior health options
and Minnesota disability health options
programs. The analysis of reimbursement
methodologies shall include, at a minimum,
a review of:
new text end
new text begin
(i) any limitations on flexibility in services or
technology for the home health provider;
new text end
new text begin
(ii) the Medicare program reimbursement
methodologies, including possible
alternatives, and Medicare benefits;
new text end
new text begin
(iii) potential access issues raised by current
reimbursement methodologies; and
new text end
new text begin
(iv) incentives, including episodic care
reimbursement methodologies, to promote
best practices and achieve identified clinical
outcomes.
new text end
new text begin
The analysis and any supporting
recommendations shall be presented
to the commissioner by December 1, 2007,
and to the chairs of the appropriate legislative
committees by December 15, 2007. In no
event shall the study disclose any specific
reimbursement amount or methodologies
attributable to an individual health carrier.
new text end
new text begin
In conducting its analysis, the organization
described in paragraph (a) shall consult with
the commissioner, the Minnesota Home Care
Association, managed care organizations,
and other interested home health entities and
advocates, and shall convene the parties to
discuss pertinent issues.
new text end
new text begin
(7) $50,000 the first year is to conduct
a feasibility study of and to predesign a
Native American juvenile treatment center
on or near the White Earth Reservation.
The facility must house and treat Native
American juveniles and provide culturally
specific programming to juveniles placed in
the treatment center. The commissioner may
contract with parties who have experience
in the design and construction of juvenile
treatment centers to assist in the feasibility
study and predesign. On or before January
15, 2008, the commissioner shall present
the results of the feasibility study and the
predesign of the facility to the chairs of house
of representatives and senate committees
having jurisdiction over human services
finance, public safety finance, and capital
investment.
new text end
new text begin
(8) $200,000 in fiscal year 2008 and $200,000
in fiscal year 2009 are to develop a statewide
quality assurance and improvement system
under Minnesota Statutes, section 256B.096,
for persons receiving disability services.
Any unspent portion of the appropriation
for the first year shall not cancel but shall
be available for the second year. These are
onetime appropriations.
new text end
new text begin
(9) $200,000 is to the commissioner to be
available until June 30, 2009, to make a
grant to Advocating Change Together for the
purposes of the Remembering With Dignity
project. As part of the Remembering With
Dignity project, the grant recipient shall:
new text end
new text begin
(i) conduct necessary research on persons
buried in state cemeteries who were residents
of state hospitals or regional treatment
centers and buried in numbered or unmarked
graves;
new text end
new text begin
(ii) purchase and install headstones that are
properly inscribed with their names on the
graves of those persons; and
new text end
new text begin
(iii) collaborate with community groups
and state and local government agencies to
build community involvement and public
awareness, ensure public access to the
graves, and ensure appropriate perpetual
maintenance of state cemeteries.
new text end
new text begin
(10) $500,000 each year are to fund
the Regional Children's Mental Health
Initiative pilot project. This is a onetime
appropriation. This paragraph does not apply
to a radiation therapy facility that is being
built attached to a community hospital in
Wright County and meets the following
conditions prior to August 1, 2007: the
capital expenditure report required under
Minnesota Statutes, section 62J.17, has been
filed with the commissioner of health; a
timely construction schedule is developed,
stipulating dates for beginning, achieving
various stages, and completing construction;
and all zoning and building permits applied
for.
new text end
new text begin
Provider-Directed Care Coordination. In
addition to medical assistance reimbursement
under Minnesota Statutes, sections
256B.0625 and 256B.76, clinics participating
in provider-directed care coordination under
Minnesota Statutes, section 256B.0625, also
receive a monthly payment per client when
the clinic serves an eligible client. The
payments across the program must average
$50 per month per client.
new text end
|
new text begin
(d) General Assistance Medical Care Grants new text end |
||||||
|
new text begin
General new text end |
new text begin
238,822,000 new text end |
new text begin
251,412,000 new text end |
|
new text begin
(e) Other Health Care Grants new text end |
||||||
|
new text begin
General new text end |
new text begin
421,000 new text end |
new text begin
921,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
850,000 new text end |
new text begin
900,000 new text end |
new text begin
Community-Based Health Care
Demonstration Project. Of the general
fund appropriation, $212,000 each year is
to be transferred to the commissioner of
health for the demonstration project grant
described in Minnesota Statutes, section
62Q.80, subdivision 1a. This appropriation
shall remain part of base level funding until
June 30, 2012. Notwithstanding any contrary
provision in this article, this rider expires
July 1, 2012.
new text end
new text begin
new text begin Care Coordination Pilot Projects.new text end Of
the health care access fund appropriation,
$881,000 in fiscal year 2009 is for the health
care pilot projects for children and adults
with complex health care needs. Base level
funding for this program is $878,000 in 2010
and $0 in 2011.
new text end
new text begin
Patient Incentive Programs. Of the general
fund appropriation, $500,000 in fiscal year
2009 is for patient incentive programs.
new text end
new text begin
Base Adjustment. The health care access
fund base is $900,000 in fiscal year 2010 and
$150,000 in fiscal year 2011.
new text end
new text begin
Oral Health Care Innovations Grants. (a)
Of the health care access fund appropriation,
$400,000 for the fiscal year beginning July 1,
2007, is to award competitive oral health care
innovations grants to organizations described
in Minnesota Statutes, section 256B.76,
paragraph (b), clause (4), or coalitions of
such organizations, providing access to oral
health services for low-income and uninsured
persons. The commissioner shall award one
grant for a project to develop a nonprofit
dental clinic serving public program
recipients and uninsured persons in Beltrami
County; one grant for the maintenance of
nonprofit dental clinics providing oral health
care services to children ages birth to 18 in
St. Louis County; and one grant for the bright
smiles program to increase access to oral
health care for low-income and immigrant
children, ages birth to five years, and their
families in underserved areas in Minneapolis.
new text end
new text begin
(b) This grant shall not become part of base
level funding.
new text end
new text begin
State Health Policies Grant. Of the health
care access fund appropriation, $300,000 in
fiscal year 2008 is to provide a grant to a
research center associated with a safety net
hospital and county-affiliated health system
to develop the capabilities necessary for
evaluating the effects of changes in state
health policies on low-income and uninsured
individuals, including the impact on state
health care program costs, health outcomes,
cost-shifting to different units and levels
of government, and utilization patterns
including use of emergency room care and
hospitalization rates. The center shall report
on the use of this money by December 1,
2008, to the chairs of the senate and house
of representatives committees with relevant
jurisdiction.
new text end
new text begin Subd. 7. new text end
new text begin
Health Care Management
|
||||||
new text begin
The amounts that may be spent from the
appropriation for each purpose are as follows:
new text end
|
new text begin
(a) Health Care Policy Administration new text end |
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
10,954,000 new text end |
new text begin
10,936,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
1,788,000 new text end |
new text begin
2,730,000 new text end |
new text begin
Minnesota Senior Health Options
Reimbursement. Federal administrative
reimbursement resulting from the Minnesota
senior health options project is appropriated
to the commissioner for this activity.
new text end
new text begin
Disproportionate Share Hospital Payment
Formulas. The commissioner is prohibited
from altering formulas for disbursement of
disproportionate share hospital funds under
the disproportionate share hospital program
by rule, bulletin, or any other administrative
method without explicit legislative authority.
new text end
new text begin
Utilization Review. Federal administrative
reimbursement resulting from prior
authorization and inpatient admission
certification by a professional review
organization is dedicated to the commissioner
for these purposes. A portion of these funds
must be used for activities to decrease
unnecessary pharmaceutical costs in medical
assistance.
new text end
new text begin
Base Adjustment. The health care access
fund base is $3,763,000 in fiscal year 2010
and $3,396,000 in fiscal year 2011, for health
care administration.
new text end
new text begin
Base Adjustment. The general fund base
is $10,701,000 in fiscal year 2010 and
$10,520,00 in fiscal year 2011.
new text end
|
new text begin
(b) Health Care Operations new text end |
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
21,241,000 new text end |
new text begin
21,874,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
22,965,000 new text end |
new text begin
21,672,000 new text end |
new text begin
Base Adjustment. The general fund base
is $21,839,000 in each of fiscal years 2010
and 2011. The health care access fund
base is $21,697,000 in fiscal year 2010 and
$21,373,000 in fiscal year 2011.
new text end
new text begin
Outreach Funding. Of these appropriations,
the following amounts are to the
commissioner for the Minnesota health care
outreach program under Minnesota Statutes,
section 256.962:
new text end
new text begin
(1) $950,000 the first year and $1,000,000
the second year from the health care access
fund for a statewide outreach campaign
under Minnesota Statutes, section 256.962,
subdivision 1;
new text end
new text begin
(2) $350,000 the first year and $500,000
the second year from the general fund and
$150,000 the first year and $250,000 the
second year from the health care access
fund are for the incentive program under
Minnesota Statutes, section 256.962,
subdivision 5. For the biennium beginning
July 1, 2009, base level funding for this
activity shall be $450,000 from the general
fund and $200,000 from the health care
access fund; and
new text end
new text begin
(3) $150,000 each year from the health
care access fund appropriation for other
health care grants for a grant to a nonprofit
organization to provide a statewide toll-free
number under Minnesota Statutes, section
256.962, subdivision 4.
new text end
new text begin Subd. 8. new text end
new text begin
Continuing Care Grants
|
||||||
new text begin
The amounts that may be spent from the
appropriation for each purpose are as follows:
new text end
|
new text begin
(a) Aging and Adult Services Grants new text end |
||||||
|
new text begin
General new text end |
new text begin
14,357,000 new text end |
new text begin
14,727,000 new text end |
new text begin
Information and Assistance
Reimbursement. Federal administrative
reimbursement obtained from information
and assistance services provided by the
Senior LinkAge Line to people who are
identified as eligible for medical assistance
is appropriated to the commissioner for this
activity.
new text end
new text begin
Senior Companion Program. Of this
appropriation, $42,000 each year is for the
senior companion program under Minnesota
Statutes, section 256.977.
new text end
new text begin
Volunteer Senior Citizens. Of this
appropriation, $42,000 each year is for the
volunteer programs for retired senior citizens
under Minnesota Statutes, section 256.9753.
new text end
new text begin
Foster Grandparent Program. Of this
appropriation, $41,000 each year is for the
foster grandparent program in Minnesota
Statutes, section 256.976.
new text end
new text begin
Senior Nutrition. Of this appropriation,
$125,000 each year is for the senior nutrition
programs under Minnesota Statutes, section
256.9752. The commissioner shall give
priority to increase services to: (1) persons
facing language or cultural barriers, (2)
persons with special diets, (3) persons
living in isolated rural areas, and (4) other
hard-to-serve populations.
new text end
new text begin
Base Adjustment. The general fund base
is $14,774,000 in fiscal year 2010 and
$14,899,000 in fiscal year 2011.
new text end
|
new text begin
(b) Alternative Care Grants new text end |
||||||
|
new text begin
General new text end |
new text begin
49,858,000 new text end |
new text begin
51,758,000 new text end |
new text begin
Alternative Care Transfer. Any money
allocated to the alternative care program that
is not spent for the purposes indicated does
not cancel but is transferred to the medical
assistance account.
new text end
new text begin
Base Adjustment. The general fund
base is $52,120,000 in fiscal year 2010
and $52,277,000 in fiscal year 2011 for
alternative care grants.
new text end
|
new text begin
(c) Medical Assistance Grants - Long-Term Care Facilities new text end |
||||||
|
new text begin
General new text end |
new text begin
496,920,000 new text end |
new text begin
499,556,000 new text end |
new text begin
Long-Term Care Consultation Funding
Increase. For the rate year beginning
October 1, 2008, the county long-term
care consultation allocations in Minnesota
Statutes, section 256B.0911, subdivision
6, must be increased based on the number
of transitional long-term care consultation
visits projected by the commissioner in
each county. For the rate year beginning
October 1, 2009, final allocations must be
determined based on the average between
the actual number of transitional long-term
care visits that were conducted in the prior
12-month period and the projected number
of consultations that will be provided in
the rate year beginning October 1, 2009.
Notwithstanding any contrary provision in
this article, this paragraph expires June 30,
2010.
new text end
new text begin
Nursing Facility Sprinkler Systems. Of
the general fund appropriation, $2,500,000
the first year is to reimburse the costs of
nursing facility sprinkler systems under
Minnesota Statutes, section 256B.434,
subdivision 4, paragraph (e). Any portion of
this appropriation not spent in the first year
shall not cancel but shall be available for the
second year.
new text end
new text begin
Nursing Home Moratorium Exceptions.
During fiscal year 2008, the commissioner of
health may approve moratorium exception
projects under Minnesota Statutes, section
144A.073, for which the full annualized
state share of medical assistance costs does
not exceed $3,000,000. During fiscal year
2009, the commissioner of health may
approve moratorium exception projects
under Minnesota Statutes, section 144A.073,
for which the full annualized state share of
medical assistance costs does not exceed
$3,000,000 less the amount approved during
the first year. Priority shall be given to
proposals that entail:
new text end
new text begin
(1) complete building replacement in
conjunction with reductions in the number of
beds in a county, with greater weight given
to projects in counties with a greater than
average number of beds per 1,000 elderly;
new text end
new text begin
(2) technology improvements;
new text end
new text begin
(3) improvements in life safety;
new text end
new text begin
(4) construction of nursing facilities that are
part of senior services campuses; and
new text end
new text begin
(5) improvements in the work environment.
new text end
|
new text begin
(d) Medical Assistance Grants - Long-Term Care Waivers and Home Care Grants new text end |
||||||
|
new text begin
General new text end |
new text begin
957,020,000 new text end |
new text begin
1,075,074,000 new text end |
new text begin
County CADI allocation adjustment.
(1) The commissioner shall adjust 2007
home and community-based allocations
under Minnesota Statutes, section 256B.49,
to qualifying counties that transferred
persons to the community alternatives for
disabled individuals (CADI) waiver program
under Laws 2006, chapter 282, article 20,
section 35. The adjustment shall reflect
the amount that county-authorized funding
for CADI waiver services exceeded the
allowable amount as shown in the Medicaid
Management Information System (MMIS)
on March 1, 2007.
new text end
new text begin
(2) A county that may qualify under
paragraph (1) shall apply to the commissioner
by June 10, 2007. Following a review of the
county request and the MMIS documentation,
the commissioner shall adjust the county
allocation, as appropriate, by June 25, 2007.
new text end
new text begin
(3) The amounts provided to a county under
this section shall become part of the county's
base level state allocation for the CADI
waiver for the biennium beginning July 1,
2007.
new text end
new text begin
(4) This rider is effective the day following
final enactment.
new text end
|
new text begin
(e) Mental Health Grants new text end |
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
59,632,000 new text end |
new text begin
62,217,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
750,000 new text end |
new text begin
750,000 new text end |
|
new text begin
Lottery Prize new text end |
new text begin
1,933,000 new text end |
new text begin
1,633,000 new text end |
new text begin
Mental Health Crisis Services. Of the
general fund appropriation, $2,528,000 in
fiscal year 2008 and $3,278,000 in fiscal
year 2009 are for statewide funding of adult
mental health crisis services. Providers must
utilize all available funding streams.
new text end
new text begin
Adult Mental Health Evidence-Based
and Best Practices. Of the general fund
appropriation, $375,000 in fiscal year 2008
and $750,000 in fiscal year 2009 are for
adult mental health evidence-based and
best practices including, but not limited
to, Assertive Community Treatment and
Integrated Dual Diagnosis Treatment
services. The commissioner shall require
grantees to utilize all available third-party
reimbursement sources as a condition of
using state grant funds.
new text end
new text begin
Culturally Specific Mental Health
Treatment Grants. Of the general fund
appropriation, $75,000 in fiscal year 2008
and $300,000 in fiscal year 2009 are for adult
mental health grants to support increased
availability of mental health services for
persons from cultural and ethnic minorities
within the state. The commissioner shall use
at least 20 percent of these funds to help
members of cultural and ethnic minority
communities to become qualified mental
health professionals and practitioners. The
commissioner shall assist grantees to meet
third-party credentialing requirements
and require them to utilize all available
third-party reimbursement sources as a
condition of using state grant funds.
new text end
new text begin
Mental Health Services for Adults with
Special Treatment Needs. Of the general
fund appropriation, $50,000 in fiscal year
2008 and $200,000 in fiscal year 2009 are
for adult mental health grants to support
increased availability of mental health
services for adults with special treatment
needs. These adults shall include, but not
be limited to: victims of trauma, including
persons subjected to abuse or neglect,
veterans and their families, and refugee
populations; person's with complex treatment
needs, such as eating disorders; and those
with low incidence disorders.
new text end
new text begin
Supportive Housing Services for Adults
with Mental Illness. Of the general fund
appropriation, $1,750,000 in fiscal year
2008 and $1,500,000 in fiscal year 2009 are
for adult mental health grants to support
increased availability of a range of housing
options with supports for persons with
serious mental illness.
new text end
new text begin
National Council on Problem Gambling.
(1) Of the appropriation from the lottery prize
fund, $225,000 each year is for a grant to
the state affiliate recognized by the National
Council on Problem Gambling. The affiliate
must provide services to increase public
awareness of problem gambling, education,
and training for individuals and organizations
providing effective treatment services to
problem gamblers and their families, and
research relating to problem gambling. These
services must be complementary to and not
duplicative of the services provided through
the problem gambling program administered
by the commissioner of human services. This
grant does not prevent the commissioner
from regular monitoring and oversight of the
grant or the ability to reallocate the funds to
other services within the problem gambling
program for nonperformance of duties by
the grantee.
new text end
new text begin
(2) Of this appropriation, $100,000 in
fiscal year 2008 and $100,000 in fiscal year
2009 are contingent on the contribution
of nonstate matching funds. Matching
funds may be either cash or qualifying
in-kind contributions. The commissioner of
finance may disburse the state portion of the
matching funds in increments of $25,000
upon receipt of a commitment for an equal
amount of matching nonstate funds. The
general fund base shall be $100,000 in fiscal
year 2010 and $100,000 in fiscal year 2011.
new text end
new text begin
(3) Of the lottery prize fund appropriation,
$100,000 in fiscal year 2008 is for a grant
or grants to be awarded competitively
to develop programs and services for
problem gambling treatment, prevention,
and education in immigrant communities.
This appropriation is available until June
30, 2009, at which time the project must
be completed and final products delivered,
unless an earlier completion date is specified
in the work program.
new text end
new text begin
Compulsive Gambling. Of the lottery prize
fund appropriation, $300,000 in fiscal year
2008 and $100,000 in fiscal year 2009 are for
purposes of compulsive gambling education,
assessment, and treatment under Minnesota
Statutes, section 245.98.
new text end
new text begin
Compulsive Gambling Study. Of the lottery
prize fund appropriation, $100,000 in fiscal
year 2008 is to continue the study currently
being done on compulsive gambling
treatment effectiveness and long-term effects
of gambling.
new text end
new text begin
Base Adjustment. The general fund base
is $59,460,000 in each of fiscal years 2010
and 2011.
new text end
new text begin
Base Adjustment. The lottery prize fund
base is $1,508,000 in each of fiscal years
2010 and 2011.
new text end
|
new text begin
(f) Deaf and Hard-of-Hearing Grants new text end |
||||||
|
new text begin
General new text end |
new text begin
1,730,000 new text end |
new text begin
1,964,000 new text end |
new text begin
Hearing Loss Mentors.
new text end
new text begin
Of the general
fund appropriation, $40,000 each year is to
provide mentors who have a hearing loss
to parents of newly identified infants and
children with hearing loss.
new text end
new text begin
Base Adjustment. The general fund base is
$1,968,000 in each of fiscal years 2010 and
2011.
new text end
|
new text begin
(g) Chemical Dependency Entitlement Grants new text end |
||||||
|
new text begin
General new text end |
new text begin
78,225,000 new text end |
new text begin
88,138,000 new text end |
|
new text begin
(h) Chemical Dependency Nonentitlement Grants new text end |
||||||
|
new text begin
General new text end |
new text begin
1,655,000 new text end |
new text begin
1,805,000 new text end |
|
new text begin
TANF new text end |
new text begin
150,000 new text end |
new text begin
150,000 new text end |
new text begin
Methamphetamine Abuse Grants. Of the
general fund appropriation, $175,000 in the
first year and $375,000 in the second year
are for grants to existing programs that treat
methamphetamine abuse, and the abuse
of other substances in Carlton, Faribault,
Martin, Olmsted, and Anoka Counties, that
received grant funds under Laws 2005,
chapter 136, article 1, section 9, subdivision
6. The commissioner shall administer the
grants to programs that the commissioner
deems successful, and may discontinue
grants to programs after an evaluation of
the program and a determination by the
commissioner that the program should no
longer receive funds. This appropriation
shall not become part of base level funding.
new text end
new text begin
Native American Juvenile Treatment
Center. Of the general fund appropriation,
$50,000 is to conduct a feasibility study
of and to predesign a Native American
juvenile treatment center on or near the
White Earth Reservation. The facility must
house and treat Native American juveniles
and provide culturally specific programming
to juveniles placed in the treatment center.
The commissioner of human services may
contract with parties who have experience
in the design and construction of juvenile
treatment centers to assist in the feasibility
study and predesign. On or before January
15, 2008, the commissioner shall present
the results of the feasibility study and the
predesign of the facility to the chairs of house
of representatives and senate committees
having jurisdiction over human services
finance, public safety finance, and capital
investment.
new text end
new text begin
Leech Lake Youth Treatment Center. Of
the general fund appropriation, $75,000 each
year are for a grant to the Leech Lake Youth
Treatment Center project partners, in order
to pay the salaries and other directly related
costs associated with the development of this
project. This is a onetime appropriation.
new text end
new text begin
Base Adjustment. The general fund base is
$1,055,000 in each of fiscal years 2010 and
2011.
new text end
|
new text begin
(i) Other Continuing Care Grants new text end |
||||||
|
new text begin
General new text end |
new text begin
21,409,000 new text end |
new text begin
16,983,000 new text end |
new text begin
Repayment. Of the general fund
appropriation, $4,302,000 the first year
is to repay the amount of overspending
in the waiver program for persons with
developmental disabilities incurred by
Fillmore, Steele, and St. Louis Counties in
calendar years 2004 and 2005.
new text end
new text begin
Department of Employment and Economic
Development Transfer. For fiscal year 2008,
the commissioner of finance shall transfer
$200,000 from the methamphetamine
abatement loan fund to the commissioner
of human services for methamphetamine
treatment programs.
new text end
new text begin
Disability Linkage Line. Of the general
fund appropriation, $469,000 in fiscal year
2008 and $626,000 in fiscal year 2009 are to
establish and maintain the disability linkage
line.
new text end
new text begin
Base Adjustment. The general fund base
is $17,103,000 in fiscal year 2010 and
$17,141,000 in fiscal year 2011 for other
continuing care grants.
new text end
new text begin Subd. 9. new text end
new text begin
Continuing Care Management
|
||||||
|
new text begin
General new text end |
new text begin
19,387,000 new text end |
new text begin
19,699,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
122,000 new text end |
new text begin
125,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
293,000 new text end |
new text begin
-0- new text end |
|
new text begin
Lottery Prize new text end |
new text begin
252,000 new text end |
new text begin
157,000 new text end |
new text begin
Base Adjustment. The general fund base
is $19,530,000 in fiscal year 2010 and
$19,620,000 in fiscal year 2011.
new text end
new text begin Subd. 10. new text end
new text begin
State-Operated Services
|
||||||
new text begin
Transfer Authority Related to
State-Operated Services. Money
appropriated to finance state-operated
services programs and administrative
services may be transferred between fiscal
years of the biennium with the approval of
the commissioner of finance.
new text end
|
new text begin
(a) Mental Health Services new text end |
||||||
|
new text begin
General new text end |
new text begin
116,185,000 new text end |
new text begin
119,507,000 new text end |
new text begin
Appropriation Limitation. No part of
the appropriation in this article to the
commissioner for mental health treatment
services at the regional treatment centers
shall be used for the Minnesota sex offender
program.
new text end
|
new text begin
(b) Minnesota Sex Offender Services new text end |
||||||
|
new text begin
General new text end |
new text begin
67,614,000 new text end |
new text begin
62,569,000 new text end |
|
new text begin
(c) Minnesota Security Hospital and METO Services new text end |
||||||
|
new text begin
General new text end |
new text begin
82,495,000 new text end |
new text begin
84,505,000 new text end |
new text begin
Minnesota Security Hospital. For the
purposes of enhancing the safety of
the public, improving supervision, and
enhancing community-based mental health
treatment, state-operated services may
establish additional community capacity
for providing treatment and supervision
of clients who have been ordered into
less restrictive alternative care from the
state-operated services transitional services
program consistent with Minnesota Statutes,
section 246.014.
new text end
Sec. 4. new text begin COMMISSIONER OF HEALTH
|
||||||
new text begin Subdivision 1. new text end
new text begin
Total Appropriation
|
new text begin
$ new text end |
new text begin
154,874,000 new text end |
new text begin
$ new text end |
new text begin
148,015,000 new text end |
||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
2008 new text end |
new text begin
2009 new text end |
|
|
new text begin
General new text end |
new text begin
84,862,000 new text end |
new text begin
79,348,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
43,796,000 new text end |
new text begin
42,799,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
14,798,000 new text end |
new text begin
14,135,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
11,418,000 new text end |
new text begin
11,733,000 new text end |
new text begin
Pay for Performance. (a) For the biennium
beginning July 1, 2009, of the general fund
appropriation, $91,000 each year shall
be made available to the commissioner
of health on January 1, 2011, only after
notification by the commissioner of health to
the commissioner of finance and to the chairs
of the relevant house of representatives and
senate finance and policy committees that the
state has met by that date the health disparity
elimination goals established in Minnesota
Statutes, section 145.928, subdivision 1.
new text end
new text begin
(b) Regardless of whether these
appropriations are made available to
the commissioner of health, they shall be
part of base level funding for the biennium
beginning July 1, 2011.
new text end
new text begin
(c) Notwithstanding any contrary provision
of this article, this rider shall not expire.
new text end
new text begin
Transfer from the State Government
Special Revenue Fund. (a) During the
fiscal year beginning July 1, 2007, the
commissioner of finance shall transfer
$7,200,000 from the state government
special revenue fund to the general fund.
new text end
new text begin
(b) Of this amount:
new text end
new text begin
(1) $200,000 the first year is for the heart
disease and stroke prevention unit to fund
data collection and other activities to improve
cardiovascular health and reduce the burden
of heart disease and stroke in Minnesota.
This is a onetime appropriation.
new text end
new text begin
(2) $300,000 in fiscal year 2008 is to provide
planning grants to community collaboratives
to cover the uninsured. This is a onetime
appropriation.
new text end
new text begin
(3) $250,000 in 2008 is for an AIDS
prevention initiative focusing on foreign-born
residents. This appropriation is a onetime
appropriation and shall not become part of
the base level funding for the 2010-2011
biennium.
new text end
new text begin
The commissioner of health shall award
grants in accordance with Minnesota Statutes,
section 145.924, paragraph (b), for a public
education and awareness campaign targeting
communities of foreign-born Minnesota
residents. The grants shall be designed to
promote knowledge and understanding about
HIV and to increase knowledge in order
to eliminate and reduce the risk for HIV
infection; to encourage screening and testing
for HIV; and to link individuals to public
health and health care resources. The grants
must be awarded to collaborative efforts that
bring together nonprofit community-based
groups with demonstrated experience in
addressing the public health, health care,
and social service needs of foreign-born
communities.
new text end
new text begin
(4) $199,000 the first year is for the
purpose of providing family support and
assistance to families with children who
are deaf or have a hearing loss. The
family support provided must include direct
parent-to-parent assistance and information
on communication, educational, and medical
options. The commissioner may contract
with a nonprofit organization that has the
ability to provide these services throughout
the state. This appropriation is available until
June 30, 2009.
new text end
new text begin
(c) Notwithstanding any contrary provision
in this article, this rider shall not expire.
new text end
new text begin Subd. 2. new text end
new text begin
Community and Family Health
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
44,271,000 new text end |
new text begin
43,836,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
870,000 new text end |
new text begin
875,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
4,050,000 new text end |
new text begin
4,086,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
8,735,000 new text end |
new text begin
8,735,000 new text end |
new text begin
TANF Appropriations. (a) $3,579,000 of
the TANF funds is appropriated in each year
of the biennium to the commissioner for
home visiting and nutritional services listed
under Minnesota Statutes, section 145.882,
subdivision 7, clauses (6) and (7). Funding
shall be distributed to community health
boards according to Minnesota Statutes,
section 145A.131, subdivision 1.
new text end
new text begin
(b) $4,000,000 in the first year and $4,000,000
in the second year are appropriated to the
commissioner of health for the family
home visiting grant program according
to Minnesota Statutes, section 145A.17.
Funding shall be distributed to community
health boards according to Minnesota
Statutes, section 145A.131, subdivision 1.
The commissioner may use five percent of
the funds appropriated in each fiscal year to
conduct the ongoing evaluations required
under Minnesota Statutes, section 145A.17,
subdivision 7, and may use ten percent of
the funds appropriated each fiscal year to
provide training and technical assistance as
required under Minnesota Statutes, section
145A.17, subdivisions 4 and 5.
new text end
new text begin
TANF Carryforward. Any unexpended
balance of the TANF appropriation in the
first year of the biennium does not cancel but
is available for the second year.
new text end
new text begin
Loan Forgiveness. $400,000 in fiscal
year 2010 and $400,000 in fiscal year
2011 from the state government special
revenue fund are to the commissioner
for the loan forgiveness program under
Minnesota Statutes, section 144.1501. This
appropriation shall not become part of base
level funding for the biennium beginning
July 1, 2011. Notwithstanding any contrary
provision in this article, this rider expires
December 31, 2011.
new text end
new text begin
MN ENABL. Base level funding for the MN
ENABL program, under Minnesota Statutes,
section 145.9255, is reduced by $220,000
each year of the biennium beginning July 1,
2007.
new text end
new text begin
Fetal Alcohol Spectrum Disorder.
$500,000 each year from the general fund is
added to the base for fetal alcohol spectrum
disorder.
new text end
new text begin
(1) On July 1 of each fiscal year, the
portion of the general fund appropriation
to the commissioner of health for fetal
alcohol spectrum disorder administration
and grants shall be transferred to a
statewide organization that focuses solely
on prevention of and intervention with fetal
alcohol spectrum disorder as follows:
new text end
new text begin
(i) on July 1, 2007, $1,690,000; and
new text end
new text begin
(ii) on July 1, 2008, $1,690,000.
new text end
new text begin
(2) The money shall be used for prevention
and intervention services and programs,
including, but not limited to, community
grants, professional education, public
awareness, and diagnosis. The organization
may retain $60,000 of the transferred money
for administrative costs. The organization
shall report to the commissioner annually
by January 15 on the services and programs
funded by the appropriation.
new text end
new text begin
(3) Notwithstanding any contrary provision
in this article, this rider shall not expire.
new text end
new text begin
Family Planning Grants. Of the TANF
appropriation, $1,156,000 each year is for
family planning grants under Minnesota
Statutes, section 145.925.
new text end
new text begin
Suicide prevention programs. Of the
general fund appropriation, $335,000 in fiscal
year 2008 and $145,000 in fiscal year 2009
are to fund the suicide prevention program.
new text end
new text begin
Hearing Aid and Instrument Loan Bank.
Of the general fund appropriation, $70,000
each year is to the commissioner for the
purpose of providing a grant to cover
administrative costs for a statewide hearing
aid and instrument loan bank to families with
children newly diagnosed with hearing loss
from birth to the age of ten.
new text end
new text begin
Medical Home Learning Collaborative.
Of the health care access fund appropriation,
$500,000 in fiscal year 2008 and $500,000 in
fiscal year 2009 are to expand the medical
home learning collaborative initiative in
collaboration with the commissioner of
human services. Services provided under this
funding must support a medical home model
for children with special health care needs.
The collaborative shall report back to the
legislature on use of the funds by January 15,
2010. This appropriation shall not become
part of the base funding for the 2010-2011
biennium.
new text end
new text begin
Base Adjustment. The health care access
fund base is $3,586,000 in each of fiscal
years 2010 and 2011.
new text end
new text begin Subd. 3. new text end
new text begin
Policy, Quality, and Compliance
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
11,732,000 new text end |
new text begin
11,450,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
13,451,000 new text end |
new text begin
13,597,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
10,748,000 new text end |
new text begin
10,049,000 new text end |
new text begin
Transformation Task Force. Of the health
care access fund appropriation, $170,000 the
first year is for the health care Transformation
Task Force.
new text end
new text begin
Health Care Access Survey. Of the
health care access fund appropriation,
$600,000 in fiscal year 2008 is appropriated
to the commissioner to conduct a health
insurance survey of Minnesota households,
in partnership with the State Health Access
Data Assistance Center at the University
of Minnesota. The commissioner shall
contract with the State Health Access Data
Assistance Center to conduct a survey that
provides information on the characteristics
of the uninsured in Minnesota and the
reasons for changing patterns of insurance
coverage and access to health care services.
This appropriation shall become part of the
agency's base budget for even-numbered
fiscal years.
new text end
new text begin
MERC Federal Compliance. Of the general
fund appropriation, $6,250,000 each year is
to the commissioner to distribute to the Mayo
Clinic for the purpose of providing transition
funding while federal compliance changes
are made to the medical education and
research cost funding distribution formula in
Minnesota Statutes, section 62J.692.
new text end
new text begin
The base level funding for 2010 and 2011 is
$2,000,000 each year. This funding shall not
become part of the base in 2012 and 2013.
new text end
new text begin
Notwithstanding any contrary provision of
this article, this rider expires June 30, 2012.
new text end
new text begin
Health Information Technology. Of the
health care access fund appropriation; (1)
$3,500,000 each fiscal year is to implement
Minnesota Statutes, section 144.3345; (2) up
to $350,000 each fiscal year is available for
grant administration and health information
technology technical assistance; and (3)
$3,150,000 each year is to establish a
revolving loan account under Minnesota
Statutes, section 62J.496. This appropriation
shall not be included in the agency's base
budget for the fiscal year beginning July 1,
2009.
new text end
new text begin
Uniform Electronic Transactions. Of
the health care access fund appropriation,
$146,000 in fiscal year 2008 is for
development of uniform electronic
transactions and implementation guide
standards under Minnesota Statutes, section
62J.536. Funding for the 2010-2011
biennium shall be from the general fund.
new text end
new text begin
Federally Qualified Health Centers. Of the
general fund appropriation, $1,500,000 in
each fiscal year is for subsidies to federally
qualified health centers under Minnesota
Statutes, section 145.9269.
new text end
new text begin
Community Collaboratives. Of the general
fund appropriation, $300,000 in fiscal
year 2008 is to provide planning grants
to community collaboratives to cover the
uninsured. This is a onetime appropriation.
new text end
new text begin
Base Adjustment. The general fund base
is $7,346,000 in each of fiscal years 2010
and 2011. The health care access fund
base is $3,503,000 in fiscal year 2010 and
$2,903,000 in fiscal year 2011. The state
government special revenue fund base
is $14,015,000 in fiscal year 2010 and
$14,002,000 in fiscal year 2011.
new text end
new text begin Subd. 4. new text end
new text begin
Health Protection
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
15,315,000 new text end |
new text begin
10,526,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
27,475,000 new text end |
new text begin
28,327,000 new text end |
new text begin
Pandemic Influenza Preparedness. Of the
general fund appropriation, (1) $115,000 in
fiscal year 2008 is for department activities
of epidemiology, laboratory services,
exercises, and planning, and (2) $3,970,000
is to purchase antiviral medications and
prepare and manage a stockpile of health
care supplies.
new text end
new text begin
Lead Abatement. Of the general fund
appropriation, $388,000 in each fiscal year is
for the lead abatement program in Minnesota
Statutes, section 144.9512.
new text end
new text begin
Water Treatment. Of the general fund
appropriation, $40,000 in fiscal year 2008
is to augment any appropriation from the
remediation fund to conduct an evaluation of
point of use water treatment units at removing
perfluorooctanoic acid, perfluorooctane
sulfonate, and perfluorobutanoic acid from
known concentrations of these compounds
in drinking water. The evaluation shall be
completed by December 31, 2007, and the
commissioner may contract for services to
complete the evaluation. This is a onetime
appropriation.
new text end
new text begin
HIV Information. Of the general fund
appropriation, $80,000 each year is to fund
a community-based nonprofit organization
with demonstrated capacity to operate a
statewide HIV information and referral
service using telephone, Internet, and other
appropriate technologies. This appropriation
shall become part of base level funding for
the biennium beginning July 1, 2009.
new text end
new text begin
Base Adjustment. The general fund base is
$10,526,000 in each of the fiscal years 2010
and 2011.
new text end
new text begin Subd. 5. new text end
new text begin
Minority and Multicultural Health
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
5,047,000 new text end |
new text begin
5,012,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
2,683,000 new text end |
new text begin
2,998,000 new text end |
new text begin
TANF Appropriations. (a) $2,000,000
of the TANF funds is appropriated in each
year of the biennium to the commissioner
for decreasing racial and ethnic disparities
in infant mortality rates under Minnesota
Statutes, section 145.928, subdivision 7.
new text end
new text begin
(b) $683,000 the first year and $998,000
the second year of the TANF funds are
appropriated to the commissioner for the
family home visiting and grant program
under Minnesota Statutes, section 145A.17.
Funding shall be distributed to tribal
governments based on Minnesota Statutes,
section 145A.14, subdivision 2a, paragraph
(b). The commissioner may use five percent
of the funds appropriated in each fiscal year
to conduct the ongoing evaluations required
under Minnesota Statutes, section 145A.17,
subdivision 7, and may use ten percent of
the funds appropriated each fiscal year to
provide training and technical assistance as
required under Minnesota Statutes, section
145A.17, subdivisions 4 and 5.
new text end
new text begin
TANF Carryforward. Any unexpended
balance of the TANF appropriation in the
first year of the biennium does not cancel but
is available for the second year.
new text end
new text begin Subd. 6. new text end
new text begin
Administrative Support Services
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
8,497,000 new text end |
new text begin
8,524,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
2,000,000 new text end |
new text begin
-0- new text end |
new text begin
Disease Surveillance. Of the state
government special revenue fund
appropriation, $2,000,000 the first year is for
redesigning and implementing coordinated
and modern disease surveillance systems
for the department, and for modifying the
Minnesota Cancer Surveillance database and
communicating with providers to include
occupational and residential histories. This
is a onetime appropriation.
new text end
Sec. 5. new text begin VETERANS NURSING HOMES
|
new text begin
$ new text end |
new text begin
43,184,000 new text end |
new text begin
$ new text end |
new text begin
45,206,000 new text end |
||
new text begin
Veterans Homes Special Revenue Account.
The general fund appropriations made to
the board may be transferred to a veterans
homes special revenue account in the
special revenue fund in the same manner
as other receipts are deposited according to
Minnesota Statutes, section 198.34, and are
appropriated to the board for the operation of
board facilities and programs.
new text end
new text begin
Repair and Betterment. Of this
appropriation, $3,250,000 in fiscal year 2008
and $3,250,000 in fiscal year 2009 are to be
used for repair, maintenance, rehabilitation,
and betterment activities at facilities
statewide. This is a onetime appropriation.
new text end
new text begin
Base Adjustment. The general fund base is
$41,956,000 in each year of the fiscal 2010
and 2011 biennium.
new text end
new text begin
Pay for Performance. (a) For fiscal year
2008, $50,000 shall be made available to
the board on January 1, 2009, only after
notification by the board to the commissioner
of finance and to the chairs of the relevant
house of representatives and senate finance
and policy committees that during the period
October 1, 2007, to September 30, 2008, the
Department of Health has not issued any
penalty assessments under the provisions
of Minnesota Statutes, section 144.653 or
144A.10, or any correction orders under the
provisions of Minnesota Statutes, section
144.653 or 144A.10, that the Department
of Health deems equivalent to findings of
either immediate jeopardy or substandard
quality of care, as defined in Code of Federal
Regulations, title 42, section 488.301.
new text end
new text begin
(b) Regardless of whether this appropriation
is made available to the board, it shall be
part of base level funding for the biennium
beginning July 1, 2009.
new text end
Sec. 6. new text begin HEALTH-RELATED BOARDS
|
||||||
new text begin Subdivision 1. new text end
new text begin
Total Appropriation; State
|
new text begin
$ new text end |
new text begin
14,654,000 new text end |
new text begin
$ new text end |
new text begin
14,527,000 new text end |
||
new text begin
The amounts that may be spent for each
purpose are specified in the following
subdivisions.
new text end
new text begin Subd. 2. new text end
new text begin
Board of Chiropractic Examiners
|
new text begin
450,000 new text end |
new text begin
447,000 new text end |
||||
new text begin Subd. 3. new text end
new text begin
Board of Dentistry
|
new text begin
987,000 new text end |
new text begin
1,009,000 new text end |
||||
new text begin Subd. 4. new text end
new text begin
Board of Dietetic and Nutrition
|
new text begin
103,000 new text end |
new text begin
119,000 new text end |
||||
new text begin
Base Adjustment. Of this appropriation in
fiscal year 2009, $14,000 is onetime.
new text end
new text begin Subd. 5. new text end
new text begin
Board of Marriage and Family
|
new text begin
134,000 new text end |
new text begin
154,000 new text end |
||||
new text begin
Base Adjustment. Of this appropriation in
fiscal year 2009, $17,000 is onetime.
new text end
new text begin Subd. 6. new text end
new text begin
Board of Medical Practice
|
new text begin
4,120,000 new text end |
new text begin
3,674,000 new text end |
||||
new text begin Subd. 7. new text end
new text begin
Board of Nursing
|
new text begin
3,985,000 new text end |
new text begin
4,146,000 new text end |
||||
new text begin Subd. 8. new text end
new text begin
Board of Nursing Home
|
new text begin
633,000 new text end |
new text begin
647,000 new text end |
||||
new text begin
Administrative Services Unit. Of this
appropriation, $430,000 in fiscal year
2008 and $439,000 in fiscal year 2009 are
for the administrative services unit. The
administrative services unit may receive
and expend reimbursements for services
performed by other agencies.
new text end
new text begin Subd. 9. new text end
new text begin
Board of Optometry
|
new text begin
98,000 new text end |
new text begin
114,000 new text end |
||||
new text begin
Base Adjustment. Of this appropriation in
fiscal year 2009, $13,000 is onetime.
new text end
new text begin Subd. 10. new text end
new text begin
Board of Pharmacy
|
new text begin
1,375,000 new text end |
new text begin
1,442,000 new text end |
||||
new text begin
Base Adjustment. Of this appropriation in
fiscal year 2009, $29,000 is onetime.
new text end
new text begin Subd. 11. new text end
new text begin
Board of Physical Therapy
|
new text begin
306,000 new text end |
new text begin
295,000 new text end |
||||
new text begin Subd. 12. new text end
new text begin
Board of Podiatry
|
new text begin
54,000 new text end |
new text begin
63,000 new text end |
||||
new text begin
Base Adjustment. Of this appropriation in
fiscal year 2009, $7,000 is onetime.
new text end
new text begin Subd. 13. new text end
new text begin
Board of Psychology
|
new text begin
788,000 new text end |
new text begin
806,000 new text end |
||||
new text begin Subd. 14. new text end
new text begin
Board of Social Work
|
new text begin
997,000 new text end |
new text begin
1,022,000 new text end |
||||
new text begin Subd. 15. new text end
new text begin
Board of Veterinary Medicine
|
new text begin
230,000 new text end |
new text begin
195,000 new text end |
||||
new text begin Subd. 16. new text end
new text begin
Board of Behavioral Health and
|
new text begin
394,000 new text end |
new text begin
394,000 new text end |
||||
Sec. 7. new text begin EMERGENCY MEDICAL SERVICES
|
new text begin
$ new text end |
new text begin
4,346,000 new text end |
new text begin
$ new text end |
new text begin
4,392,000 new text end |
||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
2008 new text end |
new text begin
2009 new text end |
|
|
new text begin
General new text end |
new text begin
3,659,000 new text end |
new text begin
3,688,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
687,000 new text end |
new text begin
704,000 new text end |
new text begin
Regional Grants. Of the general fund
appropriation, $400,000 in fiscal year 2008
and $400,000 in fiscal year 2009 are to
the board for regional emergency medical
services programs, to be distributed equally
to the eight emergency medical service
regions. This amount shall not become part
of base level funding. Notwithstanding
Minnesota Statutes, section 144E.50, 100
percent of the appropriation shall be passed
on to the emergency medical service regions.
new text end
new text begin
Longevity Award and Incentive Program.
(a) Of the general fund appropriation,
$700,000 in fiscal year 2008 and $700,000
in fiscal year 2009 are to the board for the
ambulance service personnel longevity award
and incentive program, under Minnesota
Statutes, section 144E.40.
new text end
new text begin
(b) In fiscal year 2008, $800,000 shall be
transferred from the ambulance service
personnel longevity award and incentive
trust to the general fund.
new text end
new text begin
Health Professional Services Program.
$687,000 in fiscal year 2008 and $704,000 in
fiscal year 2009 from the state government
special revenue fund are for the health
professional services program.
new text end
new text begin
Base Adjustment. The general fund base is
$3,288,000 in each year of the fiscal 2010
and 2011 biennium.
new text end
Sec. 8. new text begin COUNCIL ON DISABILITY
|
new text begin
$ new text end |
new text begin
812,000 new text end |
new text begin
$ new text end |
new text begin
524,000 new text end |
||
new text begin
Assistive Technology. Of the general
fund appropriation to the Council on
Disability in fiscal year 2008, $100,000
is to provide financial support to the
Minnesota Regional Assistive Technology
Collaborative, and $200,000 is for a transfer
to the commissioner of administration
for the purposes of completing the state's
remaining share of the local match required
to access the federal Technology Related
Assistance Act for Persons with Disabilities,
Title III, Alternative Financing Project 2003
grant award, which provides microloans
to individuals for the purpose of acquiring
assistive technology devices and services.
new text end
Sec. 9. new text begin OMBUDSMAN FOR MENTAL
|
new text begin
$ new text end |
new text begin
1,584,000 new text end |
new text begin
$ new text end |
new text begin
1,655,000 new text end |
||
Sec. 10. new text begin OMBUDSMAN FOR FAMILIES
|
new text begin
$ new text end |
new text begin
255,000 new text end |
new text begin
$ new text end |
new text begin
265,000 new text end |
||
Sec. 11.
Minnesota Statutes 2006, section 16A.724, is amended by adding a
subdivision to read:
new text begin Subd. 3. new text end
new text begin MinnesotaCare federal receipts. new text end
new text begin
Receipts received as a result of federal
participation pertaining to administrative costs of the Minnesota health care reform waiver
shall be deposited as nondedicated revenue in the health care access fund. Receipts
received as a result of federal participation pertaining to grants shall be deposited in the
federal fund and shall offset health care access funds for payments to providers.
new text end
Sec. 12.
Minnesota Statutes 2006, section 16A.724, is amended by adding a
subdivision to read:
new text begin Subd. 4. new text end
new text begin MinnesotaCare funding. new text end
new text begin
The commissioner of human services may
expend money appropriated from the health care access fund for MinnesotaCare in either
year of the biennium.
new text end
Sec. 13.
Minnesota Statutes 2006, section 69.021, subdivision 11, is amended to read:
Subd. 11.
Excess police state-aid holding account.
(a) The excess police state-aid
holding account is established in the general fund. The excess police state-aid holding
account must be administered by the commissioner.
(b) Excess police state aid determined according to subdivision 10, must be
deposited in the excess police state-aid holding account.
(c) From the balance in the excess police state-aid holding account, $900,000
deleted text begin is appropriated to anddeleted text end must be deleted text begin transferreddeleted text end new text begin canceled new text end annually deleted text begin to the ambulance service
personnel longevity award and incentive suspense account established by section 144E.42,
subdivision 2deleted text end new text begin to the general fundnew text end .
(d) If a police officer stress reduction program is created by law and money is
appropriated for that program, an amount equal to that appropriation must be transferred
to the administrator of that program from the balance in the excess police state-aid holding
account.
(e) On October 1 of each year, one-half of the balance of the excess police
state-aid holding account remaining after the deductions under paragraphs (c) and (d) is
appropriated for additional amortization aid under section 423A.02, subdivision 1b.
(f) Annually, the remaining balance in the excess police state-aid holding account,
after the deductions under paragraphs (c), (d), and (e), cancels to the general fund.
Sec. 14.
Minnesota Statutes 2006, section 245.771, is amended by adding a subdivision
to read:
new text begin Subd. 4. new text end
new text begin Food stamp bonus awards. new text end
new text begin
In the event that Minnesota qualifies for
the United States Department of Agriculture Food and Nutrition Services Food Stamp
Program performance bonus awards, the funding is appropriated to the commissioner. The
commissioner shall retain 25 percent of the funding and distribute the other 75 percent
among the counties according to a formula that takes into account each county's impact
on state performance in the applicable bonus categories.
new text end
Sec. 15.
Minnesota Statutes 2006, section 256.01, is amended by adding a subdivision
to read:
new text begin Subd. 23. new text end
new text begin Nonstate funding for program costs. new text end
new text begin
Notwithstanding sections 16A.013
to 16A.016, the commissioner may accept, on behalf of the state, additional funding
from sources other than state funds for the purpose of financing the cost of assistance
program grants or nongrant administration. All additional funding is appropriated to the
commissioner for use as designated by the grantor of funding.
new text end
Sec. 16.
Minnesota Statutes 2006, section 256.01, is amended by adding a subdivision
to read:
new text begin Subd. 24. new text end
new text begin Systems continuity. new text end
new text begin
In the event of disruption of technical systems or
computer operations, the commissioner may use available grant appropriations to ensure
continuity of payments for maintaining the health, safety, and well-being of clients served
by programs administered by the Department of Human Services. Grant funds must be
used in a manner consistent with the original intent of the appropriation.
new text end
Sec. 17.
Minnesota Statutes 2006, section 256J.02, is amended by adding a subdivision
to read:
new text begin Subd. 6. new text end
new text begin TANF funds appropriated to other entities. new text end
new text begin
Any expenditures from
the TANF block grant shall be expended in accordance with the requirements and
limitations of part A of Title IV of the Social Security Act, as amended, and any other
applicable federal requirement or limitation. Prior to any expenditure of these funds, the
commissioner shall ensure that funds are expended in compliance with the requirements
and limitations of federal law and that any reporting requirements of federal law are
met. It shall be the responsibility of any entity to which these funds are appropriated to
implement a memorandum of understanding with the commissioner that provides the
necessary assurance of compliance prior to any expenditure of funds. The commissioner
shall receipt TANF funds appropriated to other state agencies and coordinate all related
interagency accounting transactions necessary to implement these appropriations.
Unexpended TANF funds appropriated to any state, local, or nonprofit entity cancel at the
end of the state fiscal year unless appropriating or statutory language permits otherwise.
new text end
Sec. 18.
Minnesota Statutes 2006, section 256J.77, is amended to read:
256J.77 AGING OF CASH BENEFITS.
Cash benefits under chapters 256D, 256J, and 256Knew text begin , except food stamp benefits
under chapter 256D, new text end by warrants or electronic benefit transfer that have not been accessed
within 90 days of issuance shall be canceled. Cash benefits may be replaced after they are
canceled, for up to one year after the date of issuance, if failure to do so would place the
client or family at risk. For purposes of this section, "accessed" means cashing a warrant
or making at least one withdrawal from benefits deposited in an electronic benefit account.
Sec. 19.
Minnesota Statutes 2006, section 518A.56, is amended by adding a
subdivision to read:
new text begin Subd. 13. new text end
new text begin Child support payment center. new text end
new text begin
Payments to the commissioner from
other governmental units, private enterprises, and individuals for services performed by
the child support payment center must be deposited in the state systems account authorized
under section 256.014. These payments are appropriated to the commissioner for the
operation of the child support payment center or system, according to section 256.014.
new text end
Sec. 20. new text begin NONGRANT OPERATING CARRYFORWARD.
new text end
new text begin
For the biennium ending June 30, 2007, any remaining nongrant operating balances
in the Department of Human Services, Minnesota Department of Health, veterans homes,
health-related boards, emergency medical services boards, Council on Disability, the
ombudsman for mental health and developmental disabilities, and the ombudsman
for families direct appropriated accounts may be transferred, with the approval of the
commissioner of finance, to a special revenue account. Funds in those accounts are
appropriated for costs associated with onetime technology, infrastructure, and systems
development projects. Remaining nongrant operating balances in fiscal year 2007 in
the Minnesota sex offender program and the Minnesota security hospital shall not be
transferred.
new text end
new text begin
(a) Transfers to a special revenue account shall be reported to the chairs and the
ranking members of the senate Health and Human Services Budget Division and the house
of representatives Health Care and Human Services Finance Division.
new text end
new text begin
(b) When these balances originate in nongeneral funds, the transfers shall be made
to separate accounts within the same funds and may only be used to support projects
relevant to the original funding source.
new text end
new text begin
(c) Uses of these special revenue account funds shall be reported annually by each
agency to the commissioner of finance, and to the chairs and ranking members of the
senate Health and Human Services Budget Division and the house of representatives
Health Care and Human Services Finance Division.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 21. new text begin TRANSFERS.
new text end
new text begin Subdivision 1. new text end
new text begin Grants. new text end
new text begin
The commissioner of human services, with the approval
of the commissioner of finance and after notifying the chairs of the senate and house
committees with jurisdiction, may transfer unencumbered appropriation balances for the
biennium ending June 30, 2009, within fiscal years among the MFIP; general assistance;
general assistance medical care; medical assistance; MFIP child care assistance under
Minnesota Statutes, section 119B.05; Minnesota supplemental aid and group residential
housing programs; and the entitlement portion of the chemical dependency consolidated
treatment fund and between fiscal years of the biennium.
new text end
new text begin Subd. 2. new text end
new text begin Administration. new text end
new text begin
Positions, salary money, and nonsalary administrative
money may be transferred within the Departments of Human Services and Health and
within the programs operated by the Veterans Nursing Homes Board as the commissioners
and the board consider necessary, with the advance approval of the commissioner of
finance. The commissioner or the board shall inform the chairs of the house and senate
committees with jurisdiction quarterly about transfers made under this provision.
new text end
Sec. 22. new text begin INDIRECT COSTS NOT TO FUND PROGRAMS.
new text end
new text begin
The commissioners of health and of human services shall not use indirect cost
allocations to pay for the operational costs of any program for which they are responsible.
new text end
Sec. 23. new text begin SUNSET OF UNCODIFIED LANGUAGE.
new text end
new text begin
All uncodified language contained in this article expires on June 30, 2009, unless a
different expiration date is explicit.
new text end
Sec. 24. new text begin EFFECTIVE DATE.
new text end
new text begin
The provisions in this article are effective July 1, 2007, unless a different effective
date is specified.
new text end