EIGHTY-SECOND SESSION 2001
__________________
FIFTY-THIRD DAY
Saint Paul, Minnesota, Monday, May 14, 2001
This Journal as a PDF document
The House of Representatives convened at 10:30 a.m. and was called to order by Steve Sviggum, Speaker of the House.
Prayer was offered by Bill Hargis, Woodbury Community Church, Woodbury, Minnesota.
The members of the House gave the pledge of allegiance to the flag of the United States of America.
The roll was called and the following members were present:
| Abeler | Dorn | Holberg | Lenczewski | Osskopp | Solberg | |
| Abrams | Eastlund | Holsten | Leppik | Osthoff | Stanek | |
| Anderson, B. | Entenza | Howes | Lieder | Otremba | Stang | |
| Anderson, I. | Erhardt | Huntley | Lindner | Ozment | Swapinski | |
| Bakk | Erickson | Jacobson | Lipman | Paulsen | Swenson | |
| Bernardy | Evans | Jaros | Luther | Pawlenty | Sykora | |
| Biernat | Finseth | Jennings | Mahoney | Paymar | Thompson | |
| Bishop | Folliard | Johnson, J. | Mares | Pelowski | Tingelstad | |
| Boudreau | Fuller | Johnson, R. | Mariani | Penas | Tuma | |
| Bradley | Gerlach | Johnson, S. | Marko | Peterson | Vandeveer | |
| Buesgens | Gleason | Juhnke | Marquart | Pugh | Wagenius | |
| Carlson | Goodno | Kahn | McElroy | Rhodes | Walker | |
| Cassell | Goodwin | Kalis | McGuire | Rifenberg | Walz | |
| Clark, J. | Gray | Kelliher | Milbert | Rukavina | Wasiluk | |
| Daggett | Greiling | Kielkucki | Molnau | Ruth | Wenzel | |
| Davids | Gunther | Knoblach | Mulder | Schumacher | Westerberg | |
| Davnie | Haas | Koskinen | Mullery | Seagren | Westrom | |
| Dawkins | Hackbarth | Krinkie | Murphy | Seifert | Wilkin | |
| Dehler | Harder | Kubly | Ness | Skoe | Winter | |
| Dempsey | Hausman | Kuisle | Nornes | Skoglund | Wolf | |
| Dibble | Hilstrom | Larson | Olson | Slawik | Workman | |
| Dorman | Hilty | Leighton | Opatz | Smith | Spk. Sviggum | |
A quorum was present.
Clark, K., was excused until 1:05 p.m. Sertich was excused until 1:35 p.m.
The Chief Clerk proceeded to read the Journal of the preceding day. Ruth moved that further reading of the Journal be suspended and that the Journal be approved as corrected by the Chief Clerk. The motion prevailed.
REPORTS OF CHIEF CLERK
S. F. No. 179 and H. F. No. 281, which had been referred to the Chief Clerk for comparison, were examined and found to be identical with certain exceptions.
Greiling moved that the rules be so far suspended that S. F. No. 179 be substituted for H. F. No. 281 and that the House File be indefinitely postponed. The motion prevailed.
S. F. No. 1485 and H. F. No. 1311, which had been referred to the Chief Clerk for comparison, were examined and found to be identical with certain exceptions.
McElroy moved that the rules be so far suspended that S. F. No. 1485 be substituted for H. F. No. 1311 and that the House File be indefinitely postponed. The motion prevailed.
S. F. No. 1944 and H. F. No. 1697, which had been referred to the Chief Clerk for comparison, were examined and found to be identical with certain exceptions.
Smith moved that the rules be so far suspended that S. F. No. 1944 be substituted for H. F. No. 1697 and that the House File be indefinitely postponed. The motion prevailed.
Abrams from the Committee on Taxes to which was referred:
H. F. No. 84, A bill for an act relating to taxation; making technical corrections and administrative changes to income and franchise, property, sales and use, petroleum, deed, cigarette and tobacco, liquor, MinnesotaCare, and other taxes; making administrative and technical changes to property tax refund and local government aid provisions; clarifying abandoned personal property sale procedures; providing that certain water service connection fees be paid to the commissioner of health; making technical changes to the Revenue Recapture Act; amending Minnesota Statutes 2000, sections 144.3831, subdivision 2; 270.06; 270A.03, subdivision 5; 273.072, subdivision 1; 273.1104, subdivision 2; 273.111, subdivision 4; 273.124, subdivision 13; 282.04, subdivision 2; 287.20, subdivision 9; 289A.12, subdivision 3; 289A.50, subdivision 2a; 290.067, subdivisions 2 and 2b; 290.0671, subdivisions 1 and 7; 290.0921, subdivision 3; 290.35, subdivision 2; 290A.04, subdivision 4; 295.50, subdivisions 3 and 15; 295.52, subdivision 4; 295.57, subdivision 1; 296A.16, subdivision 2; 296A.21, subdivisions 1 and 4; 297A.01, subdivision 3; 297A.25, subdivisions 3 and 11; 297F.16, subdivision 4; 297G.15, subdivision 4; 297G.16, subdivisions 5 and 7; and 477A.011, subdivision 36; proposing coding for new law in Minnesota Statutes, chapter 296A; repealing Minnesota Statutes 2000, sections 290.095, subdivision 7; 290.23; 290.25; 290.31, subdivisions 2, 2a, 3, 4, 5, and 19; 296A.16, subdivision 6; and 297B.032.
Reported the same back with the recommendation that the bill pass.
Abrams from the Committee on Taxes to which was referred:
H. F. No. 187, A bill for an act relating to taxation; prohibiting modification and limiting expenditures of certain tax increment financing districts; proposing coding for new law in Minnesota Statutes, chapter 469.
Reported the same back with the recommendation that the bill pass.
The report was adopted.
Bishop from the Committee on Ways and Means to which was referred:
H. F. No. 2037, A bill for an act relating to public finance; updating and making technical changes to public finance and related provisions related to county and county-supported hospitals, municipally-owned nursing homes, lake improvement districts, and the metropolitan council; extending a sunset date for certain county capital improvement bonds and limiting the inclusiveness of capital improvements; removing election requirements as preconditions for issuance of certain obligations; requiring reverse referenda in certain cases; clarifying the effect of a state guaranty as not creating constitutional public debt of the state; authorizing some flexibility in stating certain ballot questions; authorizing Scott and Carver counties to grant certain economic development powers to their housing and redevelopment authorities; authorizing the Chisago Lakes joint sewage treatment commission to issue bonds; authorizing expanded funding by the county for certain multijurisdictional program activities in Hennepin county; authorizing Hassan township to create and empower an economic development authority; updating and changing the Minnesota Bond Allocation Act; amending Minnesota Statutes 2000, sections 103B.555, by adding a subdivision; 165.10, subdivision 2; 275.60; 373.40, subdivisions 1, 7; 373.45, subdivision 3; 376.06, subdivision 1; 376.07; 376.08, subdivisions 1, 2, 3, by adding a subdivision; 376.09; 383B.79, by adding a subdivision; 473.39, by adding a subdivision; 474A.02, subdivisions 8, 13a, 22a, 22b, 23a; 474A.03, subdivisions 1, 2a, 4; 474A.04, subdivisions 1a, 5; 474A.045; 474A.047, subdivisions 1, 2; 474A.061, subdivisions 1, 2a, 2b, 2c, 4; 474A.091, subdivisions 2, 3, 4, 5, 6, by adding a subdivision; 474A.131, subdivisions 1, 2, by adding a subdivision; 474A.14; 475.54, subdivision 1; 475.58, subdivisions 1, 1a, by adding a subdivision; Laws 1974, chapter 473; Laws 1980, chapter 482; proposing coding for new law in Minnesota Statutes, chapter 474A; repealing Minnesota Statutes 2000, section 474A.061, subdivision 6.
Reported the same back with the following amendments:
Page 10, line 29, delete "$45,000,000" and insert "$44,000,000"
Page 10, line 32, after "for" insert "computer software, or for"
Page 10, line 33, delete the third comma and insert "or"
Page 10, line 34, before "busways" insert "construction or maintenance of"
Page 47, line 26, after the period, insert "Hearings under section 48 may be held at any time after the date of enactment."
With the recommendation that when so amended the bill pass.
Abrams from the Committee on Taxes to which was referred:
H. F. No. 2241, A bill for an act relating to a new sports stadium; creating a task force to study stadiums; mandating issues to be studied; imposing a deadline; inviting proposals; requiring a report.
Reported the same back with the recommendation that the bill pass.
The report was adopted.
Abrams from the Committee on Taxes to which was referred:
H. F. No. 2506, A bill for an act relating to finance; updating and changing the Minnesota Bond Allocation Act; amending Minnesota Statutes 2000, sections 474A.02, subdivisions 8, 13a, 22a, 22b, 23a; 474A.03, subdivisions 1, 2a, 4; 474A.04, subdivisions 1a, 5; 474A.045; 474A.047, subdivisions 1, 2; 474A.061, subdivisions 1, 2a, 2b, 2c, 4; 474A.091, subdivisions 2, 3, 4, 5, 6, by adding a subdivision; 474A.131, subdivisions 1, 2, by adding a subdivision; 474A.14; proposing coding for new law in Minnesota Statutes, chapter 474A; repealing Minnesota Statutes 2000, section 474A.061, subdivision 6.
Reported the same back with the recommendation that the bill pass.
The report was adopted.
H. F. Nos. 84, 187, 2037, 2241 and 2506 were read for the second time.
S. F. Nos. 179, 1485 and 1944 were read for the second time.
The following House Files were introduced:
Hackbarth; Rukavina; Davids; Bakk; McElroy; Leighton; Stang; Sertich; Gunther; Abeler; Haas; Opatz; Kielkucki; Marquart; Larson; Lindner; Walz; Fuller; Kalis; Ruth; Ozment; Murphy; Westerberg; Wenzel; Clark, J.; Howes; Solberg; Entenza; Sykora; Vandeveer and Hilstrom introduced:
H. F. No. 2525, A bill for an act relating to employment; requiring that employers allow unpaid leave for employees to perform volunteer firefighter duties; proposing coding for new law in Minnesota Statutes, chapter 181.
The bill was read for the first time and referred to the Committee on Commerce, Jobs and Economic Development.
Paulsen introduced:
H. F. No. 2526, A bill for an act relating to redistricting; adopting a congressional redistricting plan for use in 2002 and thereafter; amending Minnesota Statutes 2000, section 2.031, subdivision 2; repealing Minnesota Statutes 2000, sections 2.742; 2.752; 2.762; 2.772; 2.782; 2.792; 2.802; 2.812.
The bill was read for the first time and referred to the Committee on Redistricting.
Jaros introduced:
H. F. No. 2527, A bill for an act relating to higher education; directing the board of trustees of the Minnesota state colleges and universities and requesting the board of regents of the University of Minnesota to adopt a policy requiring a year of study abroad for certain students.
The bill was read for the first time and referred to the Committee on Higher Education Finance.
Hackbarth, Rhodes, Schumacher, Milbert, Stang and Erickson introduced:
H. F. No. 2528, A bill for an act relating to gambling; proposing an amendment to the Minnesota Constitution by adding a section to article XIII; allowing the legislature to authorize one or more privately operated casinos with the state's share of net proceeds as defined by law dedicated to highway purposes and educational infrastructure.
The bill was read for the first time and referred to the Committee on Governmental Operations and Veterans Affairs Policy.
Kahn, Greiling, Krinkie, Mares and Rhodes introduced:
H. F. No. 2529, A bill for an act relating to retirement; providing that certain aid is contingent on compliance with filing requirements; mandating a study of a merger of certain retirement plans; proposing coding for new law in Minnesota Statutes, chapter 356A.
The bill was read for the first time and referred to the Committee on Governmental Operations and Veterans Affairs Policy.
Kahn, Greiling, Krinkie, Mares and Rhodes introduced:
H. F. No. 2530, A bill for an act relating to retirement; various state retirement aid programs; conditioning state aid receipt on compliance with economic interest and investment business recipient disclosure requirements; amending Minnesota Statutes 2000, sections 10A.02, subdivision 8; 69.021, subdivisions 4, 7, 7a; 354A.12, subdivision 3a; 356A.06, subdivision 5; 422A.101, subdivision 3.
The bill was read for the first time and referred to the Committee on Governmental Operations and Veterans Affairs Policy.
Goodno, Nornes, Rhodes, Huntley and Abeler introduced:
H. F. No. 2531, A bill for an act relating to health; regulating hospice care providers; amending Minnesota Statutes 2000, sections 13.381, subdivision 10; 144A.43, subdivisions 1, 3, 4; 144A.45, subdivisions 1, 2; 144A.46, subdivisions 3a, 3b, 4; 144A.4605, subdivisions 2, 3, 4; 145C.01, subdivision 7; 157.17, subdivision 2; 609.7495, subdivision 1; proposing coding for new law in Minnesota Statutes, chapter 144A; repealing Minnesota Statutes 2000, section 144A.48.
The bill was read for the first time and referred to the Committee on Health and Human Services Policy.
Huntley, Cassell, Swapinski, Murphy, Jaros and Kalis introduced:
H. F. No. 2532, A bill for an act relating to appropriations; appropriating money for the state's share of the cost of the new Poe Lock at Sault Ste. Marie Narrows.
The bill was read for the first time and referred to the Committee on Jobs and Economic Development Finance.
The following messages were received from the Senate:
Mr. Speaker:
I hereby announce that the Senate accedes to the request of the House for the appointment of a Conference Committee on the amendments adopted by the Senate to the following House File:
H. F. No. 82, A bill for an act relating to education; providing for kindergarten through grade 12 education including general education revenue; education excellence; special programs; facilities and technology; nutrition, school accounting, and other programs; agency provisions; deficiencies; local achievement testing; and technical amendments; appropriating money; amending Minnesota Statutes 2000, sections 16B.616, subdivision 4; 120A.05, by adding a subdivision; 120B.02; 120B.031, subdivision 11; 120B.13, subdivision 1; 120B.30, subdivision 1; 120B.31, subdivision 3; 120B.35; 121A.11, by adding subdivisions; 121A.41, subdivision 10; 121A.45, subdivision 2, by adding a subdivision; 121A.582; 121A.61, subdivision 2; 122A.06, by adding a subdivision; 122A.09, subdivision 4; 122A.162; 122A.163; 122A.18, subdivisions 1, 2, 2a, 4, by adding subdivisions; 122A.20, subdivision 2; 122A.21; 122A.26, subdivision 3; 122A.31; 122A.61, subdivision 1; 123B.03, subdivision 3; 123B.143, subdivision 1; 123B.42, subdivision 3; 123B.44, subdivision 6; 123B.53, subdivisions 1, 2, 4, 5; 123B.54; 123B.57, subdivisions 3, 6, 8; 123B.71, subdivisions 1, 4, 8, 9; 123B.75, subdivision 5, by adding subdivisions; 123B.80, subdivision 1; 123B.92, by adding subdivisions; 124D.10, subdivisions 1, 3, 4, 6, 8, 10, 14, 15, 19, 23, 25, by adding subdivisions; 124D.11, subdivisions 4, 5, 9; 124D.128, subdivisions 1, 2, 3, 6; 124D.454, subdivision 11; 124D.65, subdivision 5; 124D.69, subdivision 1; 124D.74, subdivisions 1, 2, 3, 4, 6; 124D.75, subdivision 6; 124D.76; 124D.78, subdivision 1; 124D.81, subdivisions 1, 3, 5, 6, 7; 124D.86, subdivisions 3, 6; 125A.023, subdivision 4; 125A.08; 125A.09, subdivision 3; 125A.11, subdivision 3; 125A.17; 125A.27, subdivision 15; 125A.76, subdivisions 1, 2; 126C.05, subdivisions 1, 3, 5, 6, 15; 126C.10, subdivisions 1, 2, 3, 9, 20, 21, 22, 24, 25, 27, by adding a subdivision; 126C.12, subdivisions 2, 3, 4, 5, by adding a subdivision; 126C.13, subdivision 1; 126C.15, subdivisions 1, 2, 5; 126C.16, by adding a subdivision; 126C.17, subdivisions 1, 2, 5, 6, 9, 10, 11; 126C.23, subdivision 5; 126C.41, subdivision 3; 126C.43, subdivision 3; 126C.63, subdivision 8; 126C.69, subdivisions 2, 3, 9, 12, 15; 127A.05, subdivision 1; 127A.41, subdivisions 5, 8, 9; 127A.45, subdivision 12, by adding a subdivision; 127A.50, subdivision 2; 136D.281, subdivision 4; 136D.741, subdivision 4; 136D.88, subdivision 4; 179A.20, by adding a subdivision; 214.01, subdivision 3; 214.04, subdivisions 1, 3; 214.12, subdivision 1; 260A.01;
260C.163, subdivision 11; 475.53, subdivision 4; 475.61, subdivision 3; 626.556, subdivision 2; Laws 1992, chapter 499, article 7, section 31, as amended; Laws 2000, chapter 489, article 2, sections 34, 36, 37, subdivision 3, 39, subdivision 2; Laws 2000, chapter 489, article 3, sections 24, 25, subdivision 5; Laws 2000, chapter 489, article 5, section 21; Laws 2000, chapter 489, article 7, section 15, subdivision 3; proposing coding for new law in Minnesota Statutes, chapters 120B; 122A; 123B; 124D; 127A; repealing Minnesota Statutes 2000, sections 120B.031; 120B.31, subdivisions 1, 2, 4; 123B.05; 123B.71, subdivisions 3, 10; 124D.07; 124D.1155; 124D.128, subdivision 7; 124D.32; 124D.85; 126C.01, subdivision 10; 126C.10, subdivisions 3, 12, 23, 28; 126C.16, subdivision 2; 126C.17, subdivision 12; 126C.18; 126C.22; 126C.30; 126C.31; 126C.32; 126C.33; 126C.34; 126C.35; 126C.36; 126C.42, subdivisions 2, 3; 126C.47; 127A.44; 135A.081; 136D.281, subdivision 8; 136D.741, subdivision 8; 136D.88, subdivision 8; 136D.94; Laws 2000, chapter 254, section 30; Laws 2000, chapter 489, article 1, section 18; Minnesota Rules, parts 3501.0300; 3501.0310; 3501.0320; 3501.0330; 3501.0340; 3501.0350; 3501.0370; 3501.0380; 3501.0390; 3501.0400; 3501.0410; 3501.0420; 3501.0430; 3501.0440; 3501.0441; 3501.0442; 3501.0443; 3501.0444; 3501.0445; 3501.0446; 3501.0447; 3501.0448; 3501.0449; 3501.0450; 3501.0460; 3501.0461; 3501.0462; 3501.0463; 3501.0464; 3501.0465; 3501.0466; 3501.0467; 3501.0468; 3501.0469.
The Senate has appointed as such committee:
Senators Stumpf; Pappas; Robertson; Kelley, S. P., and Tomassoni.
Said House File is herewith returned to the House.
Patrick E. Flahaven, Secretary of the Senate
Mr. Speaker:
I hereby announce the passage by the Senate of the following House File, herewith returned, as amended by the Senate, in which amendments the concurrence of the House is respectfully requested:
H. F. No. 1507, A bill for an act relating to municipal planning; zoning; clarifying the treatment of legal nonconforming uses; amending Minnesota Statutes 2000, section 462.357, by adding a subdivision.
Patrick E. Flahaven, Secretary of the Senate
Bishop moved that the House refuse to concur in the Senate amendments to H. F. No. 1507, that the Speaker appoint a Conference Committee of 3 members of the House, and that the House requests that a like committee be appointed by the Senate to confer on the disagreeing votes of the two houses. The motion prevailed.
Mr. Speaker:
I hereby announce the passage by the Senate of the following House File, herewith returned, as amended by the Senate, in which amendments the concurrence of the House is respectfully requested:
H. F. No. 1153, A bill for an act relating to local government; exempting certain building projects from the requirement to employ an architect; amending Minnesota Statutes 2000, section 326.03, by adding a subdivision.
Patrick E. Flahaven, Secretary of the Senate
Mulder moved that the House refuse to concur in the Senate amendments to H. F. No. 1153, that the Speaker appoint a Conference Committee of 3 members of the House, and that the House requests that a like committee be appointed by the Senate to confer on the disagreeing votes of the two houses. The motion prevailed.
Mr. Speaker:
I hereby announce the passage by the Senate of the following House File, herewith returned, as amended by the Senate, in which amendments the concurrence of the House is respectfully requested:
H. F. No. 707, A bill for an act relating to crime prevention; classifying Carisoprodol as a controlled substance upon the effective date of a final rule adding Carisoprodol to the federal schedules of controlled substances; amending Laws 1997, chapter 239, article 4, section 15, as amended.
Patrick E. Flahaven, Secretary of the Senate
Skoglund moved that the House refuse to concur in the Senate amendments to H. F. No. 707, that the Speaker appoint a Conference Committee of 3 members of the House, and that the House requests that a like committee be appointed by the Senate to confer on the disagreeing votes of the two houses. The motion prevailed.
Mr. Speaker:
I hereby announce the passage by the Senate of the following House File, herewith returned, as amended by the Senate, in which amendments the concurrence of the House is respectfully requested:
H. F. No. 1155, A bill for an act relating to insurance; regulating action plans of certain health plan companies; requiring an affirmative provider consent to participate in a network under a category of coverage; requiring disclosure of changes in a provider's contract; imposing a moratorium on managed care auto insurance plans; amending Minnesota Statutes 2000, sections 62Q.07; 62Q.74, subdivisions 2, 3, and 4; proposing coding for new law in Minnesota Statutes, chapter 62Q.
Patrick E. Flahaven, Secretary of the Senate
Abeler moved that the House refuse to concur in the Senate amendments to H. F. No. 1155, that the Speaker appoint a Conference Committee of 3 members of the House, and that the House requests that a like committee be appointed by the Senate to confer on the disagreeing votes of the two houses. The motion prevailed.
Mr. Speaker:
I hereby announce that the Senate refuses to concur in the House amendments to the following Senate File:
S. F. No. 229, A bill for an act relating to criminal records; requiring that crime victims be notified of expungement proceedings and allowed to submit a statement; amending Minnesota Statutes 2000, section 609A.03, subdivisions 2, 3, and 4.
The Senate respectfully requests that a Conference Committee be appointed thereon. The Senate has appointed as such committee:
Senators Ranum, Foley and Limmer.
Said Senate File is herewith transmitted to the House with the request that the House appoint a like committee.
Patrick E. Flahaven, Secretary of the Senate
McGuire moved that the House accede to the request of the Senate and that the Speaker appoint a Conference Committee of 3 members of the House to meet with a like committee appointed by the Senate on the disagreeing votes of the two houses on S. F. No. 229. The motion prevailed.
Mr. Speaker:
I hereby announce the passage by the Senate of the following House File, herewith returned, as amended by the Senate, in which amendments the concurrence of the House is respectfully requested:
H. F. No. 1487, A bill for an act relating to natural resources; modifying provisions rendered obsolete by the electronic licensing system; modifying the disposition of certain taxes and proceeds; clarifying certain licensing and training requirements; providing for removal of submerged vehicles; modifying watercraft license and title provisions; clarifying sale of live animals and animal portions; modifying rulemaking authority; modifying certain license revocation provisions; clarifying taxidermy and bow fishing provisions; modifying fish house requirements; repealing certain fleeing provisions; amending Minnesota Statutes 2000, sections 6.48; 84.788, subdivisions 3 and 4; 84.796; 84.798, subdivisions 3 and 5; 84.82, subdivision 2; 84.83, subdivisions 3 and 5; 84.862, subdivisions 1 and 2; 84.872, subdivision 1; 84.922, subdivisions 2 and 3; 86B.401, subdivisions 1, 3, and 4; 86B.705, subdivision 2; 86B.820, subdivision 13; 86B.825, subdivision 1; 86B.830, subdivision 1; 97A.065, subdivision 2; 97A.105, subdivisions 4 and 9; 97A.421, subdivision 1; 97A.425, subdivision 1; 97A.441, subdivision 1; 97A.512; 97B.055, subdivision 2; 97C.355, subdivision 1, and by adding a subdivision; and 297A.94; proposing coding for new law in Minnesota Statutes, chapter 86B; repealing Minnesota Statutes 2000, sections 84.792; and 84.801.
Patrick E. Flahaven, Secretary of the Senate
Haas moved that the House refuse to concur in the Senate amendments to H. F. No. 1487, that the Speaker appoint a Conference Committee of 3 members of the House, and that the House requests that a like committee be appointed by the Senate to confer on the disagreeing votes of the two houses. The motion prevailed.
LEGISLATIVE ADMINISTRATION
Pawlenty from the Committee on Rules and Legislative Administration, pursuant to rule 1.21, designated the following bills to be placed on the Calendar for the Day, immediately following the remaining bills on the Calendar for the Day, for Monday, May 14, 2001:
S. F. No. 722; H. F. No. 94; S. F. Nos. 414 and 1430; H. F. No. 1019; S. F. Nos. 1397, 2142 and 1964; H. F. Nos. 2093 and 1270; and S. F. No. 494.
S. F. No. 694 was reported to the House.
Howes moved to amend S. F. No. 694 as follows:
Delete everything after the enacting clause and insert:
"Section 1. [COUNCIL.]
Propane producers and propane retail marketers, as defined by United States Code, title 15, section 6402, may form a propane education and research council for the purpose of establishing, supporting, or conducting research, training, and education programs concerning the safe and efficient use of propane.
Sec. 2. [ORGANIZATION.]
Organization and membership of the council shall be in compliance with United States Code, title 15, sections 6403, subsections (a) and (b), and 6404, subsection (c), and must abide by the requirements of United States Code, title 15, section 6409. The council is established upon certification by the commissioner of public safety that the council has been organized in compliance with United States Code, title 15, sections 6403, subsections (a) and (b), and 6404, subsection (c).
Sec. 3. [ASSESSMENT.]
A propane education and research council, established and certified pursuant to section 2, may assess propane producers and retail marketers an amount not to exceed one mill per gallon of odorized propane in a manner established by the council in compliance with United States Code, title 15, section 6405, subsections (a) to (c). Propane producers and retail marketers shall be responsible for the amounts assessed.
Sec. 4. [ANNUAL REPORT.]
A propane education and research council collecting assessments pursuant to section 3 shall annually report to the commissioner of public safety, detailing collections and expenditures made pursuant to this act.
Sec. 5. [CONTINGENT REPEALER.]
Sections 1 to 4 are repealed effective August 1, 2004, if no propane energy and research council has been established by that date.
Sec. 6. [REPEALER.]
Sections 1 to 5 are repealed effective August 1, 2009."
The motion prevailed and the amendment was adopted.
S. F. No. 694, A bill for an act relating to public safety; providing for creation of a propane education and research council.
The bill was read for the third time, as amended, and placed upon its final passage.
The question was taken on the passage of the bill and the roll was called. There were 103 yeas and 28 nays as follows:
Those who voted in the affirmative were:
Those who voted in the negative were:
| Anderson, B. | Finseth | Johnson, J. | Lindner | Rifenberg | Wilkin | |
| Boudreau | Gerlach | Kielkucki | Marko | Ruth | Workman | |
| Bradley | Holberg | Knoblach | Nornes | Swenson | Spk. Sviggum | |
| Buesgens | Holsten | Krinkie | Olson | Vandeveer | ||
| Dorman | Jacobson | Kuisle | Paulsen | Westerberg | ||
The bill was passed, as amended, and its title agreed to.
S. F. No. 1821, A bill for an act relating to utilities; modifying provisions regulating utility facilities in railroad rights-of-way; amending Minnesota Statutes 2000, section 237.04.
The bill was read for the third time and placed upon its final passage.
The question was taken on the passage of the bill and the roll was called. There were 131 yeas and 0 nays as follows:
Those who voted in the affirmative were:
The bill was passed and its title agreed to.
H. F. No. 156, A bill for an act relating to occupations; regulating registration renewal fees for certain multiple barber shops operated by a single barber; amending Minnesota Statutes 2000, section 154.15, subdivision 1.
The bill was read for the third time and placed upon its final passage.
The question was taken on the passage of the bill and the roll was called. There were 117 yeas and 11 nays as follows:
Those who voted in the affirmative were:
| Abeler | Dibble | Hilstrom | Leppik | Ozment | Stang | |
| Abrams | Dorman | Hilty | Lieder | Paulsen | Swenson | |
| Anderson, B. | Dorn | Holberg | Lipman | Pawlenty | Sykora | |
| Anderson, I. | Eastlund | Howes | Mahoney | Pelowski | Thompson | |
| Bakk | Entenza | Huntley | Mares | Penas | Tingelstad | |
| Bernardy | Erhardt | Jacobson | Mariani | Peterson | Tuma | |
| Biernat | Erickson | Jennings | Marquart | Pugh | Vandeveer | |
| Bishop | Evans | Johnson, J. | McElroy | Rhodes | Walker | |
| Boudreau | Finseth | Johnson, R. | McGuire | Rifenberg | Walz | |
| Bradley | Folliard | Juhnke | Milbert | Rukavina | Wenzel | |
| Buesgens | Fuller | Kalis | Molnau | Ruth | Westerberg | |
| Carlson | Gerlach | Kelliher | Mulder | Schumacher | Westrom | |
| Cassell | Goodno | Kielkucki | Mullery | Seagren | Wilkin | |
| Clark, J. | Goodwin | Knoblach | Ness | Seifert | Winter | |
| Daggett | Gray | Koskinen | Nornes | Skoe | Wolf | |
| Davids | Greiling | Kubly | Olson | Skoglund | Workman | |
| Davnie | Gunther | Kuisle | Opatz | Slawik | Spk. Sviggum | |
| Dawkins | Haas | Larson | Osskopp | Smith | ||
| Dehler | Hackbarth | Leighton | Osthoff | Solberg | ||
| Dempsey | Harder | Lenczewski | Otremba | Stanek | ||
Those who voted in the negative were:
| Gleason | Johnson, S. | Krinkie | Luther | Swapinski | Wasiluk | |
| Hausman | Kahn | Lindner | Paymar | Wagenius | ||
The bill was passed and its title agreed to.
H. F. No. 1424 was reported to the House.
Krinkie moved that H. F. No. 1424 be returned to the General Register. The motion prevailed.
S. F. No. 2046 was reported to the House.
Rukavina, Marko, Pugh and Solberg moved to amend S. F. No. 2046 as follows:
Page 1, after line 17, insert:
"Section 1. Minnesota Statutes 2000, section 176.031, is amended to read:
176.031 [EMPLOYER'S LIABILITY EXCLUSIVE.]
(a) Except as otherwise provided in this section, the liability of an employer prescribed by this chapter is exclusive and in the place of any other liability to such employee, personal representative, surviving spouse, parent, any child, dependent, next of kin, or other person entitled to recover damages on account of such injury or death. If an employer other than the state or any municipal subdivision thereof fails to insure or self-insure liability for compensation to injured employees and their dependents, an injured employee, or legal representatives or, if death results from the injury, any dependent may elect to claim compensation under this chapter or to maintain an action in the courts for damages on account of such injury or death. In such action it is not necessary to plead or prove freedom from contributory negligence. The defendant may not plead as a defense that the injury was caused by the negligence of a fellow servant, that the employee assumed the risk of employment, or that the injury was due to the contributory negligence of the employee, unless it appears that such negligence was willful on the part of the employee. The burden of proof to establish such willful negligence is upon the defendant. For the purposes of this chapter the state and each municipal subdivision thereof is treated as a self-insurer when not carrying insurance at the time of the injury or death of an employee.
(b) In addition to the liability prescribed by this chapter, an injured employee or legal representative, or, if death results from the injury, any dependent, may maintain an action in the courts for damages on account of the injury or death if the employer knowingly violated a safety law, rule, standard, or ordinance, and the violation was a substantial contributing cause of the injury or death. It is negligence per se on the part of an employer if it is proved by a preponderance of the evidence that the employer knowingly violated a safety law, rule, standard, or ordinance, and the violation was a substantial contributing cause of the injury or death. Any recovery under this paragraph must be reduced by any benefits paid or payable under this chapter."
Renumber the sections in sequence and correct the internal references
Amend the title accordingly
A roll call was requested and properly seconded.
The question was taken on the Rukavina et al amendment and the roll was called. There were 66 yeas and 66 nays as follows:
Those who voted in the affirmative were:
Those who voted in the negative were:
| Abeler | Dehler | Haas | Leppik | Ozment | Swenson | |
| Abrams | Dempsey | Hackbarth | Lindner | Paulsen | Sykora | |
| Anderson, B. | Dorman | Harder | Lipman | Pawlenty | Tingelstad | |
| Bishop | Eastlund | Holberg | Mares | Penas | Vandeveer | |
| Boudreau | Erhardt | Holsten | McElroy | Rhodes | Walz | |
| Bradley | Erickson | Jacobson | Molnau | Rifenberg | Westerberg | |
| Buesgens | Finseth | Johnson, J. | Mulder | Ruth | Westrom | |
| Cassell | Fuller | Kielkucki | Ness | Seagren | Wilkin | |
| Clark, J. | Gerlach | Knoblach | Nornes | Seifert | Wolf | |
| Daggett | Goodno | Krinkie | Olson | Stanek | Workman | |
| Davids | Gunther | Kuisle | Osskopp | Stang | Spk. Sviggum | |
The motion did not prevail and the amendment was not adopted.
S. F. No. 2046, A bill for an act relating to workers' compensation; making technical changes; requiring interest earned on revenue collected by the special compensation fund to be deposited into the fund; extending a pilot program; providing for payment of various penalties to the commissioner of labor and industry; amending Minnesota Statutes 2000, sections 176.042, subdivision 2; 176.102, subdivisions 3a, 11, 14; 176.103, subdivision 3; 176.129, subdivisions 10, 13, by adding a subdivision; 176.1351, subdivision 5; 176.138; 176.1812, subdivision 6; 176.191, subdivision 1a; 176.192; 176.194, subdivision 4; 176.221, subdivisions 1, 3, 3a, 6; 176.231, subdivisions 2, 6, 10; 176.238, subdivision 10; repealing Minnesota Statutes 2000, section 176.445.
The bill was read for the third time and placed upon its final passage.
The question was taken on the passage of the bill and the roll was called. There were 131 yeas and 0 nays as follows:
Those who voted in the affirmative were:
The bill was passed and its title agreed to.
S. F. No. 1264, A bill for an act relating to insurance; no-fault auto; regulating income loss benefits to senior citizens; amending Minnesota Statutes 2000, section 65B.491.
The bill was read for the third time and placed upon its final passage.
The question was taken on the passage of the bill and the roll was called. There were 132 yeas and 0 nays as follows:
Those who voted in the affirmative were:
| Abeler | Dorn | Holberg | Lenczewski | Osskopp | Solberg | |
| Abrams | Eastlund | Holsten | Leppik | Osthoff | Stanek | |
| Anderson, B. | Entenza | Howes | Lieder | Otremba | Stang | |
| Anderson, I. | Erhardt | Huntley | Lindner | Ozment | Swapinski | |
| Bakk | Erickson | Jacobson | Lipman | Paulsen | Swenson | |
| Bernardy | Evans | Jaros | Luther | Pawlenty | Sykora | |
| Biernat | Finseth | Jennings | Mahoney | Paymar | Thompson | |
| Bishop | Folliard | Johnson, J. | Mares | Pelowski | Tingelstad | |
| Boudreau | Fuller | Johnson, R. | Mariani | Penas | Tuma | |
| Bradley | Gerlach | Johnson, S. | Marko | Peterson | Vandeveer | |
| Buesgens | Gleason | Juhnke | Marquart | Pugh | Wagenius | |
| Carlson | Goodno | Kahn | McElroy | Rhodes | Walker | |
| Cassell | Goodwin | Kalis | McGuire | Rifenberg | Walz | |
| Clark, J. | Gray | Kelliher | Milbert | Rukavina | Wasiluk | |
| Daggett | Greiling | Kielkucki | Molnau | Ruth | Wenzel | |
| Davids | Gunther | Knoblach | Mulder | Schumacher | Westerberg | |
| Davnie | Haas | Koskinen | Mullery | Seagren | Westrom | |
| Dawkins | Hackbarth | Krinkie | Murphy | Seifert | Wilkin | |
| Dehler | Harder | Kubly | Ness | Skoe | Winter | |
| Dempsey | Hausman | Kuisle | Nornes | Skoglund | Wolf | |
| Dibble | Hilstrom | Larson | Olson | Slawik | Workman | |
| Dorman | Hilty | Leighton | Opatz | Smith | Spk. Sviggum | |
The bill was passed and its title agreed to.
S. F. No. 1222, A bill for an act relating to veterans; authorizing the placement of a plaque on the capitol mall recognizing the service of Minnesota's civilians who contributed valiantly to the nation's war efforts during World War II.
The bill was read for the third time and placed upon its final passage.
The question was taken on the passage of the bill and the roll was called. There were 130 yeas and 0 nays as follows:
Those who voted in the affirmative were:
| Abeler | Dorn | Holberg | Leppik | Osthoff | Stanek | |
| Abrams | Eastlund | Holsten | Lieder | Otremba | Stang | |
| Anderson, B. | Entenza | Howes | Lindner | Ozment | Swenson | |
| Anderson, I. | Erhardt | Jacobson | Lipman | Paulsen | Sykora | |
| Bakk | Erickson | Jaros | Luther | Pawlenty | Thompson | |
| Bernardy | Evans | Jennings | Mahoney | Paymar | Tingelstad | |
| Biernat | Finseth | Johnson, J. | Mares | Pelowski | Tuma | |
| Bishop | Folliard | Johnson, R. | Mariani | Penas | Vandeveer | |
| Boudreau | Fuller | Johnson, S. | Marko | Peterson | Wagenius | |
| Bradley | Gerlach | Juhnke | Marquart | Pugh | Walker | |
| Buesgens | Gleason | Kahn | McElroy | Rhodes | Walz | |
| Carlson | Goodno | Kalis | McGuire | Rifenberg | Wasiluk | |
| Cassell | Goodwin | Kelliher | Milbert | Rukavina | Wenzel | |
| Clark, J. | Gray | Kielkucki | Molnau | Ruth | Westerberg | |
| Daggett | Greiling | Knoblach | Mulder | Schumacher | Westrom | |
| Davids | Gunther | Koskinen | Mullery | Seagren | Wilkin | |
| Davnie | Haas | Krinkie | Murphy | Seifert | Winter | |
| Dawkins | Hackbarth | Kubly | Ness | Skoe | Wolf | |
| Dehler | Harder | Kuisle | Nornes | Skoglund | Workman | |
| Dempsey | Hausman | Larson | Olson | Slawik | Spk. Sviggum | |
| Dibble | Hilstrom | Leighton | Opatz | Smith | ||
| Dorman | Hilty | Lenczewski | Osskopp | Solberg | ||
The bill was passed and its title agreed to.
S. F. No. 1610 was reported to the House.
Entenza moved to amend S. F. No. 1610 as follows:
Delete everything after the enacting clause and insert the following language of H. F. No. 1615, the first engrossment:
"Section 1. Minnesota Statutes 2000, section 60A.11, subdivision 10, is amended to read:
Subd. 10. [DEFINITIONS.] The following terms have the meaning assigned in this subdivision for purposes of this section and section 60A.111:
(a) "Adequate evidence" means a written confirmation, advice, or other verification issued by a depository, issuer, or custodian bank which shows that the investment is held for the company;
(b) "Adequate security" means a letter of credit qualifying under subdivision 11, paragraph (f), cash, or the pledge of an investment authorized by any subdivision of this section;
(c) "Admitted assets," for purposes of computing percentage limitations on particular types of investments, means the assets as shown by the company's annual statement, required by section 60A.13, as of the December 31 immediately preceding the date the company acquires the investment;
(d) "Clearing corporation" means The Depository Trust Company or any other clearing agency registered with the securities and exchange commission pursuant to the Securities Exchange Act of 1934, section 17A, Euro-clear Clearance System Limited and CEDEL S.A., and, with the approval of the commissioner, any other clearing corporation as defined in section 336.8-102;
(e) "Control" has the meaning assigned to that term in, and must be determined in accordance with, section 60D.15, subdivision 4;
(f) "Custodian bank" means a bank or trust company or a branch of a bank or trust company that is acting as custodian and is supervised and examined by state or federal authority having supervision over the bank or trust company or with respect to a company's foreign investments only by the regulatory authority having supervision over banks or trust companies in the jurisdiction in which the bank, trust company, or branch is located, and any banking institutions qualifying as an "Eligible Foreign Custodian" under the Code of Federal Regulations, section 270.17f-5, adopted under section 17(f) of the Investment Company Act of 1940, and specifically including Euro-clear Clearance System Limited and CEDEL S.A., acting as custodians;
(g) "Evergreen clause" means a provision that automatically renews a letter of credit for a time certain if the issuer of the letter of credit fails to affirmatively signify its intention to nonrenew upon expiration;
(h) "Government obligations" means direct obligations for the payment of money, or obligations for the payment of money to the extent guaranteed as to the payment of principal and interest by any governmental issuer where the obligations are payable from ad valorem taxes or guaranteed by the full faith, credit, and taxing power of the issuer and are not secured solely by special assessments for local improvements;
(i) "Noninvestment grade obligations" means obligations which, at the time of acquisition, were rated below Baa/BBB or the equivalent by a securities rating agency or which, at the time of acquisition, were not in one of the two highest categories established by the securities valuation office of the National Association of Insurance Commissioners;
(j) "Issuer" means the corporation, business trust, governmental unit, partnership, association, individual, or other entity which issues or on behalf of which is issued any form of obligation;
(k) "Licensed real estate appraiser" means a person who develops and communicates real estate appraisals and who holds a current, valid license under chapter 82B or a substantially similar licensing requirement in another jurisdiction;
(l) "Member bank" means a national bank, state bank or trust company which is a member of the Federal Reserve System;
(m) "National securities exchange" means an exchange registered under section 6 of the Securities Exchange Act of 1934 or an exchange regulated under the laws of the Dominion of Canada;
(n) "NASDAQ" means the reporting system for securities meeting the definition of National Market System security as provided under Part I to Schedule D of the National Association of Securities Dealers Incorporated bylaws;
(o) "Obligations" include bonds, notes, debentures, transportation equipment certificates, repurchase agreements, bank certificates of deposit, time deposits, bankers' acceptances, and other obligations for the payment of money not in default as to payments of principal and interest on the date of investment, whether constituting general obligations of the issuer or payable only out of certain revenues or certain funds pledged or otherwise dedicated for payment. Leases are considered obligations if the lease is assigned for the benefit of the company and is nonterminable by the lessee or lessees thereunder upon foreclosure of any lien upon the leased property, and rental payments are sufficient to amortize the investment over the primary lease term;
(p) "Qualified assets" means the sum of (1) all investments qualified in accordance with this section other than investments in affiliates and subsidiaries, (2) investments in obligations of affiliates as defined in section 60D.15, subdivision 2, secured by real or personal property sufficient to qualify the investment under subdivision 19 or 23, (3) qualified investments in subsidiaries, as defined in section 60D.15, subdivision 9, on a consolidated basis with the insurance company without allowance for goodwill or other intangible value, and (4) cash on hand and on deposit, agent's balances or uncollected premiums not due more than 90 days, assets held pursuant to section 60A.12, subdivision 2, investment income due and accrued, funds due or on deposit or recoverable on loss payments under contracts of reinsurance entered into pursuant to section 60A.09, premium bills and notes receivable, federal income taxes recoverable, and equities and deposits in pools and associations;
(q) "Qualified net earnings" means that the net earnings of the issuer after elimination of extraordinary nonrecurring items of income and expense and before income taxes and fixed charges over the five immediately preceding completed fiscal years, or its period of existence if less than five years, has averaged not less than 1-1/4 times its average annual fixed charges applicable to the period;
(r) "Replicated investment position" means the statement value of the position reported under the heading "Replicated (Synthetic) Asset" on Schedule DB, Part F, of the annual statement of the insurer, or any successor provision;
(s) "Replication transaction" means a derivative transaction that is intended to replicate the performance of one or more assets that an insurer is authorized to acquire under this section. A derivative transaction that either is authorized by subdivision 18, clause (5), or by subdivision 24, or is entered into as a hedging transaction shall not be considered a replication transaction;
(t) "Required liabilities" means the sum of (1) total liabilities as required to be reported in the company's most recent annual report to the commissioner of commerce of this state, (2) for companies operating under the stock plan, the minimum paid-up capital and surplus required to be maintained pursuant to section 60A.07, subdivision 5a, (3) for companies operating under the mutual or reciprocal plan, the minimum amount of surplus required to be maintained pursuant to section 60A.07, subdivision 5b, and (4) the amount, if any, by which the company's loss and loss adjustment expense reserves exceed 350 percent of its surplus as it pertains to policyholders as of the same date. The commissioner may waive the requirement in clause (4) unless the company's written premiums exceed 300 percent of its surplus as it pertains to policyholders as of the same date. In addition to the required amounts pursuant to clauses (1) to (4), the commissioner may require that the amount of any apparent reserve deficiency that may be revealed by one to five year loss and loss adjustment expense development analysis for the five years reported in the company's most recent annual statement to the commissioner be added to required liabilities;
(s) (u) "Revenue obligations" means obligations for the payment of money by a governmental
issuer where the obligations are payable from revenues, earnings, or special assessments on properties benefited by
local improvements of the issuer which are specifically pledged therefor;
(t) (v) "Security" has the meaning given in section 5 of the Security Act of 1933 and specifically
includes, but is not limited to, stocks, stock equivalents, warrants, rights, options, obligations, American Depository
Receipts (ADR's), repurchase agreements, and reverse repurchase agreements; and
(u) (w) "Unrestricted surplus" means the amount by which qualified assets exceed 110 percent
of required liabilities.
Sec. 2. Minnesota Statutes 2000, section 60A.11, is amended by adding a subdivision to read:
Subd. 25a. [REPLICATION TRANSACTIONS.] An insurer engaging in replication transactions shall include all replicated investment positions in calculating compliance with the limitations on investments applicable to the insurer. Replication transactions are permitted only under the authority of subdivision 25. An insurer may invest its unrestricted surplus in a replication transaction only to the extent that the replicated investment position does not cause the total positions represented by the unrestricted surplus to be greater than the total positions represented by the unrestricted surplus as would be permitted in the absence of the replicated investment position.
Sec. 3. Minnesota Statutes 2000, section 60A.129, subdivision 5, is amended to read:
Subd. 5. [CONSOLIDATED FILING.] (a) The commissioner may allow an insurer to file a consolidated loss reserve certification required by subdivision 2, in lieu of separate loss certifications and may allow an insurer to file consolidated or combined audited financial statements required by subdivision 3, paragraph (a), in lieu of separate annual audited financial statements, where it can be demonstrated that an insurer is part of a group of insurance companies that has a pooling or 100 percent reinsurance agreement which substantially affects the solvency and integrity of the reserves of the insurer and the insurer cedes all of its direct and assumed business to the pool. An affiliated insurance company not meeting these requirements may be included in the consolidated or combined audited financial statements, if the company's total admitted assets are less than five percent of the consolidated group's total admitted assets. If these circumstances exist, then the company may file a written application to file a consolidated loss reserve certification and/or consolidated or combined audited financial statements. This application shall be for a specified period.
(b) Upon written application by a domestic insurer, the commissioner may authorize the domestic insurer to include additional affiliated insurance companies in the consolidated or combined audited financial statements. Foreign insurers must obtain the prior written authorization of the commissioner of their state of domicile in order to submit an application for authority to file consolidated or combined audited financial statements. This application shall be for a specified period.
(c) A consolidated annual audit filing shall include a columnar consolidated or combining worksheet. Amounts shown on the audited consolidated or combined financial statement shall be shown on the worksheet. Amounts for each insurer shall be stated separately. Noninsurance operations may be shown on the worksheet on a combined or individual basis. Explanations of consolidating or eliminating entries shall be shown on the worksheet. A reconciliation of any differences between the amounts shown in the individual insurer columns of the worksheet and comparable amounts shown on the annual statement of the insurers shall be included on the worksheet.
Sec. 4. [60A.975] [DEFINITIONS.]
Subdivision 1. [APPLICATION.] For purposes of sections 60A.975 and 60A.976, the definitions in this section have the meanings given them.
Subd. 2. [ANNUITY ISSUER.] "Annuity issuer" means an insurer that issues an insurance contract used to fund periodic payments under a structured settlement agreement.
Subd. 3. [STRUCTURED SETTLEMENT.] "Structured settlement" means an arrangement for periodic payment of damages entered on behalf of a minor or incompetent person for personal injuries established by settlement or judgment.
Subd. 4. [STRUCTURED SETTLEMENT AGREEMENT.] "Structured settlement agreement" means the agreement, judgment, stipulation, or release embodying the terms of a structured settlement.
Sec. 5. [60A.976] [ANNUITY ISSUERS FINANCIAL REQUIREMENTS.]
An annuity purchased to finance a structured settlement agreement may be purchased only from an annuity issuer with a financial rating equivalent to A.M. Best Company A+ Class 8 or better; or a Standard & Poor's AA or better.
Sec. 6. Minnesota Statutes 2000, section 60B.44, subdivision 4, is amended to read:
Subd. 4. [LOSS CLAIMS; INCLUDING CLAIMS NOT COVERED BY A GUARANTY ASSOCIATION.] All claims under policies or contracts of coverage for losses incurred including third party claims, and all claims against the insurer for liability for bodily injury or for injury to or destruction of tangible property which are not under policies or contracts. All claims under life insurance and annuity policies, including funding agreements issued pursuant to section 61A.276, whether for death proceeds, annuity proceeds, or investment values, shall be treated
as loss claims. That portion of any loss for which indemnification is provided by other benefits or advantages recovered or recoverable by the claimant shall not be included in this class, other than benefits or advantages recovered or recoverable in discharge of familial obligations of support or by way of succession at death or as proceeds of life insurance, or as gratuities. No payment made by an employer to an employee shall be treated as a gratuity. Claims not covered by a guaranty association are loss claims.
Sec. 7. Minnesota Statutes 2000, section 60L.01, is amended by adding a subdivision to read:
Subd. 13a. [REPLICATED INVESTMENT POSITION.] "Replicated investment position" means the statement value of the position reported under the heading "Replicated (Synthetic) Asset" on Schedule DB, Part F, of the annual statement of the insurer, or any successor provision.
Sec. 8. Minnesota Statutes 2000, section 60L.01, subdivision 14, is amended to read:
Subd. 14. [REPLICATION TRANSACTION.] "Replication" "Replication transaction"
means a derivative transaction involving one or more derivative instruments being used to modify the cash flow
characteristics of one or more investments held by an insurer in a manner so that the aggregate cash flows of the
derivative instruments and investments reproduce the cash flows of another investment having a higher risk-based
capital charge than the risk-based capital charge of the original investments or investments that is intended
to replicate the performance of one or more assets that an insurer is authorized to acquire under sections 60L.01 to
60L.15. A derivative transaction that is entered into as a hedging transaction is not considered a replication
transaction.
Sec. 9. Minnesota Statutes 2000, section 60L.08, is amended by adding a subdivision to read:
Subd. 7. [REPLICATION TRANSACTIONS.] (a) An insurer engaging in replication transactions shall include all replicated investment positions in calculating compliance with the limitations on investments contained in this section. So long as the insurer so complies with the limitations on investments contained in this section, then the insurer may count a replication transaction and any related investment of the insurer for the purposes specified in section 60L.11, to the extent the insurer has appropriately assigned the transaction or other investment to an investment class authorized in section 60L.07. An insurer shall not otherwise count replicated investment positions for the purposes specified in section 60L.11.
(b) If an investment position of the insurer includes a replicated investment position and exceeds an applicable limitation contained in this section, then the insurer may allocate part or all of the replicated investment position as follows for the purposes of calculating compliance with the limitations on investments and other requirements contained in sections 60L.01 to 60L.15: to the extent an insurer owns assets in excess of its minimum asset requirement, the insurer may deem a replicated investment position to be among such excess assets, but only to the extent that the replicated investment position does not cause the total positions represented by such excess assets to be greater than the total positions represented by such excess assets as would be permitted in the absence of the replicated investment position.
Sec. 10. Minnesota Statutes 2000, section 60L.10, subdivision 1, is amended to read:
Subdivision 1. [PROHIBITIONS.] An insurer may not invest in investments that are prohibited for an insurer
by law. The use of a derivative instrument for replication, or for any purposes other than hedging
or, income generation, or replication is prohibited.
Sec. 11. Minnesota Statutes 2000, section 61A.276, subdivision 2, is amended to read:
Subd. 2. [ISSUANCE.] The funding agreements may be issued to: (1) individuals; or (2) persons authorized by a state or foreign country to engage in an insurance business or subsidiaries or affiliates of these persons; or (3) entities other than individuals and other than persons authorized to engage in an insurance business, and subsidiaries and affiliates of these persons, for the following purposes: (i) to fund benefits under any employee benefit plan as defined in the Employee Retirement Income Security Act of 1974, as now or hereafter amended, maintained in the
United States or in a foreign country; (ii) to fund the activities of any organization exempt from taxation under
section 501(c) of the Internal Revenue Code of 1986, as amended through December 31, 1992, or of any similar
organization in any foreign country; (iii) to fund any program of any state, foreign country or political subdivision
thereof, or any agency or instrumentality thereof; (iv) to fund any agreement providing for periodic payments in
satisfaction of a claim; or (v) to fund a program of a financial an institution limited to banks,
thrifts, credit unions, and investment companies registered under the Investment Company Act of 1940. No funding
agreement shall be issued in an amount less than $1,000,000 that has assets in excess of $25,000,000.
No funding agreement shall be issued in an amount less than $1,000,000.
Sec. 12. Minnesota Statutes 2000, section 61A.28, subdivision 6, is amended to read:
Subd. 6. [STOCKS, OBLIGATIONS, AND OTHER INVESTMENTS.] (a) Common stocks, common stock
equivalents, or securities convertible into common stock or common stock equivalents of a business entity organized
under the laws of the United States or any state thereof, or the Dominion of Canada or any province thereof, if
the net earnings of the business entity after the elimination of extraordinary nonrecurring items of income and
expense and before income taxes and fixed charges over the five immediately preceding completed fiscal years, or
its period of existence if less than five years, has averaged not less than 1-1/4 times its average annual fixed charges
applicable to the period.
(b) Preferred stock of, or common or preferred stock guaranteed as to dividends by a business entity organized under the laws of the United States or any state thereof, or the Dominion of Canada or any province thereof, under the following conditions: (1) No investment may be made under this paragraph in a stock upon which any dividend, current or cumulative, is in arrears; (2) the company may not invest in stocks under this paragraph and in common stocks under paragraph (a) if the investment causes the company's aggregate investments in the common or preferred stocks to exceed 25 percent of the company's total admitted assets, provided that no more than 20 percent of the company's admitted assets may be invested in common stocks under paragraph (a); and (3) the company may not invest in any preferred stock or common stock guaranteed as to dividends, which is rated in the four lowest categories established by the securities valuation office of the National Association of Insurance Commissioners, if the investment causes the company's aggregate investment in the lower rated preferred or common stock guaranteed as to dividends to exceed five percent of its total admitted assets.
(c) Warrants, options, and rights to purchase stock if the stock, at the time of the acquisition of the warrant, option, or right to purchase, would qualify as an investment under paragraph (a) or (b), whichever is applicable. A company shall not invest in a warrant, option, or right to purchase stock if, upon purchase and immediate exercise thereof, the acquisition of the stock violates any of the concentration limitations contained in paragraphs (a) and (b).
(d) In addition to amounts that may be invested under subdivision 8 and without regard to the percentage
limitation applicable to stocks, warrants, options, and rights to purchase, the securities of any face amount certificate
company, unit investment trust, or management type investment company, registered or in the process of registration
under the Investment Company Act of 1940 as from time to time amended. In addition, the company may transfer
assets into one or more of its separate accounts for the purpose of establishing, or supporting its contractual
obligations under, the accounts in accordance with the provisions of sections 61A.13 to 61A.21. A company may
not invest in a security authorized under this paragraph if the investment causes the company's aggregate investments
in the securities to exceed five ten percent of its total admitted assets, except that for a health service
plan corporation operating under chapter 62C, and for a health maintenance organization operating under chapter
62D, the company's aggregate investments may not exceed 20 percent of its total admitted assets. No more than five
percent of the allowed investment by health service plan corporations or health maintenance organizations may be
invested in funds that invest in assets not backed by the federal government. When investing in money market
mutual funds, nonprofit health service plans regulated under chapter 62C, and health maintenance organizations
regulated under chapter 62D, shall establish a trustee custodial account for the transfer of cash into the money market
mutual fund.
(e) Investment grade obligations that are:
(1) bonds, obligations, notes, debentures, repurchase agreements, or other evidences of indebtedness of a business entity, organized under the laws of the United States or any state thereof, or the Dominion of Canada or any province thereof; and
(2) rated in one of the four highest rating categories by at least one nationally recognized statistical rating organization, or are rated in one of the two highest categories established by the securities valuation office of the National Association of Insurance Commissioners.
(f) Noninvestment grade obligations: A company may acquire noninvestment grade obligations as defined in subclause (i) (hereinafter noninvestment grade obligations) which meet the earnings test set forth in subclause (ii). A company may not acquire a noninvestment grade obligation if the acquisition will cause the company to exceed the limitations set forth in subclause (iii).
(i) A noninvestment grade obligation is an obligation of a business entity, organized under the laws of the United States or any state thereof, or the Dominion of Canada or any province thereof, that is not rated in one of the four highest rating categories by at least one nationally recognized statistical rating organization, or is not rated in one of the two highest categories established by the securities valuation office of the National Association of Insurance Commissioners.
(ii) Noninvestment grade obligations authorized by this subdivision may be acquired by a company if the business entity issuing or assuming the obligation, or the business entity securing or guaranteeing the obligation, has had net earnings after the elimination of extraordinary nonrecurring items of income and expense and before income taxes and fixed charges over the five immediately preceding completed fiscal years, or its period of existence of less than five years, has averaged not less than 1-1/4 times its average annual fixed charges applicable to the period; provided, however, that if a business entity issuing or assuming the obligation, or the business entity securing or guaranteeing the obligation, has undergone an acquisition, recapitalization, or reorganization within the immediately preceding 12 months, or will use the proceeds of the obligation for an acquisition, recapitalization, or reorganization, then such business entity shall also have, on a pro forma basis, for the next succeeding 12 months, net earnings averaging 1-1/4 times its average annual fixed charges applicable to such period after elimination of extraordinary nonrecurring items of income and expense and before taxes and fixed charges; no investment may be made under this section upon which any interest obligation is in default.
(iii) Limitation on aggregate interest in noninvestment grade obligations. A company may not invest in a noninvestment grade obligation if the investment will cause the company's aggregate investments in noninvestment grade obligations to exceed the applicable percentage of admitted assets set forth in the following table:
Percentage of
Effective Date Admitted Assets
January 1, 1992 20
January 1, 1993 17.5
January 1, 1994 15
Nothing in this paragraph limits the ability of a company to invest in noninvestment grade obligations as provided under subdivision 12.
(g) Obligations for the payment of money under the following conditions: (1) The obligation must be secured, either solely or in conjunction with other security, by an assignment of a lease or leases on property, real or personal; (2) the lease or leases must be nonterminable by the lessee or lessees upon foreclosure of any lien upon the leased property; (3) the rents payable under the lease or leases must be sufficient to amortize at least 90 percent of the obligation during the primary term of the lease; and (4) the lessee or lessees under the lease or leases, or a governmental entity or business entity, organized under the laws of the United States or any state thereof, or the Dominion of Canada, or any province thereof, that has assumed or guaranteed any lessee's performance thereunder, must be a governmental entity or business entity whose obligations would qualify as an investment under subdivision 2 or paragraph (e) or (f). A company may acquire leases assumed or guaranteed by a noninvestment grade lessee unless the value of the lease, when added to the other noninvestment grade obligations owned by the company, exceeds 15 percent of the company's admitted assets.
(h) A company may sell call options against stocks or other securities owned by the company and may purchase call options in a closing transaction against a call option previously written by the company. In addition to the authority granted by paragraph (c), to the extent and on the terms and conditions the commissioner determines to be consistent with the purposes of this chapter, a company may purchase or sell other exchange-traded call options, and may sell or purchase exchange-traded put options.
(i) A company may not invest in a security or other obligation authorized under this subdivision if the investment, valued at cost at the date of purchase, causes the company's aggregate investment in any one business entity to exceed two percent of the company's admitted assets.
(j) For nonprofit health service plan corporations regulated under chapter 62C, and for health maintenance organizations regulated under chapter 62D, a company may invest in commercial paper rated in one of the two highest rating categories by at least one nationally recognized statistical rating organization, or rated in one of the two highest categories established by the securities valuation office of the National Association of Insurance Commissioners, if the investment, valued at cost at the date of purchase, does not cause the company's aggregate investment in any one business entity to exceed six percent of the company's admitted assets.
Sec. 13. Minnesota Statutes 2000, section 61A.28, is amended by adding a subdivision to read:
Subd. 14. [REPLICATION TRANSACTIONS.] An insurer engaging in replication transactions shall include all replicated investment positions in calculating compliance with the limitations on investments applicable to the insurer. Replication transactions are permitted only under the authority of subdivision 12. For these purposes, "replication transaction" means a derivative transaction that is intended to replicate the performance of one or more assets that an insurer is authorized to acquire under applicable law. A derivative transaction that either is authorized by subdivision 6, 8, or 9a or section 61A.29, subdivision 2, paragraph (d), or is entered into as a hedging transaction shall not be considered a replication transaction. "Replicated investment position" means the statement value of the position reported under the heading "Replicated (Synthetic) Asset" on Schedule DB, Part F, of the annual statement of the insurer, or any successor provision.
Sec. 14. Minnesota Statutes 2000, section 61A.29, subdivision 2, is amended to read:
Subd. 2. [AUTHORIZED INVESTMENTS.] A company may invest in (i) foreign assets denominated in United States dollars; (ii) foreign assets denominated in foreign currency; and (iii) United States assets denominated in foreign currency. The investments may be made in any combination of the following:
(a) Obligations of sovereign governments and political subdivisions thereof and obligations issued or fully guaranteed by a supranational bank or organization, other than those described in section 61A.28, subdivision 2, paragraph (e), provided that the obligations are rated in one of the two highest rating categories by at least one nationally recognized statistical rating organization in the United States. For purposes of this section, "supranational bank" means a bank owned by a number of sovereign nations and engaging in international borrowing and lending.
(b) Obligations of a foreign business entity, provided that the obligation (i) is rated in one of the four highest rating categories by at least one nationally recognized statistical rating organization in the United States or by a similarly recognized statistical rating organization, as approved by the commissioner, in the country where the investment is made; or (ii) is rated in one of the two highest categories established by the securities valuation office of the National Association of Insurance Commissioners.
(c) Stock or stock equivalents issued by a foreign entity if the stock or stock equivalents are regularly traded on
the Frankfurt, London, Paris, or Tokyo stock exchange or any similar securities exchange as may be approved from
time to time by the commissioner and subject to oversight by the government of the country in which the
exchange is located regular trading occurs.
(d) Financial transactions for the sole purpose of managing the foreign currency risk of investments made under this subdivision, provided that the financial transactions are entered into under a detailed plan maintained by the company. For purposes of this paragraph, "financial transactions" include, but are not limited to, the purchase or sale of currency swaps, forward agreements, and currency futures.
Sec. 15. [61A.321] [GUARANTY FUNDS.]
(a) A domestic mutual life insurance company may be formed with, or an existing domestic mutual life insurance company may establish, a guaranty fund divided into certificates of $10 each, or multiples thereof, and this guaranty fund shall be invested in the same manner as is provided for the investment of capital stock of insurance companies.
(b) The certificate holders of the guaranty fund are entitled to an annual dividend of not more than ten percent on their respective certificates, if the net profits or unused premiums left after all losses, expenses, or liabilities then incurred, with reserves for reinsurance, are provided for, are sufficient to pay the annual dividend. If the dividends in any one year are less than ten percent, the difference may be made up in any subsequent year or years from the net profits. Approval of the commissioner must be obtained before accrual for or payment of the dividend, or any repayment of principal.
(c) The guaranty fund must be applied to the payment of losses and expenses when necessary, and, if the guaranty fund is impaired, the directors may make good the whole or any part of the impairment from future profits of the company, but no dividend shall be paid on guaranty fund certificates while the guaranty fund is impaired. The holder of the guaranty fund certificate is not liable for any more than the amount of the certificate which has not been paid in, and this amount must be plainly and legibly stated on the face of the certificate.
(d) Notwithstanding any other provision of law, each certificate holder of record is entitled to one vote in person or by proxy in any meeting of the members of the company for each $10 investment in guaranty fund certificates.
(e) The guaranty fund may be reduced or retired by vote of the policyholders of the company and the assent of the commissioner, if the net assets of the company above its reinsurance reserve and all other claims and obligations and the amount of its guaranty fund certificates and interest on the certificates for two years last preceding and including the date of its last annual statement are not less than 50 percent of the premiums in force. Due notice of this proposed action on the part of the company shall be mailed to each policyholder of the company not less than 30 days before the meeting when the action may be taken.
(f) In domestic mutual life insurance companies with a guaranty fund, the certificate holders shall be entitled to choose and elect from among their own number or from among the policyholders at least one-half or more of the total number of directors.
(g) If any domestic mutual life insurance company with a guaranty fund ceases to do business, it shall not divide among its certificate holders any part of its assets or guaranty fund until all its debts and obligations have been paid or canceled.
(h) Foreign mutual life insurance companies having a guaranty fund shall not be required to make their certificate of guaranty fund conform to the provisions of this section, but when the certificates do not conform with this section, the amount of the guaranty fund shall be charged as a liability.
Sec. 16. Minnesota Statutes 2000, section 79.56, subdivision 3, is amended to read:
Subd. 3. [PENALTIES.] (a) Any insurer using a rate or a rating plan which has not been filed shall be subject to a fine of up to $100 for each day the failure to file continues. The commissioner may, after a hearing on the record, find that the failure is willful. A willful failure to meet filing requirements shall be punishable by a fine of up to $500 for each day during which a willful failure continues. These penalties shall be in addition to any other penalties provided by law.
(b) Notwithstanding this subdivision, an employer that generates $500,000 $250,000
in annual written workers' compensation premium under the rates and rating plan of an insurer before the application
of any large deductible rating plans, may be written by that insurer using rates or rating plans that are not subject
to disapproval but which have been filed. The $500,000 threshold shall be increased on January 1, 1996, and
on each January 1 thereafter by the percentage increase in the statewide average weekly wage, to the nearest $1,000.
The commissioner shall advise insurers licensed to write workers' compensation insurance in this state of the annual
threshold adjustment."
Delete the title and insert:
"A bill for an act relating to insurance; regulating liquidations and investments of insurers; regulating consolidated or combined financial statements and annuities purchased to finance structured settlement agreements; authorizing domestic mutual life companies to be formed with or establish guaranty funds; regulating certain workers compensation rates and rating plans; amending Minnesota Statutes 2000, sections 60A.11, subdivision 10, by adding a subdivision; 60A.129, subdivision 5; 60B.44, subdivision 4; 60L.01, subdivision 14, by adding a subdivision; 60L.08, by adding a subdivision; 60L.10, subdivision 1; 61A.276, subdivision 2; 61A.28, subdivision 6, by adding a subdivision; 61A.29, subdivision 2; 79.56, subdivision 3; proposing coding for new law in Minnesota Statutes, chapters 60A; 61A."
The motion prevailed and the amendment was adopted.
S. F. No. 1610, A bill for an act relating to insurance; regulating liquidations and investments of insurers; amending Minnesota Statutes 2000, sections 60A.11, subdivision 10, by adding a subdivision; 60B.44, subdivision 4; 60L.01, subdivision 14, by adding a subdivision; 60L.08, by adding a subdivision; 60L.10, subdivision 1; 61A.276, subdivision 2; 61A.28, subdivision 6, by adding a subdivision; 61A.29, subdivision 2.
The bill was read for the third time, as amended, and placed upon its final passage.
The question was taken on the passage of the bill and the roll was called. There were 132 yeas and 0 nays as follows:
Those who voted in the affirmative were:
The bill was passed, as amended, and its title agreed to.
H. F. No. 1541, A bill for an act relating to landlords and tenants; requiring a study of rental application fees.
The bill was read for the third time and placed upon its final passage.
The question was taken on the passage of the bill and the roll was called. There were 117 yeas and 14 nays as follows:
Those who voted in the affirmative were:
| Abeler | Dorman | Holsten | Lieder | Osskopp | Stang | |
| Abrams | Dorn | Howes | Lindner | Osthoff | Swapinski | |
| Anderson, B. | Entenza | Huntley | Lipman | Otremba | Swenson | |
| Anderson, I. | Erhardt | Jacobson | Luther | Ozment | Sykora | |
| Bakk | Evans | Jaros | Mahoney | Paymar | Thompson | |
| Bernardy | Finseth | Jennings | Mares | Pelowski | Tingelstad | |
| Biernat | Folliard | Johnson, R. | Mariani | Penas | Tuma | |
| Bishop | Fuller | Johnson, S. | Marko | Peterson | Wagenius | |
| Boudreau | Gerlach | Juhnke | Marquart | Pugh | Walker | |
| Bradley | Gleason | Kahn | McElroy | Rhodes | Walz | |
| Carlson | Goodno | Kalis | McGuire | Rifenberg | Wasiluk | |
| Cassell | Gray | Kelliher | Milbert | Rukavina | Wenzel | |
| Clark, J. | Greiling | Knoblach | Molnau | Ruth | Westrom | |
| Daggett | Gunther | Koskinen | Mulder | Schumacher | Winter | |
| Davids | Haas | Kubly | Mullery | Seagren | Wolf | |
| Davnie | Hackbarth | Kuisle | Murphy | Skoe | Workman | |
| Dawkins | Harder | Larson | Ness | Skoglund | Spk. Sviggum | |
| Dehler | Hausman | Leighton | Nornes | Slawik | ||
| Dempsey | Hilstrom | Lenczewski | Olson | Solberg | ||
| Dibble | Hilty | Leppik | Opatz | Stanek | ||
Those who voted in the negative were:
| Buesgens | Holberg | Krinkie | Seifert | Westerberg | Wilkin | |
| Eastlund | Johnson, J. | Paulsen | Smith | |||
| Erickson | Kielkucki | Pawlenty | Vandeveer | |||
The bill was passed and its title agreed to.
S. F. No. 970 was reported to the House.
Davids moved to amend S. F. No. 970 as follows:
Page 2, line 8, after "plus" insert "the lesser of" and before the period, insert "or eight cents"
The motion prevailed and the amendment was adopted.
Sykora moved to amend S. F. No. 970, as amended, as follows:
Page 1, after line 7, insert:
"Section 1. Minnesota Statutes 2000, section 8.31, subdivision 1, is amended to read:
Subdivision 1. [INVESTIGATE OFFENSES AGAINST THE PROVISIONS OF CERTAIN DESIGNATED
SECTIONS; ASSIST IN ENFORCEMENT.] The attorney general shall must actively and
thoroughly investigate violations of the law of this state respecting unfair, discriminatory, and other unlawful
practices in business, commerce, or trade, and specifically, but not exclusively, the Nonprofit Corporation Act
(sections 317A.001 to 317A.909), the Act Against Unfair Discrimination and Competition (sections 325D.01 to
325D.07), the Unlawful Trade Practices Act (sections 325D.09 to 325D.16), the Antitrust Act (sections 325D.49 to
325D.66), section 325F.67 and other laws against false or fraudulent advertising, the antidiscrimination acts
contained in section 325D.67, the act against monopolization of food products (section 325D.68), the act against
unlawful gasoline sales (section 325D.071), the act regulating telephone advertising services (section 325E.39),
the Prevention of Consumer Fraud Act (sections 325F.68 to 325F.70), and chapter 53A regulating currency
exchanges and, assist in the enforcement of, and prosecute in the name of the state of Minnesota
any action or suit to enforce those laws as in this section provided. The attorney general must conduct
public service campaigns for the purpose of educating the public about those laws provided in this section and for
the purpose of soliciting complaints from the public regarding possible violations of those laws."
Page 2, line 26, delete everything after "325D.04"
Page 2, line 27, delete everything before "In"
Renumber the sections in sequence and correct the internal references
Amend the title accordingly
The motion did not prevail and the amendment was not adopted.
Bradley moved to amend S. F. No. 970, as amended, as follows:
Page 2, line 8, delete everything after "fees" and insert a period
A roll call was requested and properly seconded.
The question was taken on the Bradley amendment and the roll was called. There were 51 yeas and 79 nays as follows:
Those who voted in the affirmative were:
Those who voted in the negative were:
| Anderson, I. | Evans | Huntley | Lieder | Otremba | Tuma | |
| Bakk | Finseth | Jaros | Luther | Ozment | Vandeveer | |
| Bishop | Folliard | Jennings | Mahoney | Paymar | Wagenius | |
| Cassell | Fuller | Johnson, R. | Mares | Pelowski | Walker | |
| Daggett | Gleason | Johnson, S. | Mariani | Peterson | Walz | |
| Davids | Goodwin | Juhnke | Marko | Pugh | Wasiluk | |
| Davnie | Greiling | Kahn | Marquart | Rifenberg | Wenzel | |
| Dawkins | Gunther | Kalis | McGuire | Rukavina | Westrom | |
| Dehler | Haas | Kelliher | Murphy | Schumacher | Winter | |
| Dibble | Hackbarth | Koskinen | Ness | Skoe | ||
| Dorn | Harder | Kubly | Olson | Solberg | ||
| Eastlund | Hilstrom | Larson | Opatz | Stang | ||
| Entenza | Hilty | Leighton | Osskopp | Swapinski | ||
| Erickson | Holsten | Lenczewski | Osthoff | Swenson | ||
The motion did not prevail and the amendment was not adopted.
S. F. No. 970, as amended, was read for the third time.
Abeler was excused between the hours of 1:05 p.m. and 2:35 p.m.
On the motion of Pawlenty and on the demand of 10 members, a call of the House was ordered. The following members answered to their names:
Pawlenty moved that further proceedings of the roll call be suspended and that the Sergeant at Arms be instructed to bring in the absentees. The motion prevailed and it was so ordered.
S. F. No. 970, A bill for an act relating to trade regulations; prohibiting gasoline sales below cost; providing enforcement authority; amending Minnesota Statutes 2000, section 325D.01, subdivision 5, and by adding subdivisions; proposing coding for new law in Minnesota Statutes, chapter 325D.
The bill, as amended, was placed upon its final passage.
The question was taken on the passage of the bill and the roll was called. There were 85 yeas and 46 nays as follows:
Those who voted in the affirmative were:
| Anderson, I. | Eastlund | Hilty | Leighton | Otremba | Swenson | |
| Bakk | Entenza | Holberg | Lenczewski | Ozment | Tingelstad | |
| Biernat | Erickson | Holsten | Lieder | Paymar | Tuma | |
| Bishop | Evans | Howes | Lipman | Pelowski | Vandeveer | |
| Cassell | Finseth | Huntley | Mahoney | Penas | Walker | |
| Clark, J. | Fuller | Jaros | Mares | Peterson | Wasiluk | |
| Clark, K. | Gleason | Jennings | Mariani | Pugh | Wenzel | |
| Daggett | Gray | Johnson, R. | Marko | Rifenberg | Westrom | |
| Davids | Greiling | Johnson, S. | Marquart | Rukavina | Winter | |
| Davnie | Gunther | Juhnke | McGuire | Schumacher | Workman | |
| Dawkins | Haas | Kalis | Murphy | Skoe | ||
| Dehler | Hackbarth | Kelliher | Ness | Slawik | ||
| Dempsey | Harder | Koskinen | Olson | Solberg | ||
| Dibble | Hausman | Kubly | Opatz | Stang | ||
| Dorn | Hilstrom | Larson | Osskopp | Swapinski | ||
Those who voted in the negative were:
| Abrams | Erhardt | Knoblach | Molnau | Ruth | Wagenius | |
| Anderson, B. | Gerlach | Krinkie | Mulder | Seagren | Walz | |
| Bernardy | Goodno | Kuisle | Mullery | Seifert | Westerberg | |
| Boudreau | Goodwin | Leppik | Nornes | Skoglund | Wilkin | |
| Bradley | Jacobson | Lindner | Osthoff | Smith | Wolf | |
| Buesgens | Johnson, J. | Luther | Paulsen | Stanek | Spk. Sviggum | |
| Carlson | Kahn | McElroy | Pawlenty | Sykora | ||
| Dorman | Kielkucki | Milbert | Rhodes | Thompson | ||
The bill was passed, as amended, and its title agreed to.
CALL OF THE HOUSE LIFTED
Pugh moved that the call of the House be suspended. The motion prevailed and it was so ordered.
S. F. No. 2031 was reported to the House.
Bakk and Rukavina moved to amend S. F. No. 2031 as follows:
Page 2, after line 14, insert:
"Sec. 2. Minnesota Statutes 2000, section 16A.124, subdivision 1, is amended to read:
Subdivision 1. [DEFINITIONS.] For the purposes of this section, the following terms have the meanings here given them.
(a) "Commissioner" means the commissioner of finance.
(b) "State agency" has the meaning assigned to it in section 16B.01 and, in addition, includes the University of Minnesota.
Sec. 3. Minnesota Statutes 2000, section 16C.02, subdivision 2, is amended to read:
Subd. 2. [AGENCY.] "Agency" means any state officer, employee, board, commission, authority, department, entity, or organization of the executive branch of state government.
Unless specifically provided elsewhere in this chapter, agency "agency" does not include the
Minnesota state colleges and universities. Except as specifically provided elsewhere in this chapter, "agency"
does include the University of Minnesota for the purposes of contracts the university proposes to enter into where
funds appropriated by the legislature will be expended in connection with those contracts.
Sec. 4. Minnesota Statutes 2000, section 16C.25, is amended to read:
16C.25 [BUILDING AND CONSTRUCTION CONTRACTS.]
(a) Notwithstanding any contrary law, the provisions of Minnesota Statutes 1996, section 16B.07, 16B.08, 16B.09, and all other laws applicable to competitive bidding for building and construction contracts on June 30, 1998, apply to building and construction contracts entered into on or after July 1, 1998.
(b) Paragraph (a) applies to all projects undertaken by the University of Minnesota involving the demolition of, or construction of improvements to, real property."
Page 2, line 15, delete "2" and insert "5"
Amend the title as follows:
Page 1, line 3, after the semicolon, insert "extending competitive bidding and prompt payment requirements to the University of Minnesota; amending Minnesota Statutes 2000, sections 16A.124, subdivision 1; 16C.02, subdivision 2; 16C.25;"
The motion did not prevail and the amendment was not adopted.
S. F. No. 2031, A bill for an act relating to contracts; regulating public works contracts; proposing coding for new law in Minnesota Statutes, chapter 15.
The bill was read for the third time and placed upon its final passage.
The question was taken on the passage of the bill and the roll was called. There were 133 yeas and 0 nays as follows:
Those who voted in the affirmative were:
| Abrams | Eastlund | Howes | Lindner | Paulsen | Swenson | |
| Anderson, B. | Entenza | Huntley | Lipman | Pawlenty | Sykora | |
| Anderson, I. | Erhardt | Jacobson | Luther | Paymar | Thompson | |
| Bakk | Erickson | Jaros | Mahoney | Pelowski | Tingelstad | |
| Bernardy | Evans | Jennings | Mares | Penas | Tuma | |
| Biernat | Finseth | Johnson, J. | Mariani | Peterson | Vandeveer | |
| Bishop | Folliard | Johnson, R. | Marko | Pugh | Wagenius | |
| Boudreau | Fuller | Johnson, S. | Marquart | Rhodes | Walker | |
| Bradley | Gerlach | Juhnke | McElroy | Rifenberg | Walz | |
| Buesgens | Gleason | Kahn | McGuire | Rukavina | Wasiluk | |
| Carlson | Goodno | Kalis | Milbert | Ruth | Wenzel | |
| Cassell | Goodwin | Kelliher | Molnau | Schumacher | Westerberg | |
| Clark, J. | Gray | Kielkucki | Mulder | Seagren | Westrom | |
| Clark, K. | Greiling | Knoblach | Mullery | Seifert | Wilkin | |
| Daggett | Gunther | Koskinen | Murphy | Sertich | Winter | |
| Davids | Haas | Krinkie | Ness | Skoe | Wolf | |
| Davnie | Hackbarth | Kubly | Nornes | Skoglund | Workman | |
| Dawkins | Harder | Kuisle | Olson | Slawik | Spk. Sviggum | |
| Dehler | Hausman | Larson | Opatz | Smith | ||
| Dempsey | Hilstrom | Leighton | Osskopp | Solberg | ||
| Dibble | Hilty | Lenczewski | Osthoff | Stanek | ||
| Dorman | Holberg | Leppik | Otremba | Stang | ||
| Dorn | Holsten | Lieder | Ozment | Swapinski | ||
The bill was passed and its title agreed to.
S. F. No. 1215 was reported to the House.
Holberg moved to amend S. F. No. 1215 as follows:
Delete everything after the enacting clause and insert the following language of H. F. No. 767, the first engrossment:
"Section 1. Minnesota Statutes 2000, section 363.01, is amended by adding a subdivision to read:
Subd. 7a. [CLOSED INTAKE FILE.] "Closed intake file" means a file containing human rights investigative data in which a charge of discrimination was not filed. The human rights investigative data contained in the closed intake file; the records made by the department of the department's contact with a potential charging party; and all other data that identify the potential charging party, witnesses, and potential respondents are confidential or protected nonpublic data.
Sec. 2. Minnesota Statutes 2000, section 363.01, subdivision 21, is amended to read:
Subd. 21. [HUMAN RIGHTS INVESTIGATIVE DATA.] "Human rights investigative data" means written documents issued or gathered, whether solicited or unsolicited, by the department for the purpose of determining whether to draft or file a charge of discrimination or for the purpose of investigating and prosecuting alleged or suspected discrimination.
Sec. 3. Minnesota Statutes 2000, section 363.01, subdivision 41, is amended to read:
Subd. 41. [SEXUAL HARASSMENT.] "Sexual harassment" includes unwelcome sexual advances, requests for sexual favors, sexually motivated physical contact or other verbal or physical conduct or communication of a sexual nature when:
(1) submission to that conduct or communication is made a term or condition, either explicitly or implicitly, of obtaining employment, public accommodations or public services, education, or housing;
(2) submission to or rejection of that conduct or communication by an individual is used as a factor in decisions affecting that individual's employment, public accommodations or public services, education, or housing; or
(3) that conduct or communication has the purpose or effect of substantially interfering with an individual's
employment, public accommodations or public services, education, or housing, or creating an intimidating, hostile,
or offensive employment, public accommodations, public services, educational, or housing environment; and in
the case of employment, the employer knows or should know of the existence of the harassment and fails to take
timely and appropriate action.
Sec. 4. Minnesota Statutes 2000, section 363.03, subdivision 8a, is amended to read:
Subd. 8a. [BUSINESS DISCRIMINATION.] It is an unfair discriminatory practice for a person engaged in a trade or business or in the provision of a service:
(a) to refuse to do business with or provide a service to a woman based on her use of her current or former surname; or
(b) to impose, as a condition of doing business with or providing a service to a woman, that a woman use her current surname rather than a former surname; or
(c) intentionally to intentionally refuse to do business with, to refuse to contract with, or to
discriminate in the basic terms, conditions, or performance of the contract because of a person's race, national
origin, color, sex, sexual orientation, or disability, unless the alleged refusal or discrimination is because of a
legitimate business purpose.
Nothing in this subdivision shall prohibit positive action plans.
Sec. 5. Minnesota Statutes 2000, section 363.06, subdivision 4, is amended to read:
Subd. 4. [INQUIRY INTO CHARGE.] (1) Consistent with clause (7), the commissioner shall promptly inquire into the truth of the allegations of the charge. The commissioner shall make an immediate inquiry when a charge alleges actual or threatened physical violence. The commissioner shall also make an immediate inquiry when it appears that a charge is frivolous or without merit and shall dismiss those charges.
The commissioner shall give priority to investigating and processing those charges, in the order below, which the commissioner determines have the following characteristics:
(a) there is evidence of irreparable harm if immediate action is not taken;
(b) there is evidence that the respondent has intentionally engaged in a reprisal;
(c) a significant number of recent charges have been filed against the respondent;
(d) the respondent is a government entity;
(e) there is potential for broadly promoting the policies of this chapter; or
(f) the charge is supported by substantial and credible documentation, witnesses, or other evidence.
The commissioner shall inform charging parties of these priorities and shall tell each party if their charge is a priority case or not.
On other charges the commissioner shall make a determination within 12 months after the charge was filed as to whether or not there is probable cause to credit the allegation of unfair discriminatory practices, and
(2) If the commissioner determines after investigation that no probable cause exists to credit the allegations of the
unfair discriminatory practice, the commissioner shall, within ten days of the determination, serve upon the charging
party and respondent written notice of the determination. Within ten days after receipt of notice, the charging party
may request in writing, on forms prepared by the department, that the commissioner reconsider the determination.
The request shall contain a brief statement of the reasons for and new evidence in support of the request for
reconsideration. At the time of submission of the request to the commissioner, the charging party shall deliver or
mail to the respondent a copy of the request for reconsideration. The commissioner shall either reaffirm
or, reverse, or vacate and remand for further consideration the determination of no
probable cause within 20 days after receipt of the request for reconsideration, and shall within ten days notify in
writing the charging party and respondent of the decision to reaffirm or, reverse, or vacate and
remand for further consideration.
A decision by the commissioner that no probable cause exists to credit the allegations of an unfair discriminatory practice shall not be appealed to the court of appeals pursuant to section 363.072 or sections 14.63 to 14.68.
(3) If the commissioner determines after investigation that probable cause exists to credit the allegations of unfair discriminatory practices, the commissioner shall serve on the respondent and the respondent's attorney if the respondent is represented by counsel, by first class mail, a notice setting forth a short plain written statement of the alleged facts which support the finding of probable cause and an enumeration of the provisions of law allegedly violated. If the commissioner determines that attempts to eliminate the alleged unfair practices through conciliation pursuant to subdivision 5 have been or would be unsuccessful or unproductive, the commissioner shall issue a complaint and serve on the respondent, by registered or certified mail, a written notice of hearing together with a copy of the complaint, requiring the respondent to answer the allegations of the complaint at a hearing before an administrative law judge at a time and place specified in the notice, not less than ten days after service of said complaint. A copy of the notice shall be furnished to the charging party and the attorney general.
(4) If, at any time after the filing of a charge, the commissioner has reason to believe that a respondent has engaged in any unfair discriminatory practice, the commissioner may file a petition in the district court in a county in which the subject of the complaint occurs, or in a county in which a respondent resides or transacts business, seeking appropriate temporary relief against the respondent, pending final determination of proceedings under this chapter, including an order or decree restraining the respondent from doing or procuring an act tending to render ineffectual an order the commissioner may enter with respect to the complaint. The court shall have power to grant temporary relief or a restraining order as it deems just and proper, but no relief or order extending beyond ten days shall be granted except by consent of the respondent or after hearing upon notice to the respondent and a finding by the court that there is reasonable cause to believe that the respondent has engaged in a discriminatory practice. Except as modified by this section, the Minnesota rules of civil procedure shall apply to an application, and the district court shall have authority to grant or deny the relief sought on conditions as it deems just and equitable. All hearings under this section shall be given precedence as nearly as practicable over all other pending civil actions.
(5) If a lessor, after engaging in a discriminatory practice defined in section 363.03, subdivision 2, clause (1)(a), leases or rents a dwelling unit to a person who has no knowledge of the practice or of the existence of a charge with respect to the practice, the lessor shall be liable for actual damages sustained by a person by reason of a final order as provided in this section requiring the person to be evicted from the dwelling unit.
(6) In any complaint issued under this section, the commissioner may seek relief for a class of individuals affected by an unfair discriminatory practice occurring on or after a date one year prior to the filing of the charge from which the complaint originates.
(7) The commissioner may adopt policies to determine which charges are processed and the order in which charges are processed based on their particular social or legal significance, administrative convenience, difficulty of resolution, or other standard consistent with the provisions of this chapter.
(8) The chief administrative law judge shall adopt policies to provide sanctions for intentional and frivolous delay caused by any charging party or respondent in an investigation, hearing, or any other aspect of proceedings before the department under this chapter.
Sec. 6. Minnesota Statutes 2000, section 363.061, subdivision 2, is amended to read:
Subd. 2. [ACCESS TO OPEN FILES.] (a) Except as otherwise provided in this subdivision, human rights investigative data contained in an open case file are confidential data on individuals or protected nonpublic data. If a verified charge of discrimination is filed, then the name and address of the charging party and respondent, factual basis of the allegations, and the statute under which the action is brought are private data on individuals or nonpublic data but are accessible to the charging party and the respondent.
(b) After making a finding of probable cause, the commissioner may make human rights investigative data
contained in an open case file accessible to a person, government agency, or the public if access will aid the
investigative and enforcement process. After a charge has been filed, the commissioner may disclose
information to persons as the commissioner deems necessary (1) to facilitate investigation or disposition of the
charge, or (2) to promote public health or safety. The commissioner may also disclose data about an open case file
to another governmental entity to assist that entity or the department in processing a complaint or to eliminate
duplication of efforts in the investigation of the same or similar facts as alleged in the charge. To the extent that data
are disclosed to other governmental entities, the data disclosed shall have the same classification in the possession
of the receiving entity as it had in the possession of the entity providing the data.
(c) After making a finding of probable cause, the commissioner may make human rights investigative data contained in an open case file accessible to a person, government agency, or the public if access will aid the investigative and enforcement process.
Sec. 7. Minnesota Statutes 2000, section 363.061, subdivision 3, is amended to read:
Subd. 3. [ACCESS TO CLOSED FILES.] (a) Except as otherwise provided in this subdivision, human rights investigative data contained in a closed case file are private data on individuals or nonpublic data. The name and address of the charging party and respondent, factual basis of the allegations, the statute under which the action is brought, the part of the summary of the investigation that does not contain identifying data on a person other than the complainant or respondent, and the commissioner's memorandum determining whether probable cause has been shown are public data. All data in a closed intake file, as defined in section 363.01, subdivision 7a, are either confidential data on individuals or protected nonpublic data.
(b) The commissioner may make human rights investigative data contained in a closed case file inaccessible to the charging party or the respondent in order to protect medical or other security interests of the parties or third persons."
Delete the title and insert:
"A bill for an act relating to human rights; changing provisions pertaining to business discrimination, and inquiry into a charge; permitting discretionary disclosure during investigation; amending Minnesota Statutes 2000, sections 363.01, subdivisions 21, 41, and by adding a subdivision; 363.03, subdivision 8a; 363.06, subdivision 4; and 363.061, subdivisions 2 and 3."
The motion prevailed and the amendment was adopted.
The Speaker called Abrams to the Chair.
Anderson, B.; Osskopp and Olson offered an amendment to S. F. No. 1215, as amended.
POINT OF ORDER
Pugh raised a point of order pursuant to rule 3.21 that the Anderson, B., et al amendment was not in order.
Pursuant to section 245 of "Mason's Manual of Legislative Procedure," Speaker pro tempore Abrams submitted the following question to the House: "Is it the judgment of the House that the Pugh point of order is well taken?"
It was the judgment of the House that the Pugh point of order was well taken and the Anderson, B., et al amendment was out of order.
S. F. No. 1215, A bill for an act relating to human rights; changing provisions pertaining to business discrimination and inquiry into a charge; permitting discretionary disclosure during investigation; amending Minnesota Statutes 2000, sections 363.01, subdivision 41; 363.03, subdivision 8a; 363.06, subdivision 4; 363.061, subdivision 2.
The bill was read for the third time, as amended, and placed upon its final passage.
The question was taken on the passage of the bill and the roll was called. There were 133 yeas and 0 nays as follows:
Those who voted in the affirmative were:
The bill was passed, as amended, and its title agreed to.
S. F. No. 1407 was reported to the House.
Walker moved to amend S. F. No. 1407 as follows:
Delete everything after the enacting clause and insert the following language of H. F. No. 1928, the first engrossment:
"Section 1. Minnesota Statutes 2000, section 245B.02, is amended by adding a subdivision to read:
Subd. 23a. [SUPPORTED EMPLOYMENT.] "Supported employment" services include individualized counseling, individualized job development and placement that produce an appropriate job match for the individual and the employer, on-the-job training in work and related work skills required for job performance, ongoing supervision and monitoring of the person's performance, long-term support services to assure job retention, training in related skills essential to obtaining and retaining employment such as the effective use of community resources, use of break and lunch areas, transportation and mobility training, and transportation between the individual's place of residence and the work place when other forms of transportation are unavailable or inaccessible.
Sec. 2. Minnesota Statutes 2000, section 245B.03, subdivision 1, is amended to read:
Subdivision 1. [APPLICABILITY.] The standards in this chapter govern services to persons with mental retardation or related conditions receiving services from license holders providing residential-based habilitation; day training and habilitation services for adults; supported employment; semi-independent living services; residential programs that serve more than four consumers, including intermediate care facilities for persons with mental retardation; and respite care provided outside the consumer's home for more than four consumers at the same time at a single site.
Sec. 3. Minnesota Statutes 2000, section 252.28, subdivision 3a, is amended to read:
Subd. 3a. [LICENSING EXCEPTION.] (a) Notwithstanding the provisions of subdivision 3, the commissioner may license service sites, each accommodating up to six residents moving from a 48-bed intermediate care facility for persons with mental retardation or related conditions located in Dakota county that is closing under section 252.292.
(b) Notwithstanding the provisions of any other state law or administrative rule, the rate provisions of section 256I.05, subdivision 1, apply to the exception in this subdivision.
(c) If a service site is licensed for six persons according to this subdivision, the capacity of the license may remain at six persons.
Sec. 4. Minnesota Statutes 2000, section 252.28, subdivision 3b, is amended to read:
Subd. 3b. [OLMSTED COUNTY LICENSING EXEMPTION.] (a) Notwithstanding subdivision 3, the commissioner may license service sites each accommodating up to five residents moving from a 43-bed intermediate care facility for persons with mental retardation or related conditions located in Olmsted county that is closing under section 252.292.
(b) Notwithstanding the provisions of any other state law or administrative rule, the rate provisions of section 256I.05, subdivision 1, apply to the exception in this subdivision.
(c) If a service site is licensed for five persons according to this subdivision, the capacity of the license may remain at five persons.
Sec. 5. Minnesota Statutes 2000, section 256B.056, subdivision 1a, is amended to read:
Subd. 1a. [INCOME AND ASSETS GENERALLY.] Unless specifically required by state law or rule or federal
law or regulation, the methodologies used in counting income and assets to determine eligibility for medical
assistance for persons whose eligibility category is based on blindness, disability, or age of 65 or more years, the
methodologies for the supplemental security income program shall be used. For families and children, which
includes all other eligibility categories, the methodologies under the state's AFDC plan in effect as of July 16, 1996,
as required by the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), Public
Law Number 104-193, shall be used. Effective upon federal approval, in-kind contributions to, and payments
made on behalf of, a recipient, by an obligor, in satisfaction of or in addition to a temporary or permanent order for
child support or maintenance, shall be considered income to the recipient. For these purposes, a "methodology"
does not include an asset or income standard, or accounting method, or method of determining effective dates.
Sec. 6. Minnesota Statutes 2000, section 256B.056, subdivision 5a, is amended to read:
Subd. 5a. [INDIVIDUALS ON FIXED OR EXCLUDED INCOME.] Recipients of medical assistance
who receive only fixed unearned or excluded income, where such when that income is
excluded from consideration as income or unvarying in amount and timing of receipt throughout the year,
shall report and verify their income annually.
Sec. 7. Minnesota Statutes 2000, section 256B.0595, subdivision 1, is amended to read:
Subdivision 1. [PROHIBITED TRANSFERS.] (a) For transfers of assets made on or before August 10, 1993, if a person or the person's spouse has given away, sold, or disposed of, for less than fair market value, any asset or interest therein, except assets other than the homestead that are excluded under the supplemental security program, within 30 months before or any time after the date of institutionalization if the person has been determined eligible for medical assistance, or within 30 months before or any time after the date of the first approved application for medical assistance if the person has not yet been determined eligible for medical assistance, the person is ineligible for long-term care services for the period of time determined under subdivision 2.
(b) Effective for transfers made after August 10, 1993, a person, a person's spouse, or any person, court, or administrative body with legal authority to act in place of, on behalf of, at the direction of, or upon the request of the person or person's spouse, may not give away, sell, or dispose of, for less than fair market value, any asset or interest therein, except assets other than the homestead that are excluded under the supplemental security income program, for the purpose of establishing or maintaining medical assistance eligibility. For purposes of determining eligibility for long-term care services, any transfer of such assets within 36 months before or any time after an institutionalized person applies for medical assistance, or 36 months before or any time after a medical assistance recipient becomes institutionalized, for less than fair market value may be considered. Any such transfer is presumed to have been made for the purpose of establishing or maintaining medical assistance eligibility and the person is
ineligible for long-term care services for the period of time determined under subdivision 2, unless the person furnishes convincing evidence to establish that the transaction was exclusively for another purpose, or unless the transfer is permitted under subdivision 3 or 4. Notwithstanding the provisions of this paragraph, in the case of payments from a trust or portions of a trust that are considered transfers of assets under federal law, any transfers made within 60 months before or any time after an institutionalized person applies for medical assistance and within 60 months before or any time after a medical assistance recipient becomes institutionalized, may be considered.
(c) This section applies to transfers, for less than fair market value, of income or assets, including assets that are considered income in the month received, such as inheritances, court settlements, and retroactive benefit payments or income to which the person or the person's spouse is entitled but does not receive due to action by the person, the person's spouse, or any person, court, or administrative body with legal authority to act in place of, on behalf of, at the direction of, or upon the request of the person or the person's spouse.
(d) This section applies to payments for care or personal services provided by a relative, unless the compensation was stipulated in a notarized, written agreement which was in existence when the service was performed, the care or services directly benefited the person, and the payments made represented reasonable compensation for the care or services provided. A notarized written agreement is not required if payment for the services was made within 60 days after the service was provided.
(e) This section applies to the portion of any asset or interest that a person, a person's spouse, or any person, court, or administrative body with legal authority to act in place of, on behalf of, at the direction of, or upon the request of the person or the person's spouse, transfers to any annuity that exceeds the value of the benefit likely to be returned to the person or spouse while alive, based on estimated life expectancy using the life expectancy tables employed by the supplemental security income program to determine the value of an agreement for services for life. The commissioner may adopt rules reducing life expectancies based on the need for long-term care.
(f) For purposes of this section, long-term care services include services in a nursing facility, services that are eligible for payment according to section 256B.0625, subdivision 2, because they are provided in a swing bed, intermediate care facility for persons with mental retardation, and home and community-based services provided pursuant to sections 256B.0915, 256B.092, and 256B.49. For purposes of this subdivision and subdivisions 2, 3, and 4, "institutionalized person" includes a person who is an inpatient in a nursing facility or in a swing bed, or intermediate care facility for persons with mental retardation or who is receiving home and community-based services under sections 256B.0915, 256B.092, and 256B.49.
(g) Effective for transfers made on or after July 1, 1995, or upon federal approval, whichever is later, a person,
a person's spouse, or any person, court, or administrative body with legal authority to act in place of, on behalf of,
at the direction of, or upon the request of the person or person's spouse, may not give away, sell, or dispose of, for
less than fair market value, any asset or interest therein, for the purpose of establishing or maintaining medical
assistance eligibility. For purposes of determining eligibility for long-term care services, any transfer of such assets
within 60 months before, or any time after, an institutionalized person applies for medical assistance, or 60 months
before, or any time after, a medical assistance recipient becomes institutionalized, for less than fair market value may
be considered. Any such transfer is presumed to have been made for the purpose of establishing or maintaining
medical assistance eligibility and the person is ineligible for long-term care services for the period of time determined
under subdivision 2, unless the person furnishes convincing evidence to establish that the transaction was exclusively
for another purpose, or unless the transfer is permitted under subdivision 3 or 4.
Sec. 8. Minnesota Statutes 2000, section 256B.0595, subdivision 2, is amended to read:
Subd. 2. [PERIOD OF INELIGIBILITY.] (a) For any uncompensated transfer occurring on or before August 10, 1993, the number of months of ineligibility for long-term care services shall be the lesser of 30 months, or the uncompensated transfer amount divided by the average medical assistance rate for nursing facility services in the state in effect on the date of application. The amount used to calculate the average medical assistance payment rate shall be adjusted each July 1 to reflect payment rates for the previous calendar year. The period of ineligibility begins with the month in which the assets were transferred. If the transfer was not reported to the local agency at the time
of application, and the applicant received long-term care services during what would have been the period of ineligibility if the transfer had been reported, a cause of action exists against the transferee for the cost of long-term care services provided during the period of ineligibility, or for the uncompensated amount of the transfer, whichever is less. The action may be brought by the state or the local agency responsible for providing medical assistance under chapter 256G. The uncompensated transfer amount is the fair market value of the asset at the time it was given away, sold, or disposed of, less the amount of compensation received.
(b) For uncompensated transfers made after August 10, 1993, the number of months of ineligibility for long-term care services shall be the total uncompensated value of the resources transferred divided by the average medical assistance rate for nursing facility services in the state in effect on the date of application. The amount used to calculate the average medical assistance payment rate shall be adjusted each July 1 to reflect payment rates for the previous calendar year. The period of ineligibility begins with the month in which the assets were transferred except that if one or more uncompensated transfers are made during a period of ineligibility, the total assets transferred during the ineligibility period shall be combined and a penalty period calculated to begin in the month the first uncompensated transfer was made. If the transfer was not reported to the local agency at the time of application, and the applicant received medical assistance services during what would have been the period of ineligibility if the transfer had been reported, a cause of action exists against the transferee for the cost of medical assistance services provided during the period of ineligibility, or for the uncompensated amount of the transfer, whichever is less. The action may be brought by the state or the local agency responsible for providing medical assistance under chapter 256G. The uncompensated transfer amount is the fair market value of the asset at the time it was given away, sold, or disposed of, less the amount of compensation received. Effective for transfers made on or after March 1, 1996, involving persons who apply for medical assistance on or after April 13, 1996, no cause of action exists for a transfer unless:
(1) the transferee knew or should have known that the transfer was being made by a person who was a resident of a long-term care facility or was receiving that level of care in the community at the time of the transfer;
(2) the transferee knew or should have known that the transfer was being made to assist the person to qualify for or retain medical assistance eligibility; or
(3) the transferee actively solicited the transfer with intent to assist the person to qualify for or retain eligibility for medical assistance.
(c) If a calculation of a penalty period results in a partial month, payments for long-term care services shall be reduced in an amount equal to the fraction, except that in calculating the value of uncompensated transfers, if the total value of all uncompensated transfers made in a month not included in an existing penalty period does not exceed $500, then such transfers shall be disregarded for each month prior to the month of application for or during receipt of medical assistance.
Sec. 9. Minnesota Statutes 2000, section 256B.0625, subdivision 9, is amended to read:
Subd. 9. [DENTAL SERVICES.] Medical assistance covers dental services. Dental services include, with prior
authorization, fixed cast metal restorations bridges that are cost-effective for persons who cannot
use removable dentures because of their medical condition.
Sec. 10. Minnesota Statutes 2000, section 256B.071, subdivision 2, is amended to read:
Subd. 2. [TECHNICAL ASSISTANCE TO PROVIDERS.] (a) The commissioner shall establish a technical
assistance program to require providers of services and equipment under this section to maximize collections from
the federal Medicare program. The technical assistance may include the provision of materials to help providers
determine those services and equipment likely to be reimbursed by Medicare. The technical assistance may also
include the provision of computer software to providers to assist in this process. The commissioner may expand the
technical assistance program to include providers of other services under this chapter.
(b) Any provider of home care services enrolled in the medical assistance program, or county public health nursing
agency responsible for personal care assessments, or county case managers for alternative care or medical assistance
waiver programs, is required to use the method developed and supplied by the department of human services for
determining Medicare coverage for home care equipment and services provided to dual entitlees to ensure
appropriate billing of Medicare. The method will be developed in two phases; the first phase is a manual system
effective July 1, 1996, and the second phase will automate the manual procedure by expanding the current Medicaid
Management Information System (MMIS) effective January 1, 1997. Both methods will determine Medicare
coverage for the dates of service and Medicare coverage for home care services, and create an audit trail
including reports. Both methods will be linked to prior authorization, therefore, either method must be used before
home care services are authorized and when there is a change of condition affecting medical assistance
authorization. The department will conduct periodic reviews of participant performance with the method and upon
demonstrating appropriate referral and billing of Medicare, participants may be determined exempt from regular
performance audits.
Sec. 11. Minnesota Statutes 2000, section 256B.094, subdivision 6, is amended to read:
Subd. 6. [MEDICAL ASSISTANCE REIMBURSEMENT OF CASE MANAGEMENT SERVICES.] (a) Medical assistance reimbursement for services under this section shall be made on a monthly basis. Payment is based on face-to-face or telephone contacts between the case manager and the client, client's family, primary caregiver, legal representative, or other relevant person identified as necessary to the development or implementation of the goals of the individual service plan regarding the status of the client, the individual service plan, or the goals for the client. These contacts must meet the minimum standards in clauses (1) and (2):
(1) there must be a face-to-face contact at least once a month except as provided in clause (2); and
(2) for a client placed outside of the county of financial responsibility, or a client served by tribal social services placed outside the reservation, in an excluded time facility under section 256G.02, subdivision 6, or through the Interstate Compact on the Placement of Children, section 260.851, and the placement in either case is more than 60 miles beyond the county or reservation boundaries, there must be at least one contact per month and not more than two consecutive months without a face-to-face contact.
(b) Except as provided under paragraph (c), the payment rate is established using time study data on activities of provider service staff and reports required under sections 245.482, 256.01, subdivision 2, paragraph (17), and 256E.08, subdivision 8.
(c) Payments for tribes may be made according to section 256B.0625 or other relevant federally approved rate setting methodology for child welfare targeted case management provided by Indian health services and facilities operated by a tribe or tribal organization.
(d) Payment for case management provided by county or tribal social services contracted vendors shall be based on a monthly rate negotiated by the host county or tribal social services. 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 tribal social services 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 tribal social services, except to reimburse the county or tribal social services for advance funding provided by the county or tribal social services to the vendor.
(e) If the service is provided by a team that includes contracted vendors and county or tribal social services staff, the costs for county or tribal social services staff participation in the team shall be included in the rate for county or tribal social services provided services. In this case, the contracted vendor and the county or tribal social services may each receive separate payment for services provided by each entity in the same month. 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 and services of the team members.
Separate payment rates may be established for different groups of providers to maximize reimbursement as determined by the commissioner. The payment rate will be reviewed annually and revised periodically to be consistent with the most recent time study and other data. Payment for services will be made upon submission of a valid claim and verification of proper documentation described in subdivision 7. Federal administrative revenue earned through the time study, or under paragraph (c), shall be distributed according to earnings, to counties, reservations, or groups of counties or reservations which have the same payment rate under this subdivision, and to the group of counties or reservations which are not certified providers under section 256F.10. The commissioner shall modify the requirements set out in Minnesota Rules, parts 9550.0300 to 9550.0370, as necessary to accomplish this.
Sec. 12. Minnesota Statutes 2000, section 256B.094, subdivision 8, is amended to read:
Subd. 8. [PAYMENT LIMITATION.] Services that are not eligible for payment as a child welfare targeted case management service include, but are not limited to:
(1) assessments prior to opening a case;
(2) therapy and treatment services;
(3) legal services, including legal advocacy, for the client;
(4) information and referral services that are part of a county's community social services plan, that are not provided to an eligible recipient;
(5) outreach services including outreach services provided through the community support services program;
(6) services that are not documented as required under subdivision 7 and Minnesota Rules, parts 9505.1800
to 9505.1880 9505.2165 and 9505.2175;
(7) services that are otherwise eligible for payment on a separate schedule under rules of the department of human services;
(8) services to a client that duplicate the same case management service from another case manager;
(9) case management services provided to patients or residents in a medical assistance facility except as described under subdivision 2, clause (9); and
(10) for children in foster care, group homes, or residential care, payment for case management services is limited to case management services that focus on permanency planning or return to the family home and that do not duplicate the facility's discharge planning services.
Sec. 13. Minnesota Statutes 2000, section 256B.5013, subdivision 1, is amended to read:
Subdivision 1. [VARIABLE RATE ADJUSTMENTS.] For rate years beginning on or after October 1, 2000,
when there is a documented increase in the resource needs of a current ICF/MR recipient or recipients, or a person
is admitted to a facility who requires additional resources, the county of financial responsibility may recommend
approval of a variable rate to enable the facility to meet the individual's increased needs based on the
recipient's screening. Variable rate adjustments made under this subdivision replace payments for persons
with special needs under section 256B.501, subdivision 8, and payments for persons with special needs for crisis
intervention services under section 256B.501, subdivision 8a. Resource needs directly attributable to an
individual that may be considered under the variable rate adjustment include increased direct staff hours
and, other specialized services, and equipment, and human resources. The
guidelines in paragraphs (a) to (d) apply for the payment rate adjustments under this section.
(a) All persons must be screened according to section 256B.092, subdivisions 7 and 8, prior to implementation
of the new payment system, and annually thereafter, and when a variable rate is being requested due to changes in
the needs of the recipient. Screening data shall be analyzed to develop broad profiles of the functional
characteristics of recipients. Screening data shall be used to monitor changes as follows:
Criteria to be used to develop these profiles shall include, but not be limited to:
(1) the functional ability of a recipient to care for and maintain the recipient's own basic needs;
(2) the intensity of any aggressive or destructive behavior; and
(3) any history of obstructive behavior in combination with a diagnosis of psychosis or neurosis;.
(b) A variable rate may be recommended for increased service needs such as:
(4) (1) a need for resources due to a change in resident day program participation because the
resident: (i) has reached the age of 65 or has a change in health condition that makes it difficult for the person to
participate in day training and habilitation services over an extended period of time because it is medically
contraindicated; and (ii) has expressed a desire for change through the developmental disabilities mental
retardation and related conditions screening process under section 256B.092; and
(5) (2) a need for additional resources for intensive short-term training
programming which is necessary prior to a recipient's discharge to a less restrictive, more integrated setting.
The recipients' screenings Recommendations for a variable rate shall be used to link resource
needs to funding. The resource profile shall determine the level of funding. The variable rate must be
applied to expenses related to increased direct staff hours and, other specialized services,
and equipment, and human resources.
(b) (c) A recipient must be screened by the county of financial responsibility using the
developmental disabilities screening document completed immediately prior to approval of a variable rate by the
county. A comparison of the updated screening and the previous screening must demonstrate an increase in resource
needs.
(c) (d) Rate adjustments projected to exceed the authorized funding level associated with the
person's profile must be submitted to the commissioner.
(d) (e) The county of financial responsibility must indicate the projected length of time that the
additional funding may be needed for the individual. The need to continue an individual variable rate must be
reviewed at the end of the anticipated duration of need but at least annually through the completion of the
developmental disabilities screening document.
Sec. 14. Minnesota Statutes 2000, section 256B.69, subdivision 3a, is amended to read:
Subd. 3a. [COUNTY AUTHORITY.] (a) The commissioner, when implementing the general assistance medical care, or medical assistance prepayment program within a county, must include the county board in the process of development, approval, and issuance of the request for proposals to provide services to eligible individuals within the proposed county. County boards must be given reasonable opportunity to make recommendations regarding the development, issuance, review of responses, and changes needed in the request for proposals. The commissioner must provide county boards the opportunity to review each proposal based on the identification of community needs under chapters 145A and 256E and county advocacy activities. If a county board finds that a proposal does not address certain community needs, the county board and commissioner shall continue efforts for improving the proposal and network prior to the approval of the contract. The county board shall make recommendations regarding the approval of local networks and their operations to ensure adequate availability and access to covered services. The provider or health plan must respond directly to county advocates and the state prepaid medical assistance ombudsperson regarding service delivery and must be accountable to the state regarding contracts with medical
assistance and general assistance medical care funds. The county board may recommend a maximum number of participating health plans after considering the size of the enrolling population; ensuring adequate access and capacity; considering the client and county administrative complexity; and considering the need to promote the viability of locally developed health plans. The county board or a single entity representing a group of county boards and the commissioner shall mutually select health plans for participation at the time of initial implementation of the prepaid medical assistance program in that county or group of counties and at the time of contract renewal. The commissioner shall also seek input for contract requirements from the county or single entity representing a group of county boards at each contract renewal and incorporate those recommendations into the contract negotiation process. The commissioner, in conjunction with the county board, shall actively seek to develop a mutually agreeable timetable prior to the development of the request for proposal, but counties must agree to initial enrollment beginning on or before January 1, 1999, in either the prepaid medical assistance and general assistance medical care programs or county-based purchasing under section 256B.692. At least 90 days before enrollment in the medical assistance and general assistance medical care prepaid programs begins in a county in which the prepaid programs have not been established, the commissioner shall provide a report to the chairs of senate and house committees having jurisdiction over state health care programs which verifies that the commissioner complied with the requirements for county involvement that are specified in this subdivision.
(b) The commissioner shall seek a federal waiver to allow a fee-for-service plan option to MinnesotaCare
enrollees. The commissioner shall develop an increase of the premium fees required under section 256L.06 up to
20 percent of the premium fees for the enrollees who elect the fee-for-service option. Prior to implementation, the
commissioner shall submit this fee schedule to the chair and ranking minority member of the senate health care
committee, the senate health care and family services funding division, the house of representatives health and
human services committee, and the house of representatives health and human services finance division.
(c) At the option of the county board, the board may develop contract requirements related to the
achievement of local public health goals to meet the health needs of medical assistance and general assistance
medical care enrollees. These requirements must be reasonably related to the performance of health plan functions
and within the scope of the medical assistance and general assistance medical care benefit sets. If the county board
and the commissioner mutually agree to such requirements, the department shall include such requirements in all
health plan contracts governing the prepaid medical assistance and general assistance medical care programs in that
county at initial implementation of the program in that county and at the time of contract renewal. The county board
may participate in the enforcement of the contract provisions related to local public health goals.
(d) (c) For counties in which prepaid medical assistance and general assistance medical care
programs have not been established, the commissioner shall not implement those programs if a county board submits
acceptable and timely preliminary and final proposals under section 256B.692, until county-based purchasing is no
longer operational in that county. For counties in which prepaid medical assistance and general assistance medical
care programs are in existence on or after September 1, 1997, the commissioner must terminate contracts with health
plans according to section 256B.692, subdivision 5, if the county board submits and the commissioner accepts
preliminary and final proposals according to that subdivision. The commissioner is not required to terminate
contracts that begin on or after September 1, 1997, according to section 256B.692 until two years have elapsed from
the date of initial enrollment.
(e) (d) In the event that a county board or a single entity representing a group of county boards
and the commissioner cannot reach agreement regarding: (i) the selection of participating health plans in that
county; (ii) contract requirements; or (iii) implementation and enforcement of county requirements including
provisions regarding local public health goals, the commissioner shall resolve all disputes after taking into account
the recommendations of a three-person mediation panel. The panel shall be composed of one designee of the
president of the association of Minnesota counties, one designee of the commissioner of human services, and one
designee of the commissioner of health.
(f) (e) If a county which elects to implement county-based purchasing ceases to implement
county-based purchasing, it is prohibited from assuming the responsibility of county-based purchasing for a period
of five years from the date it discontinues purchasing.
(g) (f) Notwithstanding the requirement in this subdivision that a county must agree to initial
enrollment on or before January 1, 1999, the commissioner shall grant a delay in the implementation of the
county-based purchasing authorized in section 256B.692 until federal waiver authority and approval has been
granted, if the county or group of counties has submitted a preliminary proposal for county-based purchasing by
September 1, 1997, has not already implemented the prepaid medical assistance program before January 1, 1998,
and has submitted a written request for the delay to the commissioner by July 1, 1998. In order for the delay to be
continued, the county or group of counties must also submit to the commissioner the following information by
December 1, 1998. The information must:
(1) identify the proposed date of implementation, as determined under section 256B.692, subdivision 5;
(2) include copies of the county board resolutions which demonstrate the continued commitment to the implementation of county-based purchasing by the proposed date. County board authorization may remain contingent on the submission of a final proposal which meets the requirements of section 256B.692, subdivision 5, paragraph (b);
(3) demonstrate actions taken for the establishment of a governance structure between the participating counties and describe how the fiduciary responsibilities of county-based purchasing will be allocated between the counties, if more than one county is involved in the proposal;
(4) describe how the risk of a deficit will be managed in the event expenditures are greater than total capitation payments. This description must identify how any of the following strategies will be used:
(i) risk contracts with licensed health plans;
(ii) risk arrangements with providers who are not licensed health plans;
(iii) risk arrangements with other licensed insurance entities; and
(iv) funding from other county resources;
(5) include, if county-based purchasing will not contract with licensed health plans or provider networks, letters of interest from local providers in at least the categories of hospital, physician, mental health, and pharmacy which express interest in contracting for services. These letters must recognize any risk transfer identified in clause (4), item (ii); and
(6) describe the options being considered to obtain the administrative services required in section 256B.692, subdivision 3, clauses (3) and (5).
(h) (g) For counties which receive a delay under this subdivision, the final proposals required
under section 256B.692, subdivision 5, paragraph (b), must be submitted at least six months prior to the requested
implementation date. Authority to implement county-based purchasing remains contingent on approval of the final
proposal as required under section 256B.692.
(i) (h) If the commissioner is unable to provide county-specific, individual-level fee-for-service
claims to counties by June 4, 1998, the commissioner shall grant a delay under paragraph (g) (f)
of up to 12 months in the implementation of county-based purchasing, and shall require implementation not later
than January 1, 2000. In order to receive an extension of the proposed date of implementation under this paragraph,
a county or group of counties must submit a written request for the extension to the commissioner by August 1, 1998,
must submit the information required under paragraph (g) (f) by December 1, 1998, and must
submit a final proposal as provided under paragraph (h) (g).
(j) (i) Notwithstanding other requirements of this subdivision, the commissioner shall not require
the implementation of the county-based purchasing authorized in section 256B.692 until six months after federal
waiver approval has been obtained for county-based purchasing, if the county or counties have submitted the final
plan as required in section 256B.692, subdivision 5. The commissioner shall allow the county or counties which
submitted information under section 256B.692, subdivision 5, to submit supplemental or additional information
which was not possible to submit by April 1, 1999. A county or counties shall continue to submit the required
information and substantive detail necessary to obtain a prompt response and waiver approval. If amendments to
the final plan are necessary due to the terms and conditions of the waiver approval, the commissioner shall allow
the county or group of counties 60 days to make the necessary amendments to the final plan and shall not require
implementation of the county-based purchasing until six months after the revised final plan has been submitted.
Sec. 15. Minnesota Statutes 2000, 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-statewide (MFIP-S), who is having a payment made on the person's behalf under sections 256I.01 to 256I.06, or who resides in group residential housing as defined in chapter 256I and can meet a spenddown using the cost of remedial services received through group residential housing; or
(2)(i) who is a resident of Minnesota; and whose equity in assets is not in excess of $1,000 per assistance unit. Exempt assets, the reduction of excess assets, and the waiver of excess assets must conform to the medical assistance program in chapter 256B, 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; and
(ii) who has countable income not in excess of the assistance standards established in section 256B.056, subdivision 4, or whose excess income is spent down according to section 256B.056, subdivision 5, using a six-month budget period. The method for calculating earned income disregards and deductions for a person who resides with a dependent child under age 21 shall follow section 256B.056, subdivision 1a. However, if a disregard of $30 and one-third of the remainder has been applied to the wage earner's income, the disregard shall not be applied again until the wage earner's income has not been considered in an eligibility determination for general assistance, general assistance medical care, medical assistance, or MFIP-S for 12 consecutive months. The earned income and work expense deductions for a person who does not reside with a dependent child under age 21 shall be the same as the method used to determine eligibility for a person under section 256D.06, subdivision 1, except the disregard of the first $50 of earned income is not allowed;
(3) who would be eligible for medical assistance except that the person resides in a facility that is determined by the commissioner or the federal Health Care Financing Administration to be an institution for mental diseases; or
(4) who is ineligible for medical assistance under chapter 256B or general assistance medical care under any other provision of this section, and is receiving care and rehabilitation services from a nonprofit center established to serve victims of torture. These individuals are eligible for general assistance medical care only for the period during which they are receiving services from the center. During this period of eligibility, individuals eligible under this clause shall not be required to participate in prepaid general assistance medical care.
(b) Beginning January 1, 2000, applicants or recipients who meet all eligibility requirements of MinnesotaCare as defined in sections 256L.01 to 256L.16, and are:
(i) adults with dependent children under 21 whose gross family income is equal to or less than 275 percent of the federal poverty guidelines; or
(ii) adults without children with earned income and whose family gross income is between 75 percent of the federal poverty guidelines and the amount set by section 256L.04, subdivision 7, shall be terminated from general assistance medical care upon enrollment in MinnesotaCare. Earned income is deemed available to family members as defined in section 256D.02, subdivision 8.
(c) For services rendered on or after July 1, 1997, eligibility is limited to one month prior to application if the person is determined eligible in the prior month. A redetermination of eligibility must occur every 12 months. Beginning January 1, 2000, Minnesota health care program applications completed by recipients and applicants who are persons described in paragraph (b), may be returned to the county agency to be forwarded to the department of human services or sent directly to the department of human services for enrollment in MinnesotaCare. If all other eligibility requirements of this subdivision are met, eligibility for general assistance medical care shall be available in any month during which a MinnesotaCare eligibility determination and enrollment are 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 paragraph (e).
(d) 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 an initial application when health care is delivered due to a medical condition or disability, a health care provider may act on the person's behalf to complete the initial application. 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. On the basis of information provided on the completed application, an applicant who meets the following criteria shall be determined eligible beginning in the month of application:
(1) has gross income less than 90 percent of the applicable income standard;
(2) has liquid assets that total within $300 of the asset standard;
(3) does not reside in a long-term care facility; and
(4) meets all other eligibility requirements.
The applicant must provide all required verifications within 30 days' notice of the eligibility determination or eligibility shall be terminated.
(e) 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.
(f) 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.
(g) 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. General assistance medical care is limited to payment of emergency services only for applicants or recipients as described in paragraph (b), whose MinnesotaCare coverage is denied or terminated for nonpayment of premiums as required by sections 256L.06 and 256L.07.
(h) In determining the amount of assets of an individual, 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.
(i) 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 Number 104-193, sections 421 and 422, and subsequently set out in federal rules.
(j)(1) An undocumented noncitizen or a nonimmigrant is ineligible for general assistance medical care other than emergency services. 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.
(2) This paragraph does not apply to a child under age 18, to a Cuban or Haitian entrant as defined in Public Law Number 96-422, section 501(e)(1) or (2)(a), or to a noncitizen who is aged, blind, or disabled as defined in Code of Federal Regulations, title 42, sections 435.520, 435.530, 435.531, 435.540, and 435.541, or effective October 1, 1998, to an individual eligible for general assistance medical care under paragraph (a), clause (4), who cooperates with the Immigration and Naturalization Service to pursue any applicable immigration status, including citizenship, that would qualify the individual for medical assistance with federal financial participation.
(k) For purposes of paragraphs (g) and (j), "emergency services" has the meaning given in Code of Federal Regulations, title 42, section 440.255(b)(1), except that it also means services rendered because of suspected or actual pesticide poisoning.
(l) 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.
Sec. 16. Minnesota Statutes 2000, section 256L.15, subdivision 1a, is amended to read:
Subd. 1a. [PAYMENT OPTIONS.] The commissioner may offer the following payment options to an enrollee:
(1) payment by check;
(2) payment by credit card;
(3) payment by recurring automatic checking withdrawal;
(4) payment by one-time electronic transfer of funds;
(5) payment by wage withholding with the consent of the employer and the employee; or
(6) payment by using state tax refund payments.
At application or reapplication, a MinnesotaCare applicant or enrollee may authorize the commissioner to use
the Revenue Recapture Act in chapter 270A to collect funds from the applicant's or enrollee's state income
tax refund for the purposes of meeting all or part of the applicant's or enrollee's MinnesotaCare premium
obligation for the forthcoming year. The applicant or enrollee may authorize the commissioner to apply for
the state working family tax credit on behalf of the applicant or enrollee. The setoff due under this subdivision shall
not be subject to the $10 fee under section 270A.07, subdivision 1.
Sec. 17. Laws 1995, chapter 178, article 2, section 36, is amended to read:
Sec. 36. [EMPOWERMENT ZONES; ADMINISTRATIVE SIMPLIFICATION OF WELFARE LAWS.]
(a) The commissioner of human services shall make recommendations to effectuate the changes in federal laws and regulations, state laws and rules, and the state plan to improve the administrative efficiency of the aid to families with dependent children, general assistance, work readiness, family general assistance, medical assistance, general assistance medical care, and food stamp programs. At a minimum, the following administrative standards and procedures must be changed.
The commissioner shall:
(1) require income or eligibility reviews no more frequently than annually for cases in which income is normally invariant, as in aid to families with dependent children cases where the only source of household income is Supplemental Social Security Income;
(2) permit households to report income annually when the source of income is excluded, such as a minor's earnings;
(3) require income or eligibility reviews no more frequently than annually for extended medical assistance
cases;
(4) require income or eligibility reviews no more frequently than annually for a medical assistance
postpartum client, where the client previously had eligibility under a different basis prior to pregnancy or if other
household members have eligibility with the same income/basis that applies to the client;
(5) (4) permit all income or eligibility reviews for foster care medical assistance cases to use the
short application form; and
(6) (5) make dependent care expenses declaratory for medical assistance; and
(7) permit households to only report gifts worth $100 or more per month.
(b) The county's administrative savings resulting from these changes may be allocated to fund any lawful purpose.
(c) The recommendations must be provided in a report to the chairs of the appropriate legislative committees by August 1, 1995. The recommendations must include a list of the administrative standards and procedures that require approval by the federal government before implementation, and also which administrative simplification standards and procedures may be implemented by a county prior to receiving a federal waiver.
(d) The commissioner shall seek the necessary waivers from the federal government as soon as possible to implement the administrative simplification standards and procedures.
Sec. 18. Laws 1996, chapter 451, article 2, section 61, is amended to read:
Sec. 61. [REPEALER.]
Minnesota Statutes 1995 Supplement, sections 256B.15, subdivision 5; 256G.05, subdivision 1; and
256G.07, subdivision 3a, are repealed.
Sec. 19. Laws 1996, chapter 451, article 2, section 62, is amended to read:
Sec. 62. [EFFECTIVE DATE; APPLICATION.]
(a) Sections 12, 14, 16, 18, 29, 30, and the portion of section 61 that repeals section 256B.15, subdivision 5,
are effective the day following final enactment to the extent permitted by federal law. If any provisions of these
sections are prohibited by federal law, the provisions shall become effective when federal law is changed to permit
their application or a waiver is received. The commissioner of human services shall notify the revisor of statutes
when federal law is enacted or a waiver is received and publish a notice in the State Register. The commissioner
must include the notice in the first State Register published after the effective date of the federal changes.
(b) If, by July 1, 1996, any provisions of the sections mentioned in paragraph (a) are not effective because of
prohibitions in federal law, the commissioner shall apply to the federal government for a waiver of those
prohibitions, and those provisions shall become effective upon receipt of a federal waiver, notification to the revisor
of statutes, and publication of a notice in the State Register to that effect. If the commissioner applies for a waiver
of the lookback period, the commissioner shall seek the longest lookback period the health care financing
administration will approve, not to exceed 72 months.
(c) Section 54 applies to estates of decedents dying on or after its effective date. Section 55 applies to
estates where the notice under Minnesota Statutes, section 524.3-801, paragraph (a), was first published on or after
its effective date. Section 55 does not affect any right or duty to provide notice to known creditors, including a local
agency, before its effective date.
(d) Sections 7, 13, 15, 17, 33, 34, 35, 38, and 60 are effective the day following final enactment.
(e) Section 11 is effective retroactive to October 1, 1993.
(f) Sections 8, 22, subdivision 3, and 34 are effective upon federal approval.
(g) Sections 10 and 31 are effective upon receipt of federal approval, retroactive to January 1, 1996.
Sec. 20. [REPEALER.]
(a) Laws 1995, chapter 178, article 2, section 46, subdivision 10; and Laws 1996, chapter 451, article 2, sections 12, 14, 16, 18, 29, and 30, are repealed.
(b) Minnesota Statutes 2000, section 256B.071, subdivision 5, is repealed."
Delete the title and insert:
"A bill for an act relating to human services; modifying provisions in health care access programs; amending Minnesota Statutes 2000, sections 245B.02, by adding a subdivision; 245B.03, subdivision 1; 252.28, subdivisions 3a and 3b; 256B.056, subdivisions 1a and 5a; 256B.0595, subdivisions 1 and 2; 256B.0625, subdivision 9; 256B.071, subdivision 2; 256B.094, subdivisions 6 and 8; 256B.5013, subdivision 1; 256B.69, subdivision 3a; 256D.03, subdivision 3; and 256L.15, subdivision 1a; Laws 1995, chapter 178, article 2, section 36; Laws 1996, chapter 451, article 2, sections 61 and 62; repealing Minnesota Statutes 2000, section 256B.071, subdivision 5; Laws 1995, chapter 178, article 2, section 46, subdivision 10; Laws 1996, chapter 451, article 2, sections 12, 14, 16, 18, 29, and 30."
The motion prevailed and the amendment was adopted.
S. F. No. 1407, A bill for an act relating to human services; modifying provisions in health care access programs; amending Minnesota Statutes 2000, sections 245B.02, by adding a subdivision; 245B.03, subdivision 1; 252.28, subdivisions 3a and 3b; 256B.056, subdivisions 1a, 4, and 5a; 256B.0595, subdivisions 1 and 2; 256B.0625, subdivision 9; 256B.0635, subdivision 1; 256B.071, subdivision 2; 256B.094, subdivisions 6 and 8; 256B.5013, subdivision 1; 256B.69, subdivision 3a; 256D.03, subdivision 3; and 256L.15, subdivision 1a; Laws 1996, chapter 451, article 2, sections 61 and 62; repealing Minnesota Statutes 2000, section 256B.071, subdivision 5; Laws 1995, chapter 178, article 2, section 46, subdivision 10; Laws 1996, chapter 451, article 2, sections 12, 14, 16, 18, 29, and 30.
The bill was read for the third time, as amended, and placed upon its final passage.
The question was taken on the passage of the bill and the roll was called. There were 132 yeas and 0 nays as follows:
Those who voted in the affirmative were:
| Abrams | Dorn | Holberg | Lenczewski | Osthoff | Solberg | |
| Anderson, B. | Eastlund | Holsten | Leppik | Otremba | Stanek | |
| Anderson, I. | Entenza | Howes | Lieder | Ozment | Stang | |
| Bakk | Erhardt | Huntley | Lindner | Paulsen | Swapinski | |
| Bernardy | Erickson | Jacobson | Lipman | Pawlenty | Swenson | |
| Biernat | Evans | Jaros | Luther | Paymar | Sykora | |
| Bishop | Finseth | Jennings | Mahoney | Pelowski | Thompson | |
| Boudreau | Folliard | Johnson, J. | Mares | Penas | Tingelstad | |
| Bradley | Fuller | Johnson, R. | Marko | Peterson | Tuma | |
| Buesgens | Gerlach | Johnson, S. | Marquart | Pugh | Vandeveer | |
| Carlson | Gleason | Juhnke | McElroy | Rhodes | Wagenius | |
| Cassell | Goodno | Kahn | McGuire | Rifenberg | Walker | |
| Clark, J. | Goodwin | Kalis | Milbert | Rukavina | Walz | |
| Clark, K. | Gray | Kelliher | Molnau | Ruth | Wasiluk | |
| Daggett | Greiling | Kielkucki | Mulder | Schumacher | Wenzel | |
| Davids | Gunther | Knoblach | Mullery | Seagren | Westerberg | |
| Davnie | Haas | Koskinen | Murphy | Seifert | Westrom | |
| Dawkins | Hackbarth | Krinkie | Ness | Sertich | Wilkin | |
| Dehler | Harder | Kubly | Nornes | Skoe | Winter | |
| Dempsey | Hausman | Kuisle | Olson | Skoglund | Wolf | |
| Dibble | Hilstrom | Larson | Opatz | Slawik | Workman | |
| Dorman | Hilty | Leighton | Osskopp | Smith | Spk. Sviggum | |
The bill was passed, as amended, and its title agreed to.
S. F. No. 974 was reported to the House.
Solberg moved to amend S. F. No. 974 as follows:
Page 1, line 17, delete "3,000" and insert "5,000"
The motion prevailed and the amendment was adopted.
S. F. No. 974, A bill for an act relating to local government; adding exceptions to the local public officer's conflict of interest law; amending Minnesota Statutes 2000, section 471.88, by adding subdivisions.
The bill was read for the third time, as amended, and placed upon its final passage.
The question was taken on the passage of the bill and the roll was called. There were 101 yeas and 31 nays as follows:
Those who voted in the affirmative were:
| Anderson, B. | Entenza | Hilty | Lenczewski | Osskopp | Slawik | |
| Anderson, I. | Erhardt | Holsten | Leppik | Osthoff | Solberg | |
| Bakk | Evans | Howes | Lieder | Otremba | Swapinski | |
| Bernardy | Finseth | Huntley | Luther | Ozment | Swenson | |
| Biernat | Folliard | Jaros | Mahoney | Paymar | Thompson | |
| Bishop | Fuller | Jennings | Mares | Pelowski | Tingelstad | |
| Carlson | Gleason | Johnson, J. | Mariani | Penas | Tuma | |
| Cassell | Goodno | Johnson, R. | Marquart | Peterson | Wagenius | |
| Clark, K. | Goodwin | Johnson, S. | McElroy | Pugh | Walker | |
| Daggett | Gray | Juhnke | McGuire | Rhodes | Walz | |
| Davids | Greiling | Kahn | Milbert | Rukavina | Wasiluk | |
| Davnie | Gunther | Kalis | Mulder | Ruth | Wenzel | |
| Dawkins | Haas | Kelliher | Mullery | Schumacher | Winter | |
| Dehler | Hackbarth | Koskinen | Murphy | Seagren | Wolf | |
| Dempsey | Harder | Kubly | Ness | Sertich | Workman | |
| Dibble | Hausman | Larson | Nornes | Skoe | Spk. Sviggum | |
| Dorn | Hilstrom | Leighton | Opatz | Skoglund | ||
Those who voted in the negative were:
| Abrams | Eastlund | Knoblach | Olson | Stanek | Wilkin | |
| Boudreau | Erickson | Krinkie | Paulsen | Stang | ||
| Bradley | Gerlach | Kuisle | Pawlenty | Sykora | ||
| Buesgens | Holberg | Lindner | Rifenberg | Vandeveer | ||
| Clark, J. | Jacobson | Lipman | Seifert | Westerberg | ||
| Dorman | Kielkucki | Molnau | Smith | Westrom | ||
The bill was passed, as amended, and its title agreed to.
H. F. No. 1292 was reported to the House.
Goodno moved that H. F. No. 1292 be returned to the General Register. The motion prevailed.
S. F. No. 491 was reported to the House.
Goodno moved to amend S. F. No. 491 as follows:
Delete everything after the enacting clause and insert the following language of H. F. No. 560, the fourth engrossment:
"Section 1. Minnesota Statutes 2000, section 45.027, subdivision 6, is amended to read:
Subd. 6. [VIOLATIONS AND PENALTIES.] The commissioner may impose a civil penalty not to exceed $10,000 per violation upon a person who violates any law, rule, or order related to the duties and responsibilities entrusted to the commissioner unless a different penalty is specified. If a civil penalty is imposed on a health carrier as defined in section 62A.011, the commissioner must divide 50 percent of the amount among any policy holders or certificate holders affected by the violation, unless the commissioner certifies in writing that the division and distribution to enrollees would be too administratively complex or that the number of enrollees affected by the penalty would result in a distribution of less than $50 per enrollee.
Sec. 2. Minnesota Statutes 2000, section 62D.02, subdivision 8, is amended to read:
Subd. 8. [HEALTH MAINTENANCE CONTRACT.] "Health maintenance contract" means any contract whereby
a health maintenance organization agrees to provide comprehensive health maintenance services to enrollees,
provided that the contract may contain reasonable enrollee copayment cost-sharing
provisions that comply with section 62D.099. An individual or group health maintenance contract may
contain the copayment and deductible provisions specified in this subdivision. Copayment and deductible
provisions in group contracts shall not discriminate on the basis of age, sex, race, length of enrollment in the plan,
or economic status; and during every open enrollment period in which all offered health benefit plans, including
those subject to the jurisdiction of the commissioners of commerce or health, fully participate without any
underwriting restrictions, copayment and deductible provisions shall not discriminate on the basis of preexisting
health status. In no event shall the sum of the annual copayments and deductible exceed the maximum
out-of-pocket expenses allowable for a number three qualified plan under section 62E.06, nor shall that sum exceed
$5,000 per family. The annual deductible must not exceed $1,000 per person. The annual deductible must not apply
to preventive health services as described in Minnesota Rules, part 4685.0801, subpart 8. Where sections 62D.01
to 62D.30 permit a health maintenance organization to contain reasonable copayment provisions for preexisting
health status, these provisions may vary with respect to length of enrollment in the plan. Any contract may provide
for health care services in addition to those set forth in subdivision 7.
Sec. 3. [62D.099] [ENROLLEE COST-SHARING.]
Subdivision 1. [COPAYMENTS.] (a) A health maintenance organization may impose coinsurance expressed as percentages, or flat fee copayments as provided in paragraph (b). Under the terms of the health plan, coinsurance may be imposed up to a maximum of 50 percent on the provider amount paid at the time the claim is processed irrespective of any subsequent adjustments that might be made based upon a withhold or year-end settlement. The 50 percent limitation does not apply to services that may be excluded, covered services that the enrollee elects to receive out-of-network or from a broader network, or to nonformulary prescription drugs.
(b) The health maintenance organization may establish predetermined flat fee copayments for categories of similar services or goods. Flat fee copayments based on categories of similar services or goods must be calculated independently for Medicare-related products, individual plans, and group plans. A health maintenance organization may impose a flat fee copayment of up to 50 percent of the median provider's charges for similar services or goods received by enrollees. A health maintenance organization may request the commissioner to approve a copayment which exceeds the 50 percent limitation for prescription drug benefits for Medicare-related products. The request must be made in writing to the commissioner and must include sufficient documentation to demonstrate that the requested copayment is reasonable under this section.
(c) For purposes of this section, a "category of similar services or goods" is any group of related services for which a single copayment is sought. Examples of categories include the following or any subset of the following:
(1) inpatient hospital care;
(3) outpatient health services, which may include, but are not limited to, office visits or outpatient laboratory and radiology;
(4) outpatient surgery, which may include provider and facility charges;
(5) emergency services, which may include provider and facility charges;
(6) outpatient prescription drugs;
(7) skilled nursing care; and
(8) any other nonphysician service categorized singly according to provider type.
(d) To determine the median aggregate charge for a category of similar services, the health maintenance organization must follow the following steps and submit the results to the commissioner for approval of the copayment:
(1) identify all charges for the services or goods for the relevant type of product: Medicare-related, individual, or group. The health maintenance organization may use all charges or may choose a sample of charges from the total population. Any sample used must be randomly selected and large enough to be statistically reliable. "Statistically reliable" means that any other sample drawn in the same manner would produce essentially the same results;
(2) if the health maintenance organization does not use charges that span 12 months, the health maintenance organization must explain how the time period used is sufficient to include seasonal fluctuations in the utilization of services;
(3) a statement that the sample is statistically reliable, with an explanation of how the sample is drawn so that it is representative of the larger health maintenance organization population; and
(4) a narrative description of the services included in the category.
Subd. 2. [DEDUCTIBLES.] Under the terms of the health plan, deductible amounts may be imposed as follows:
(1) for group health plans, $5,000 per person per year and $10,000 per family per year increased annually in accordance with the medical component of the Consumer Price Index; or
(2) for individual health plans, $10,000 per person per year and $20,000 per family per year increased annually in accordance with the medical component of the Consumer Price Index.
Subd. 3. [ANNUAL OUT-OF-POCKET MAXIMUM AMOUNTS.] A health maintenance organization shall provide for an out-of-pocket maximum on enrollee cost-sharing up to $8,000 per person per year on group health plans and up to $15,000 per person per year on individual health plans. The out-of-pocket maximum amounts shall be adjusted for inflation on an annual basis in accordance with the medical component of the Consumer Price Index.
Sec. 4. Minnesota Statutes 2000, section 62D.17, subdivision 1, is amended to read:
Subdivision 1. [ADMINISTRATIVE PENALTY.] The commissioner of health may, for any violation of statute or rule applicable to a health maintenance organization, or in lieu of suspension or revocation of a certificate of authority under section 62D.15, levy an administrative penalty in an amount up to $25,000 for each violation. In the case of contracts or agreements made pursuant to section 62D.05, subdivisions 2 to 4, each contract or agreement entered into or implemented in a manner which violates sections 62D.01 to 62D.30 shall be considered a separate violation. In determining the level of an administrative penalty, the commissioner shall consider the following factors:
(1) the number of enrollees affected by the violation;
(2) the effect of the violation on enrollees' health and access to health services;
(3) if only one enrollee is affected, the effect of the violation on that enrollee's health;
(4) whether the violation is an isolated incident or part of a pattern of violations; and
(5) the economic benefits derived by the health maintenance organization or a participating provider by virtue of the violation.
Reasonable notice in writing to the health maintenance organization shall be given of the intent to levy the penalty and the reasons therefor, and the health maintenance organization may have 15 days within which to file a written request for an administrative hearing and review of the commissioner of health's determination. Such administrative hearing shall be subject to judicial review pursuant to chapter 14. If an administrative penalty is levied, the commissioner must divide 50 percent of the amount among any enrollees affected by the violation, unless the commissioner certifies in writing that the division and distribution to enrollees would be too administratively complex or that the number of enrollees affected by the penalty would result in a distribution of less than $50 per enrollee.
Sec. 5. Minnesota Statutes 2000, section 62J.38, is amended to read:
62J.38 [COST CONTAINMENT DATA FROM GROUP PURCHASERS.]
(a) The commissioner shall require group purchasers to submit detailed data on total health care spending for each calendar year. Group purchasers shall submit data for the 1993 calendar year by April 1, 1994, and each April 1 thereafter shall submit data for the preceding calendar year.
(b) The commissioner shall require each group purchaser to submit data on revenue, expenses, and member
months, as applicable. Revenue data must distinguish between premium revenue and revenue from other sources
and must also include information on the amount of revenue in reserves and changes in reserves. Expenditure
data, including raw data from claims, may must distinguish between costs incurred for patient care and
administrative costs. Expenditure data must be provided separately for the following categories or
and for other categories required by the commissioner: physician services, dental services, other
professional services, inpatient hospital services, outpatient hospital services, emergency, pharmacy services and
other nondurable medical goods, mental health, and chemical dependency services, other expenditures, subscriber
liability, and administrative costs. Administrative costs must include costs for marketing; advertising; overhead;
salaries and benefits of central office staff who do not provide direct patient care; underwriting; lobbying; claims
processing; provider contracting and credentialing; detection and prevention of payment for fraudulent or unjustified
requests for reimbursement or services; clinical quality assurance and other types of medical care quality
improvement efforts; concurrent or prospective utilization review as defined in section 62M.02; costs incurred to
acquire a hospital, clinic, or health care facility, or the assets thereof; capital costs incurred on behalf of a hospital
or clinic; lease payments; or any other costs incurred pursuant to a partnership, joint venture, integration, or
affiliation agreement with a hospital, clinic, or other health care provider. Capital costs and costs incurred must be
reported according to standard accounting principles. The reports of this data must also separately identify expenses
for local, state, and federal taxes, fees, and assessments. The commissioner may require each group purchaser
to submit any other data, including data in unaggregated form, for the purposes of developing spending estimates,
setting spending limits, and monitoring actual spending and costs. In addition to reporting administrative costs
incurred to acquire a hospital, clinic, or health care facility, or the assets thereof; or any other costs incurred pursuant
to a partnership, joint venture, integration, or affiliation agreement with a hospital, clinic, or other health care
provider, reports submitted under this section also must include the payments made during the calendar year for
these purposes.
(c) The commissioner may collect information on:
(1) premiums, benefit levels, managed care procedures, and other features of health plan companies;
(2) prices, provider experience, and other information for services less commonly covered by insurance or for which patients commonly face significant out-of-pocket expenses; and
(3) information on health care services not provided through health plan companies, including information on prices, costs, expenditures, and utilization.
(d) All group purchasers shall provide the required data using a uniform format and uniform definitions, as prescribed by the commissioner.
Sec. 6. Minnesota Statutes 2000, section 62M.02, subdivision 21, is amended to read:
Subd. 21. [UTILIZATION REVIEW ORGANIZATION.] "Utilization review organization" means an entity including but not limited to an insurance company licensed under chapter 60A to offer, sell, or issue a policy of accident and sickness insurance as defined in section 62A.01; a health service plan licensed under chapter 62C; a health maintenance organization licensed under chapter 62D; a community integrated service network licensed under chapter 62N; an accountable provider network operating under chapter 62T; a fraternal benefit society operating under chapter 64B; a joint self-insurance employee health plan operating under chapter 62H; a multiple employer welfare arrangement, as defined in section 3 of the Employee Retirement Income Security Act of 1974 (ERISA), United States Code, title 29, section 1103, as amended; a third party administrator licensed under section 60A.23, subdivision 8, which conducts utilization review and determines certification of an admission, extension of stay, or other health care services for a Minnesota resident; or any entity performing utilization review that is affiliated with, under contract with, or conducting utilization review on behalf of, a business entity in this state. Utilization review organization does not include a clinic or health care system acting pursuant to a written delegation agreement with an otherwise regulated utilization review organization that contracts with the clinic or health care system. The regulated utilization review organization is accountable for the delegated utilization review activities of the clinic or health care system.
Sec. 7. [62Q.471] [EXCLUSION FOR SUICIDE ATTEMPTS PROHIBITED.]
(a) No health plan may exclude or reduce coverage for health care for an enrollee who is otherwise covered under the health plan on the basis that the need for the health care arose out of a suicide or suicide attempt by the enrollee.
(b) For purposes of this section, "health plan" has the meaning given in section 62Q.01, subdivision 3, but includes the coverages described in section 62A.011, subdivision 3, clauses (7) and (10).
[EFFECTIVE DATE.] This section is effective January 1, 2002, and applies to contracts issued or renewed on or after that date.
Sec. 8. [62Q.527] [COVERAGE OF NONFORMULARY DRUGS FOR MENTAL ILLNESS AND EMOTIONAL DISTURBANCE.]
Subdivision 1. [DEFINITIONS.] (a) For purposes of this section, the following terms have the meanings given to them.
(b) "Emotional disturbance" has the meaning given in section 245.4871, subdivision 15.
(c) "Mental illness" has the meaning given in section 245.462, subdivision 20, paragraph (a).
(d) "Health plan" has the meaning given in section 62Q.01, subdivision 3, but includes the coverages described in section 62A.011, subdivision 3, clauses (7) and (10).
Subd. 2. [REQUIRED COVERAGE FOR ANTIPSYCHOTIC DRUGS.] A health plan that provides
drug coverage must provide coverage for an antipsychotic drug prescribed to treat emotional disturbance or mental
illness regardless of whether the drug is in the health plan's drug formulary, if the health care provider prescribing
the drug
indicates to the dispensing pharmacist, orally or in writing according to section 151.21, that the prescription must be dispensed as communicated and certifies in writing to the health plan company that the health care provider has considered any equivalent drug in the health plan's formulary and has determined that the drug prescribed will best treat the patient's condition. A health plan is not required to provide coverage for a drug if the drug was removed from the health plan's drug formulary for safety reasons. For drugs covered under this section, no health plan company that has received the certification from the health care provider may:
(1) impose a special deductible, copayment, coinsurance, or other special payment requirement that the health plan does not apply to drugs that are in the health plan's drug formulary; or
(2) require written certification from the prescribing provider each time a prescription is refilled or renewed that the drug prescribed will best treat the patient's condition.
Subd. 3. [CONTINUING CARE.] (a) Individuals receiving a prescribed drug to treat a diagnosed mental illness or emotional disturbance may continue to receive the prescribed drug for up to one year without the imposition of a special deductible, copayment, coinsurance, or other special payment requirements, when a health plan's drug formulary changes or an enrollee changes health plans and the medication has been shown to effectively treat the patient's condition. In order to be eligible for this continuing care benefit:
(1) the patient must have been treated with the drug for 90 days prior to a change in a health plan's drug formulary or a change in the enrollee's health plan;
(2) the health care provider prescribing the drug indicates to the dispensing pharmacist, orally or in writing according to section 151.21, that the prescription must be dispensed as communicated; and
(3) the health care provider prescribing the drug annually certifies in writing to the health plan company that the drug prescribed will best treat the patient's condition.
(b) A health plan is not required to provide coverage for a drug if the drug was removed from the health plan's drug formulary for safety reasons.
(c) The continuing care benefit shall be extended annually when the health care provider prescribing the drug:
(1) indicates to the dispensing pharmacist, orally or in writing according to section 151.21, that the prescription must be dispensed as communicated; and
(2) certifies in writing to the health plan company that the drug prescribed will best treat the patient's condition.
Subd. 4. [EXCEPTION TO FORMULARY.] A health plan must promptly grant an exception to the health plan's drug formulary for a patient when the health care provider prescribing the drug indicates to the health plan that:
(1) the formulary drug causes an adverse reaction in the patient;
(2) the formulary drug is contraindicated for the patient; or
(3) the health care provider demonstrates to the health plan that the prescription must be dispensed as written to provide maximum medical benefit to the patient.
[EFFECTIVE DATE.] This section is effective January 1, 2002, and applies to contracts issued or renewed on or after that date.
Sec. 9. [62Q.535] [COVERAGE FOR COURT-ORDERED MENTAL HEALTH SERVICES.]
Subdivision 1. [MENTAL HEALTH SERVICES.] For purposes of this section, mental health services means all covered services that are intended to treat or ameliorate an emotional, behavioral, or psychiatric condition and that are covered by the policy, contract, or certificate of coverage of the enrollee's health plan company or by law.
Subd. 2. [COVERAGE REQUIRED.] All health plan companies that provide coverage for mental health services must cover or provide mental health services ordered by a court of competent jurisdiction under a court order that is issued on the basis of a behavioral care evaluation, performed by a licensed psychiatrist or a doctoral-level licensed psychologist, which includes a diagnosis and an individual treatment plan for care in the most appropriate, least restrictive environment. The health plan company must be given a copy of the court order and behavioral evaluation. The health plan company shall be financially liable for the evaluation if performed by a participating provider of the health plan company and shall be financially liable for the care included in the court-ordered treatment plan if the care is covered by the health plan company and ordered to be provided by a participating provider or another provider as required by rule or statute. This court-ordered coverage must not be subject to a separate medical necessity determination by a health plan company under its utilization procedures.
[EFFECTIVE DATE.] This section is effective July 1, 2001, and applies to contracts issued or renewed on or after that date.
Sec. 10. Minnesota Statutes 2000, section 62Q.56, is amended to read:
62Q.56 [CONTINUITY OF CARE.]
Subdivision 1. [CHANGE IN HEALTH CARE PROVIDER.] (a) If enrollees are required to access services through selected primary care providers for coverage, the health plan company shall prepare a written plan that provides for continuity of care in the event of contract termination between the health plan company and any of the contracted primary care providers, specialists, or general hospital providers. For purposes of this section, termination includes nonrenewal. The written plan must explain:
(1) how the health plan company will inform affected enrollees, insureds, or beneficiaries about
termination at least 30 days before the termination is effective, if the health plan company or health care network
cooperative has received at least 120 days' prior notice;
(2) how the health plan company will inform the affected enrollees about what other participating providers are available to assume care and how it will facilitate an orderly transfer of its enrollees from the terminating provider to the new provider to maintain continuity of care;
(3) the procedures by which enrollees will be transferred to other participating providers, when special medical needs, special risks, or other special circumstances, such as cultural or language barriers, require them to have a longer transition period or be transferred to nonparticipating providers;
(4) who will identify enrollees with special medical needs or at special risk and what criteria will be used for this determination; and
(5) how continuity of care will be provided for enrollees identified as having special needs or at special risk, and whether the health plan company has assigned this responsibility to its contracted primary care providers.
(b) If the contract termination was not for cause, enrollees can request a referral to the terminating provider
for up to 120 days if they have special medical needs or have other special circumstances, such as cultural or
language barriers. The health plan company can require medical records and other supporting documentation in
support of the requested referral. Each request for referral to a terminating provider shall be considered by the health
plan company on a case-by-case basis.:
(1) if the contract was terminated by the health plan company, the terminated provider and all enrollees being treated by that provider must be notified of the enrollees' rights to continuity of care with the terminated provider;
(2) the health plan company must provide, upon request, authorization to receive services that are otherwise covered under the terms of the health plan through the enrollee's current provider for up to 120 days if the enrollee is engaged in a current course of treatment for one or more of the following conditions:
(i) an acute condition;
(ii) a life-threatening mental or physical illness;
(iii) pregnancy beyond the first trimester of pregnancy;
(iv) a physical or mental disability defined as an inability to engage in one or more major life activities, provided that the disability has lasted or can be expected to last for at least a year or can be expected to result in death; or
(v) a disabling or chronic condition that is in an acute phase; and
(3) the health plan company must provide, upon request, authorization to receive services that are otherwise covered under the terms of the health plan through the enrollee's current provider for the rest of the enrollee's life if a physician certifies that the enrollee has an expected lifetime of 180 days or less.
For all requests for authorization to receive services under this paragraph, the health plan company must grant the request unless the enrollee does not meet the criteria provided in this paragraph.
(c) The health plan company shall prepare a written plan that provides a process for coverage determinations regarding continuity of care of up to 120 days for enrollees who request continuity of care with their former provider, if the enrollee:
(1) is receiving culturally appropriate services and the health plan company does not have a provider in its preferred provider network with special expertise in the delivery of those culturally appropriate services within the time and distance requirements of section 62D.124, subdivision 1; or
(2) does not speak English and the health plan company does not have a provider in its preferred provider network who can communicate with the enrollee, either directly or through an interpreter, within the time and distance requirements of section 62D.124, subdivision 1.
The written plan must explain the criteria that will be used to determine whether a need for continuity of care exists and how it will be provided.
(d) This paragraph applies to requests under paragraph (b) or (c). The health plan company may require medical records and other supporting documentation to be submitted with the request for authorization. If an authorization is denied, the health plan company must explain the criteria it used to make its decision on the request for authorization. If an authorization is granted, the health plan company must explain how continuity of care will be provided.
(c) (e) If the contract termination was for cause, enrollees must be notified of the change and
transferred to participating providers in a timely manner so that health care services remain available and accessible
to the affected enrollees. The health plan company is not required to refer an enrollee back to the terminating
provider if the termination was for cause.
Subd. 2. [CHANGE IN HEALTH PLANS.] (a) The health plan company shall prepare a written plan that
provides a process for coverage determinations for continuity of care for new enrollees with special needs, special
risks, or other special circumstances, such as cultural or language barriers, who request continuity of care with their
former provider for up to 120 days. The written plan must explain the criteria that will be used for determining special needs cases, and how continuity of care will be provided. If an enrollee is subject to a change in health plans, the enrollee's new health plan company must provide, upon request:
(1) authorization to receive services that are otherwise covered under the terms of the new health plan through the enrollee's current provider for up to 120 days if the enrollee is engaged in a current course of treatment for one or more of the following conditions:
(i) an acute condition;
(ii) a life-threatening mental or physical illness;
(iii) pregnancy beyond the first trimester of pregnancy;
(iv) a physical or mental disability defined as an inability to engage in one or more major life activities, provided that the disability has lasted or can be expected to last for at least a year or can be expected to result in death; or
(v) a disabling or chronic condition that is in an acute phase; and
(2) authorization to receive services that are otherwise covered under the terms of the health plan through the enrollee's current provider for the rest of the enrollee's life if a physician certifies that the enrollee has an expected lifetime of 180 days or less.
For all requests for authorization under this paragraph, the health plan company must grant the request for authorization unless the enrollee does not meet the criteria provided in this paragraph.
(b) The health plan company shall prepare a written plan that provides a process for coverage determinations regarding continuity of care of up to 120 days for new enrollees who request continuity of care with their former provider, if the new enrollee:
(1) is receiving culturally appropriate services and the health plan company does not have a provider in its preferred provider network with special expertise in the delivery of those culturally appropriate services within the time and distance requirements of section 62D.124, subdivision 1; or
(2) does not speak English and the health plan company does not have a provider in its preferred provider network who can communicate with the enrollee, either directly or through an interpreter, within the time and distance requirements of section 62D.124, subdivision 1.
The written plan must explain the criteria that will be used to determine whether a need for continuity of care exists and how it will be provided.
(c) This paragraph applies to requests under paragraph (a) or (b). The health plan company may require medical records and other supporting documentation to be submitted with the request for authorization. If an authorization is denied, the health plan company must explain the criteria it used to make its decision on the request for authorization. If an authorization is granted, the health plan company must explain how continuity of care will be provided.
(b) (d) This subdivision applies only to group coverage and continuation and conversion
coverage, and applies only to changes in health plans made by the employer.
Subd. 2a. [LIMITATIONS.] (a) Subdivisions 1 and 2 apply only if the enrollee's health care provider agrees to:
(1) accept as payment in full the lesser of the health plan company's reimbursement rate for in-network providers for the same or similar service or the enrollee's health care provider's regular fee for that service;
(2) adhere to the health plan company's preauthorization requirements; and
(3) provide the health plan company with all necessary medical information related to the care provided to the enrollee.
(b) Nothing in this section requires a health plan company to provide coverage for a health care service or treatment that is not covered under the enrollee's health plan.
Subd. 3. [DISCLOSURES DISCLOSURE.] The written plans required under this section
must be made available upon request to enrollees or prospective enrollees Information regarding an
enrollee's rights under this section must be included in member contracts or certificates of coverage and must be
provided by a health plan company upon request of an enrollee or prospective enrollee.
Sec. 11. Minnesota Statutes 2000, section 62Q.58, is amended to read:
62Q.58 [ACCESS TO SPECIALTY CARE.]
Subdivision 1. [STANDING REFERRAL.] A health plan company shall establish a procedure by which an
enrollee may apply for and, if appropriate, receive a standing referral to a health care provider who is a
specialist if a referral to a specialist is required for coverage. This procedure for a standing referral must specify the
necessary criteria and conditions, which must be met in order for an enrollee to obtain a standing referral
managed care review and approval an enrollee must obtain before such a standing referral is permitted.
Subd. 1a. [MANDATORY STANDING REFERRAL.] An enrollee who requests a standing referral to a specialist qualified to treat the specific condition described in clauses (1) to (5) must be given a standing referral for visits to such a specialist if benefits for such treatment are provided under the health plan and the enrollee has any of the following conditions:
(1) a chronic health condition;
(2) a life-threatening mental or physical illness;
(3) pregnancy beyond the first trimester of pregnancy;
(4) a degenerative disease or disability; or
(5) any other condition or disease of sufficient seriousness and complexity to require treatment by a specialist.
Nothing in this section limits the application of section 62Q.52 specifying direct access to obstetricians and gynecologists.
Subd. 2. [COORDINATION OF SERVICES.] A primary care provider or primary care group shall remain
responsible for coordinating the care of an enrollee who has received a standing referral to a specialist. The
specialist shall not make any secondary referrals related to primary care services without prior approval by the
primary care provider or primary care group. However, An enrollee with a standing referral to a specialist may
request primary care services from that specialist. The specialist, in agreement with the enrollee and primary care
provider or primary care group, may elect to provide primary care services to that the enrollee,
authorize tests and services, and make secondary referrals according to procedures established by the health plan
company. The health plan company may limit the primary care services, tests and services, and secondary
referrals authorized under this subdivision to those that are related to the specific condition or conditions for which
the standing referral was made.
Subd. 3. [DISCLOSURE.] Information regarding referral procedures must be included in member contracts or certificates of coverage and must be provided to an enrollee or prospective enrollee by a health plan company upon request.
Subd. 4. [REFERRAL.] (a) If a standing referral is authorized under subdivision 1 or is mandatory under subdivision 1a, the health plan company must provide a referral to an appropriate participating specialist who is reasonably available and accessible to provide the treatment or to a nonparticipating specialist if the health plan company does not have an appropriate participating specialist who is reasonably available and accessible to treat the enrollee's condition or disease.
(b) If an enrollee receives services from a nonparticipating specialist because a participating specialist is not available, services must be provided at no additional cost to the enrollee beyond what the enrollee would otherwise pay for services received from a participating specialist.
Sec. 12. Minnesota Statutes 2000, section 253B.02, subdivision 10, is amended to read:
Subd. 10. [INTERESTED PERSON.] "Interested person" means:
(1) an adult, including but not limited to, a public official, including a local welfare agency acting under section 626.5561, and the legal guardian, spouse, parent, legal counsel, adult child, next of kin, or other person designated by a proposed patient; or
(2) a health plan company that is providing coverage for a proposed patient.
Sec. 13. Minnesota Statutes 2000, section 253B.045, subdivision 6, is amended to read:
Subd. 6. [COVERAGE.] A health plan company that provides coverage for mental health services must
provide coverage, according to the terms of the policy, contract, or certificate of coverage, for all medically
necessary covered comply with section 62Q.535 for all mental health services as determined by
section 62Q.53 provided to an enrollee that are ordered by the court under this chapter. For purposes of this
subdivision, "mental health services" has the meaning given in section 62Q.535, subdivision 1.
[EFFECTIVE DATE.] This section is effective July 1, 2001, and applies to contracts issued or renewed on or after that date.
Sec. 14. Minnesota Statutes 2000, section 253B.10, subdivision 4, is amended to read:
Subd. 4. [PRIVATE TREATMENT.] Patients or other responsible persons are required to pay the necessary
charges for patients committed or transferred to private treatment facilities. Private treatment facilities may
refuse to accept a committed person. Insurers must provide court-ordered treatment and services as ordered
by the court under section 253B.045, subdivision 6, or as required under chapter 62M.
[EFFECTIVE DATE.] This section is effective July 1, 2001, and applies to contracts issued or renewed on or after that date.
Sec. 15. Minnesota Statutes 2000, section 260C.201, subdivision 1, is amended to read:
Subdivision 1. [DISPOSITIONS.] (a) If the court finds that the child is in need of protection or services or neglected and in foster care, it shall enter an order making any of the following dispositions of the case:
(1) place the child under the protective supervision of the local social services agency or child-placing agency in the home of a parent of the child under conditions prescribed by the court directed to the correction of the child's need for protection or services, or:
(i) the court may order the child into the home of a parent who does not otherwise have legal custody of the child, however, an order under this section does not confer legal custody on that parent;
(ii) if the court orders the child into the home of a father who is not adjudicated, he must cooperate with paternity establishment proceedings regarding the child in the appropriate jurisdiction as one of the conditions prescribed by the court for the child to continue in his home;
(iii) the court may order the child into the home of a noncustodial parent with conditions and may also order both the noncustodial and the custodial parent to comply with the requirements of a case plan under subdivision 2;
(2) transfer legal custody to one of the following:
(i) a child-placing agency; or
(ii) the local social services agency.
In placing a child whose custody has been transferred under this paragraph, the agencies shall follow the requirements of section 260C.193, subdivision 3;
(3) if the child has been adjudicated as a child in need of protection or services because the child is in
need of special treatment and services or care for reasons of physical or mental health to
treat or ameliorate a physical or mental disability, the court may order the child's parent, guardian, or custodian
to provide it. If the parent, guardian, or custodian fails or is unable to provide this treatment or care, the court may
order it provided. The court may also order the child's health plan company to provide mental health services
to the child under section 62Q.535. Absent specific written findings by the court that the child's disability is the
result of abuse or neglect by the child's parent or guardian, the court shall not transfer legal custody of the child
for the purpose of obtaining special treatment or care solely because the parent is unable to provide the treatment
or care. If the court's order for mental health treatment is based on a diagnosis made by a treatment professional,
the court may order that the diagnosing professional not provide the treatment to the child if it finds that such an
order is in the child's best interests; or
(4) if the court believes that the child has sufficient maturity and judgment and that it is in the best interests of the child, the court may order a child 16 years old or older to be allowed to live independently, either alone or with others as approved by the court under supervision the court considers appropriate, if the county board, after consultation with the court, has specifically authorized this dispositional alternative for a child.
(b) If the child was adjudicated in need of protection or services because the child is a runaway or habitual truant, the court may order any of the following dispositions in addition to or as alternatives to the dispositions authorized under paragraph (a):
(1) counsel the child or the child's parents, guardian, or custodian;
(2) place the child under the supervision of a probation officer or other suitable person in the child's own home under conditions prescribed by the court, including reasonable rules for the child's conduct and the conduct of the parents, guardian, or custodian, designed for the physical, mental, and moral well-being and behavior of the child; or with the consent of the commissioner of corrections, place the child in a group foster care facility which is under the commissioner's management and supervision;
(3) subject to the court's supervision, transfer legal custody of the child to one of the following:
(i) a reputable person of good moral character. No person may receive custody of two or more unrelated children unless licensed to operate a residential program under sections 245A.01 to 245A.16; or
(ii) a county probation officer for placement in a group foster home established under the direction of the juvenile court and licensed pursuant to section 241.021;
(4) require the child to pay a fine of up to $100. The court shall order payment of the fine in a manner that will not impose undue financial hardship upon the child;
(5) require the child to participate in a community service project;
(6) order the child to undergo a chemical dependency evaluation and, if warranted by the evaluation, order participation by the child in a drug awareness program or an inpatient or outpatient chemical dependency treatment program;
(7) if the court believes that it is in the best interests of the child and of public safety that the child's driver's license or instruction permit be canceled, the court may order the commissioner of public safety to cancel the child's license or permit for any period up to the child's 18th birthday. If the child does not have a driver's license or permit, the court may order a denial of driving privileges for any period up to the child's 18th birthday. The court shall forward an order issued under this clause to the commissioner, who shall cancel the license or permit or deny driving privileges without a hearing for the period specified by the court. At any time before the expiration of the period of cancellation or denial, the court may, for good cause, order the commissioner of public safety to allow the child to apply for a license or permit, and the commissioner shall so authorize;
(8) order that the child's parent or legal guardian deliver the child to school at the beginning of each school day for a period of time specified by the court; or
(9) require the child to perform any other activities or participate in any other treatment programs deemed appropriate by the court.
To the extent practicable, the court shall enter a disposition order the same day it makes a finding that a child is in need of protection or services or neglected and in foster care, but in no event more than 15 days after the finding unless the court finds that the best interests of the child will be served by granting a delay. If the child was under eight years of age at the time the petition was filed, the disposition order must be entered within ten days of the finding and the court may not grant a delay unless good cause is shown and the court finds the best interests of the child will be served by the delay.
(c) If a child who is 14 years of age or older is adjudicated in need of protection or services because the child is a habitual truant and truancy procedures involving the child were previously dealt with by a school attendance review board or county attorney mediation program under section 260A.06 or 260A.07, the court shall order a cancellation or denial of driving privileges under paragraph (b), clause (7), for any period up to the child's 18th birthday.
(d) In the case of a child adjudicated in need of protection or services because the child has committed domestic abuse and been ordered excluded from the child's parent's home, the court shall dismiss jurisdiction if the court, at any time, finds the parent is able or willing to provide an alternative safe living arrangement for the child, as defined in Laws 1997, chapter 239, article 10, section 2.
Sec. 16. [QUALITY OF PATIENT CARE.]
The commissioner of health shall evaluate the feasibility of collecting data on the quality of patient care provided in hospitals, outpatient surgical centers, and other health care facilities. In the evaluation, the commissioner shall examine the appropriate roles of the public and private sectors and the need for risk-adjusting data. The evaluation must consider mechanisms to identify the quality of nursing care provided to consumers by examining variables such as skin breakdown and patient injuries. Any plan developed to collect data must also address issues related to the release of the data in a useful form to the public. The commissioner shall prepare and distribute a written report of the evaluation by January 15, 2002.
Sec. 17. [EFFECTIVE DATE.]
Sections 1 and 4 are effective for violations committed on or after August 1, 2001. Section 5 is effective beginning with the report for the 2001 calendar year. Sections 6 and 16 are effective the day following final enactment. Sections 2, 3, 10, and 11 are effective January 1, 2002, and apply to health plans issued or renewed on or after that date."
Delete the title and insert:
"A bill for an act relating to health; providing patient protections; requiring certain coverage; providing for cost-sharing; amending Minnesota Statutes 2000, sections 45.027, subdivision 6; 62D.02, subdivision 8; 62D.17, subdivision 1; 62J.38; 62M.02, subdivision 21; 62Q.56; 62Q.58; 253B.02, subdivision 10; 253B.045, subdivision 6; 253B.10, subdivision 4; 260C.201, subdivision 1; proposing coding for new law in Minnesota Statutes, chapters 62D; 62Q."
The motion prevailed and the amendment was adopted.
Goodno moved to amend S. F. No. 491, as amended, as follows:
Page 17, line 18, after the headnote, insert "(a)"
Page 17, line 30, before "Nothing" insert "(b)"
Page 17, after line 32, insert:
"(c) Paragraph (a) does not apply to health plans issued under sections 43A.23 to 43A.31."
The motion prevailed and the amendment was adopted.
Otremba moved to amend S. F. No. 491, as amended, as follows:
Pages 1 to 5, delete sections 2 and 3
Renumber the sections in sequence and correct the internal references
Amend the title accordingly
A roll call was requested and properly seconded.
The question was taken on the Otremba amendment and the roll was called. There were 62 yeas and 70 nays as follows:
Those who voted in the affirmative were:
| Anderson, I. | Folliard | Juhnke | Mahoney | Paymar | Swapinski | |
| Bakk | Gleason | Kahn | Mariani | Pelowski | Thompson | |
| Bernardy | Goodwin | Kalis | Marko | Peterson | Wagenius | |
| Biernat | Gray | Kelliher | Marquart | Pugh | Walker | |
| Carlson | Greiling | Koskinen | McGuire | Rukavina | Wasiluk | |
| Clark, K. | Hausman | Kubly | Milbert | Schumacher | Wenzel | |
| Davnie | Hilstrom | Larson | Mullery | Sertich | Winter | |
| Dawkins | Hilty | Leighton | Murphy | Skoe | ||
| Dibble | Jaros | Lenczewski | Opatz | Skoglund | ||
| Dorn | Johnson, R. | Lieder | Osthoff | Slawik | ||
| Evans | Johnson, S. | Luther | Otremba | Solberg | ||
Those who voted in the negative were:
| Abrams | Dorman | Holberg | Lindner | Pawlenty | Tingelstad | |
| Anderson, B. | Eastlund | Holsten | Lipman | Penas | Tuma | |
| Bishop | Erhardt | Howes | Mares | Rhodes | Vandeveer | |
| Boudreau | Erickson | Huntley | McElroy | Rifenberg | Walz | |
| Bradley | Finseth | Jacobson | Molnau | Ruth | Westerberg | |
| Buesgens | Fuller | Jennings | Mulder | Seagren | Westrom | |
| Cassell | Gerlach | Johnson, J. | Ness | Seifert | Wilkin | |
| Clark, J. | Goodno | Kielkucki | Nornes | Smith | Wolf | |
| Daggett | Gunther | Knoblach | Olson | Stanek | Workman | |
| Davids | Haas | Krinkie | Osskopp | Stang | Spk. Sviggum | |
| Dehler | Hackbarth | Kuisle | Ozment | Swenson | ||
| Dempsey | Harder | Leppik | Paulsen | Sykora | ||
The motion did not prevail and the amendment was not adopted.
Speaker pro tempore Abrams called Boudreau to the Chair.
Bradley and Huntley moved to amend S. F. No. 491, as amended, as follows:
Page 2, line 20, reinstate the second "The"
Page 2, lines 21 and 22, reinstate the stricken language
Page 3, line 12, before the period, insert ", as determined under Minnesota Rules, part 4685.0801, subpart 4"
Page 4, line 25, delete everything after "year"
Page 4, line 26, delete everything before the semicolon
Page 4, line 28, delete everything after the second "year"
Page 4, delete line 29
Page 4, line 30, delete "Index"
Page 4, line 35, delete everything after the period
Page 4, delete line 36
Page 5, delete line 1, and insert:
"Subd. 4. [CERTAIN PREVENTIVE CARE EXCEPTED.] No copayment, deductible, or annual out-of-pocket maximum amounts shall apply to section 62A.047 or preventive health care coverage as defined in Minnesota Rules, part 4685.0100, subpart 5, item E, including child health supervision, provider health screening, and prenatal care.
Subd. 5. [PUBLIC PROGRAMS.] This section does not apply to the prepaid medical assistance program, the MinnesotaCare program, the prepaid general assistance medical care program, the federal Medicare program, or health plans provided through any of those programs."
The motion prevailed and the amendment was adopted.
Winter and Otremba moved to amend S. F. No. 491, as amended, as follows:
Page 6, after line 3, insert:
"Sec. 5. Minnesota Statutes 2000, section 62J.04, is amended by adding a subdivision to read:
Subd. 1b. [RESTRICTION ON INCREASES IN PREMIUM RATES.] Effective for health plans issued or renewed during the 2002 calendar year, no health plan company may increase premium rates by more than five percent above the rate in effect during the 2001 calendar year for the same or similar health plan coverage issued by that health plan company. Section 62A.02 applies to changes in premium rates made under this subdivision. A health plan company that wishes to increase premium rates for a health plan for calendar year 2002 by more than five percent may apply to the commissioner for the authority to do so. The commissioner may approve such an application if the commissioner finds that an additional rate increase is necessary to prevent insolvency of the health plan company, or to permit adjustments to adverse events that have affected the health plan which the health plan company could not reasonably have anticipated. The commissioner's decision regarding increases in premium rates is subject to appeal under chapter 14. For purposes of this subdivision, "health plan" has the meaning given in section 62A.011, subdivision 3, but includes the coverages described in clauses (7) and (10)."
Page 23, after line 35, insert:
"Sec. 17. [RECOMMENDATIONS; LIMITING INCREASES IN PREMIUM RATES.]
The commissioners of health and commerce shall develop a schedule for limiting increases in health plan premium rates to reasonable levels in calendar years 2003, 2004, and 2005. This schedule, recommendations on its implementation, and recommendations for a process by which health plan companies may apply to raise premium rates above the levels in the schedule, must be submitted to the legislature by January 15, 2002.
Sec. 18. [COST PROVISION; RESTRICTION ON PREMIUM RATE INCREASES.]
For biennia beginning on or after July 1, 2001, any increased costs incurred by a state agency as a result of Minnesota Statutes, section 62J.04, subdivision 1b, must be absorbed internally by the state agency within its appropriation budgeted for professional and technical services."
Renumber the sections in sequence and correct internal references
Amend the title accordingly
A roll call was requested and properly seconded.
Goodno raised a point of order pursuant to rule 3.21 that the Winter and Otremba amendment was not in order. Speaker pro tempore Boudreau ruled the point of order not well taken and the Winter and Otremba amendment in order.
The question recurred on the Winter and Otremba amendment and the roll was called. There were 64 yeas and 69 nays as follows:
Those who voted in the affirmative were:
Those who voted in the negative were:
| Abrams | Dorman | Holberg | Mares | Paymar | Tingelstad | |
| Anderson, B. | Eastlund | Holsten | McElroy | Penas | Tuma | |
| Bishop | Erhardt | Huntley | Molnau | Rhodes | Vandeveer | |
| Boudreau | Erickson | Jacobson | Mulder | Rifenberg | Westerberg | |
| Bradley | Finseth | Johnson, J. | Ness | Ruth | Westrom | |
| Buesgens | Fuller | Kielkucki | Nornes | Seagren | Wilkin | |
| Cassell | Gerlach | Knoblach | Olson | Seifert | Wolf | |
| Clark, J. | Goodno | Krinkie | Opatz | Smith | Workman | |
| Daggett | Gunther | Kuisle | Osskopp | Stanek | Spk. Sviggum | |
| Davids | Haas | Leppik | Ozment | Stang | ||
| Dehler | Hackbarth | Lindner | Paulsen | Swenson | ||
| Dempsey | Harder | Lipman | Pawlenty | Sykora | ||
The motion did not prevail and the amendment was not adopted.
Abrams moved to amend S. F. No. 491, as amended, as follows:
Page 8, after line 23, insert:
"Sec. 7. [62Q.121] [LICENSURE OF MEDICAL DIRECTORS.]
(a) No health plan company that has more than 50,000 enrollees in health plans in this state may employ a person as a medical director unless the person is licensed as a physician in this state.
(b) For purposes of this section, "medical director" means any person who makes recommendations or decisions, based upon medical training and knowledge, regarding the health plan company's medical protocols, medical policies, or treatment or coverage of treatment of a particular enrollee, regardless of whether the person's title is medical director, associate or assistant medical director, medical director for a specific subject area, chief medical officer, or similar title.
(c) This section applies only to medical directors who make recommendations or decisions that involve or affect enrollees who live in this state.
(d) Each health plan company that is subject to this section shall provide the commissioner with the names and licensure information of its medical directors and shall provide updates no later than 30 days after any changes."
Renumber the sections in sequence and correct internal references
Amend the title accordingly
A roll call was requested and properly seconded.
The question was taken on the Abrams amendment and the roll was called. There were 128 yeas and 6 nays as follows:
Those who voted in the affirmative were:
| Abeler | Dorn | Holsten | Lieder | Ozment | Swapinski | |
| Abrams | Eastlund | Howes | Lindner | Paulsen | Swenson | |
| Anderson, I. | Entenza | Huntley | Lipman | Pawlenty | Sykora | |
| Bakk | Erhardt | Jacobson | Luther | Paymar | Thompson | |
| Bernardy | Erickson | Jaros | Mahoney | Pelowski | Tingelstad | |
| Biernat | Evans | Jennings | Mares | Penas | Tuma | |
| Bishop | Finseth | Johnson, J. | Mariani | Peterson | Vandeveer | |
| Boudreau | Folliard | Johnson, R. | Marko | Pugh | Wagenius | |
| Bradley | Fuller | Johnson, S. | Marquart | Rhodes | Walker | |
| Buesgens | Gerlach | Juhnke | McElroy | Rifenberg | Walz | |
| Carlson | Gleason | Kahn | McGuire | Rukavina | Wasiluk | |
| Cassell | Goodno | Kalis | Milbert | Ruth | Wenzel | |
| Clark, J. | Goodwin | Kelliher | Molnau | Schumacher | Westerberg | |
| Clark, K. | Gray | Kielkucki | Mulder | Seagren | Westrom | |
| Daggett | Greiling | Knoblach | Mullery | Seifert | Winter | |
| Davids | Gunther | Koskinen | Murphy | Sertich | Wolf | |
| Davnie | Haas | Kubly | Ness | Skoe | Workman | |
| Dawkins | Hackbarth | Kuisle | Nornes | Skoglund | Spk. Sviggum | |
| Dehler | Harder | Larson | Opatz | Slawik | ||
| Dempsey | Hausman | Leighton | Osskopp | Solberg | ||
| Dibble | Hilstrom | Lenczewski | Osthoff | Stanek | ||
| Dorman | Hilty | Leppik | Otremba | Stang | ||
Those who voted in the negative were:
| Anderson, B. | Holberg | Krinkie | Olson | Smith | Wilkin | |
The motion prevailed and the amendment was adopted.
S. F. No. 491, A bill for an act relating to health; providing patient protections; amending Minnesota Statutes 2000, sections 45.027, subdivision 6; 62D.17, subdivision 1; 62J.38; 62M.02, subdivision 21; 62Q.56; and 62Q.58; proposing coding for new law in Minnesota Statutes, chapter 62D.
The bill was read for the third time, as amended, and placed upon its final passage.
The question was taken on the passage of the bill and the roll was called. There were 134 yeas and 0 nays as follows:
Those who voted in the affirmative were:
The bill was passed, as amended, and its title agreed to.
H. F. No. 905 was reported to the House.
Haas moved that H. F. No. 905 be continued on the Calendar for the Day. The motion prevailed.
S. F. No. 722 was reported to the House.
Wolf moved to amend S. F. No. 722, the second unofficial engrossment, as follows:
Page 58, line 33, after the period, insert "A utility may not be held liable to a customer for advice provided pursuant to this section."
Page 66, line 21, after "shall" insert ": (1)"
Page 66, line 23, after "116C.681" insert "; and (2) recodify Minnesota Statutes, section 116.85, subdivision 1a, paragraph (e) as section 116.07, subdivision 4a, paragraph (c)"
Page 70, delete lines 27 to 31 and insert:
"Subd. 6. [COMMISSION AUTHORITY.] In addition to any other authority, the commission has the authority to resolve customer complaints against a public utility whether or not the complaint involves a violation of this chapter. The commission may delegate this authority to commission staff as it deems appropriate."
Page 73, line 1, after "rates" delete the rest of the line
Page 73, delete line 2
Page 73, line 3, delete "other appropriate mechanisms"
The motion prevailed and the amendment was adopted.
Ozment, Wolf and Jennings moved to amend S. F. No. 722, the second unofficial engrossment, as amended, as follows:
Page 32, delete lines 28 to 36, and insert:
"Sec. 3. Minnesota Statutes 2000, section 216B.241, subdivision 1, is amended to read:
Subdivision 1. [DEFINITIONS.] For purposes of this section and section sections 216B.16,
subdivision 6b and 216B.2411, the terms defined in this subdivision have the meanings given them.
(a) "Commission" means the public utilities commission.
(b) "Commissioner" means the commissioner of public service commerce.
(c) "Customer facility" means all buildings, structures, equipment, and installations at a single site.
(d) "Department" means the department of public service commerce.
(e) "Energy conservation improvement" means the purchase or installation of a device, method, material, or project that:
(1) reduces consumption of or increases efficiency in the use of electricity or natural gas, including but not limited to insulation and ventilation, storm or thermal doors or windows, caulking and weatherstripping, furnace efficiency modifications, thermostat or lighting controls, awnings, or systems to turn off or vary the delivery of energy;
(2) either (i) creates, converts, or actively uses energy from renewable sources such as solar, wind, and biomass, or (ii) recovers energy from heating, cooling or ventilation systems for reuse, from air or water or other similar material, provided that the device or method conforms with national or state performance and quality standards whenever applicable;
(3) seeks to provide energy savings through reclamation or recycling and that is used as part of the infrastructure of an electric generation, transmission, or distribution system within the state or a natural gas distribution system within the state; or
(4) provides research or development of new means of increasing energy efficiency or conserving energy or research or development of improvement of existing means of increasing energy efficiency or conserving energy.
(f) "Investments and expenses of a public utility" includes the investments and expenses incurred by a public utility in connection with an energy conservation improvement, including but not limited to:
(1) the differential in interest cost between the market rate and the rate charged on a no-interest or below-market interest loan made by a public utility to a customer for the purchase or installation of an energy conservation improvement;
(2) the difference between the utility's cost of purchase or installation of energy conservation improvements and any price charged by a public utility to a customer for such improvements.
(g) "Large electric customer facility" means a customer facility that imposes a peak electrical demand on an electric utility's system of not less than 20,000 kilowatts, measured in the same way as the utility that serves the customer facility measures electrical demand for billing purposes, and for which electric services are provided at retail on a single bill by a utility operating in the state.
(h) "Load management" means an activity to change the timing or the efficiency of a customer's use of energy to reduce the demand for energy or capacity. A load management activity may be one of two types:
(1) a load management activity that increases the efficiency of energy services and that results in a demonstrable reduction in consumption of energy; or
(2) a load management activity that increases the efficiency of energy services, but that does not reduce energy consumption.
Sec. 4. Minnesota Statutes 2000, section 216B.241, subdivision 1a, is amended to read:
Subd. 1a. [INVESTMENT, EXPENDITURE, AND CONTRIBUTION; PUBLIC UTILITY.] (a) For purposes
of this subdivision and, subdivision 2 and section 216B.2411, "public utility" has the
meaning given it in section 216B.02, subdivision 4. Unless a public utility has elected to be governed by the
provisions of section 216B.2411, each public utility shall spend and invest for energy conservation
improvements under this subdivision and subdivision 2 the following amounts:
(1) for a utility that furnishes gas service, 0.5 percent of its gross operating revenues from service provided in the state;
(2) for a utility that furnishes electric service, 1.5 percent of its gross operating revenues from service provided in the state; and
(3) for a utility that furnishes electric service and that operates a nuclear-powered electric generating plant within the state, two percent of its gross operating revenues from service provided in the state.
For purposes of this paragraph (a) and section 216B.2411, "gross operating revenues" do not include
revenues from large electric customer facilities exempted by the commissioner of the department of public service
pursuant to under paragraph (b).
(b) The owner of a large electric customer facility may petition the commissioner of the department of public
service to exempt both electric and gas utilities serving the large energy customer facility from the investment
and expenditure requirements of paragraph (a) or section 216B.2411, subdivision 3 with respect to retail
revenues attributable to the facility. At a minimum, the petition must be supported by evidence relating to
competitive or economic pressures on the customer and a showing by the customer of reasonable efforts to identify,
evaluate, and implement cost-effective conservation improvements at the facility. If a petition is filed on or before
October 1 of any year, the order of the commissioner to exempt revenues attributable to the facility can be effective
no earlier than January 1 of the following year. The commissioner shall not grant an exemption if the commissioner
determines that granting the exemption is contrary to the public interest. The commissioner may, after investigation,
rescind any exemption granted under this paragraph upon a determination that cost-effective energy conservation
improvements are available at the large electric customer facility. For the purposes of this paragraph, "cost-effective"
means that the projected total cost of the energy conservation improvement at the large electric customer facility is
less than the projected present value of the energy and demand savings resulting from the energy conservation
improvement. For the purposes of investigations by the commissioner under this paragraph, the owner of any large
electric customer facility shall, upon request, provide the commissioner with updated information comparable to that
originally supplied in or with the owner's original petition under this paragraph.
(c) The commissioner may require investments or spending greater than the amounts required under this subdivision for a public utility whose most recent advance forecast required under section 216B.2422 or 216C.17 projects a peak demand deficit of 100 megawatts or greater within five years under mid-range forecast assumptions.
(d) A public utility or owner of a large electric customer facility may appeal a decision of the commissioner under paragraph (b) or (c) to the commission under subdivision 2. In reviewing a decision of the commissioner under paragraph (b) or (c), the commission shall rescind the decision if it finds that the required investments or spending will:
(1) not result in cost-effective energy conservation improvements; or
(2) otherwise not be in the public interest.
(e) Each utility shall determine what portion of the amount it sets aside for conservation improvement will be used
for conservation improvements under subdivision 2 and what portion it will contribute to the energy and conservation
account established in subdivision 2a. A public utility may propose to the commissioner to designate that all or a
portion of funds contributed to the account established in subdivision 2a be used for research and development
projects. Contributions must be remitted to the commissioner of public service by February 1 of each year.
Nothing in this subdivision prohibits a public utility from spending or investing for energy conservation
improvement more than required in this subdivision.
Sec. 5. Minnesota Statutes 2000, section 216B.241, subdivision 1b, is amended to read:
Subd. 1b. [CONSERVATION IMPROVEMENT BY COOPERATIVE ASSOCIATION OR MUNICIPALITY.] (a) This subdivision applies to:
(1) a cooperative electric association that generates and transmits electricity to associations that provide electricity at retail including a cooperative electric association not located in this state that serves associations or others in the state;
(2) a municipality that provides electric service to retail customers; and
(3) a municipality with gross operating revenues in excess of $5,000,000 from sales of natural gas to retail customers.
(b) Unless a cooperative electric association or municipality has elected to be governed by the provisions of section 216B.2411, each cooperative electric association and municipality subject to this subdivision shall spend and invest for energy conservation improvements under this subdivision the following amounts:
(1) for a municipality, 0.5 percent of its gross operating revenues from the sale of gas and one percent of its gross operating revenues from the sale of electricity not purchased from a public utility governed by subdivision 1a or a cooperative electric association governed by this subdivision, excluding gross operating revenues from electric and gas service provided in the state to large electric customer facilities; and
(2) for a cooperative electric association, 1.5 percent of its gross operating revenues from service provided in the state, excluding gross operating revenues from service provided in the state to large electric customer facilities indirectly through a distribution cooperative electric association.
(c) Each municipality and cooperative association subject to this subdivision shall identify and implement energy
conservation improvement spending and investments that are appropriate for the municipality or association, except
that a municipality or association may not spend or invest for energy conservation improvements that directly benefit
a large electric customer facility. Each municipality and cooperative electric association subject to this subdivision
may spend and invest annually up to 15 percent of the total amount required to be spent and invested on energy
conservation improvements under this subdivision on research and development projects that meet the definition of
energy conservation improvement in subdivision 1 and that are funded directly by the municipality or cooperative
electric association. Load management may be used to meet the requirements of this subdivision if it reduces
the
demand for or increases the efficiency of electric services. An energy conservation improvement that is a load management activity described in subdivision 1, paragraph (h), clause (2), may only be used to meet the following percentage of the conservation investment and spending requirements of this subdivision:
(1) 2003 - 95 percent;
(2) 2004 - 85 percent;
(3) 2005 - 75 percent;
(4) 2006 and thereafter - 70 percent.
A generation and transmission cooperative electric association may include as spending and investment required under this subdivision conservation improvement spending and investment by cooperative electric associations that provide electric service at retail to consumers and that are served by the generation and transmission association.
(d) By February 1 of each year, each municipality or cooperative shall report to the commissioner its energy conservation improvement spending and investments with a brief analysis of effectiveness in reducing consumption of electricity or gas. The commissioner shall review each report and make recommendations, where appropriate, to the municipality or association to increase the effectiveness of conservation improvement activities. The commissioner shall also review each report for whether a portion of the money spent on residential conservation improvement programs is devoted to programs that directly address the needs of renters and low-income persons unless an insufficient number of appropriate programs are available. For the purposes of this subdivision and subdivision 2, "low-income" means an income of less than 185 percent of the federal poverty level.
(e) As part of its spending for conservation improvement, a municipality or association may contribute to the energy and conservation account. A municipality or association may propose to the commissioner to designate that all or a portion of funds contributed to the account be used for research and development projects. Any amount contributed must be remitted to the commissioner of public service by February 1 of each year.
Sec. 6. Minnesota Statutes 2000, section 216B.241, subdivision 2, is amended to read:
Subd. 2. [PROGRAMS.] (a) The commissioner may by rule or order require public utilities to make investments and expenditures in energy conservation improvements, explicitly setting forth the interest rates, prices, and terms under which the improvements must be offered to the customers. The required programs must cover a two-year period. The commissioner shall require at least one public utility to establish a pilot program to make investments in and expenditures for energy from renewable resources such as solar, wind, or biomass and shall give special consideration and encouragement to programs that bring about significant net savings through the use of energy-efficient lighting. The commissioner shall evaluate the program on the basis of cost-effectiveness and the reliability of technologies employed. The rules of the department must provide to the extent practicable for a free choice, by consumers participating in the program, of the device, method, material, or project constituting the energy conservation improvement and for a free choice of the seller, installer, or contractor of the energy conservation improvement, provided that the device, method, material, or project seller, installer, or contractor is duly licensed, certified, approved, or qualified, including under the residential conservation services program, where applicable.
(b) The commissioner may require a utility to make an energy conservation improvement investment or expenditure whenever the commissioner finds that the improvement will result in energy savings at a total cost to the utility less than the cost to the utility to produce or purchase an equivalent amount of new supply of energy. The commissioner shall nevertheless ensure that every public utility operate one or more programs under periodic review by the department.
(c) An energy conservation improvement that is a load management activity described in subdivision
1, paragraph (h), clause (1), may be used to meet the requirements for energy conservation improvements under
this section if it results in a demonstrable reduction in consumption of energy.
(d) Each public utility subject to subdivision 1a may spend and invest annually up to 15 percent of the total amount required to be spent and invested on energy conservation improvements under this section by the utility on research and development projects that meet the definition of energy conservation improvement in subdivision 1 and that are funded directly by the public utility. A public utility may not spend for or invest in energy conservation improvements that directly benefit a large electric customer facility for which the commissioner has issued an exemption pursuant to subdivision 1a, paragraph (b). The commissioner shall consider and may require a utility to undertake a program suggested by an outside source, including a political subdivision or a nonprofit or community organization.
(e) No utility may make an energy conservation improvement under this section to a building envelope unless:
(1) it is the primary supplier of energy used for either space heating or cooling in the building;
(2) the commissioner determines that special circumstances, that would unduly restrict the availability of conservation programs, warrant otherwise; or
(3) the utility has been awarded a contract under subdivision 2a.
(f) The commissioner shall ensure that a portion of the money spent on residential conservation improvement programs is devoted to programs that directly address the needs of renters and low-income persons unless an insufficient number of appropriate programs are available.
(g) A utility, a political subdivision, or a nonprofit or community organization that has suggested a program, the attorney general acting on behalf of consumers and small business interests, or a utility customer that has suggested a program and is not represented by the attorney general under section 8.33 may petition the commission to modify or revoke a department decision under this section, and the commission may do so if it determines that the program is not cost-effective, does not adequately address the residential conservation improvement needs of low-income persons, has a long-range negative effect on one or more classes of customers, or is otherwise not in the public interest. The person petitioning for commission review has the burden of proof. The commission shall reject a petition that, on its face, fails to make a reasonable argument that a program is not in the public interest.
Sec. 7. Minnesota Statutes 2000, section 216B.241, subdivision 2b, is amended to read:
Subd. 2b. [RECOVERY OF EXPENSES.] The commission shall allow a utility to recover expenses resulting
from: (1) a conservation improvement program required by the department; (2) a conservation
investment plan under section 216B.2411; and (3) contributions to the energy and conservation
account, unless the recovery under clause (1), (2) or (3) would be inconsistent with a financial incentive
proposal approved by the commission. In addition, a utility may file annually, or the public utilities commission may
require the utility to file, and the commission may approve, rate schedules containing provisions for the automatic
adjustment of charges for utility service in direct relation to changes in the expenses of the utility for real and
personal property taxes, fees, and permits, the amounts of which the utility cannot control. A public utility is eligible
to file for adjustment for real and personal property taxes, fees, and permits under this subdivision only if, in the year
previous to the year in which it files for adjustment, it has spent or invested at least 1.75 percent of its gross revenues
from provision of electric service, excluding gross operating revenues from electric service provided in the state to
large electric customer facilities for which the commissioner of public service has issued an exemption under
subdivision 1a, paragraph (b), and 0.6 percent of its gross revenues from provision of gas service, excluding gross
operating revenues from gas services provided in the state to large electric customer facilities for which the
commissioner of public service has issued an exemption under subdivision 1a, paragraph (b), for that year
for energy conservation improvements under this section or section 216B.2411.
Sec. 8. Minnesota Statutes 2000, section 216B.241, subdivision 3, is amended to read:
Subd. 3. [OWNERSHIP OF ENERGY CONSERVATION IMPROVEMENT.] An energy conservation improvement made to or installed in a building in accordance with this section or section 216B.2411, except systems owned by the utility and designed to turn off, limit, or vary the delivery of energy, are the exclusive property of the
owner of the building except to the extent that the improvement is subjected to a security interest in favor of the utility in case of a loan to the building owner. The utility has no liability for loss, damage or injury caused directly or indirectly by an energy conservation improvement except for negligence by the utility in purchase, installation, or modification of the product.
Sec. 9. Minnesota Statutes 2000, section 216B.241, subdivision 5, is amended to read:
Subd. 5. [EFFICIENT LIGHTING PROGRAM.] (a) Each public utility, cooperative electric association, and municipal utility that provides electric service to retail customers shall include as part of its conservation improvement activities under this section or section 216B.2411 a program to strongly encourage the use of fluorescent and high intensity discharge lamps. The program must include at least a public information campaign to encourage use of the lamps and proper management of spent lamps by all customer classifications.
(b) A public utility that provides electric service at retail to 200,000 or more customers shall establish, either directly or through contracts with other persons, including lamp manufacturers, distributors, wholesalers, and retailers and local government units, a system to collect for delivery to a reclamation or recycling facility spent fluorescent and high intensity discharge lamps from households and from small businesses as defined in section 645.445 that generate an average of fewer than ten spent lamps per year.
(c) A collection system must include establishing reasonably convenient locations for collecting spent lamps from households and financial incentives sufficient to encourage spent lamp generators to take the lamps to the collection locations. Financial incentives may include coupons for purchase of new fluorescent or high intensity discharge lamps, a cash back system, or any other financial incentive or group of incentives designed to collect the maximum number of spent lamps from households and small businesses that is reasonably feasible.
(d) A public utility that provides electric service at retail to fewer than 200,000 customers, a cooperative electric association, or a municipal utility that provides electric service at retail to customers may establish a collection system under paragraphs (b) and (c) as part of conservation improvement activities required under this section.
(e) The commissioner of the pollution control agency may not, unless clearly required by federal law, require a public utility, cooperative electric association, or municipality that establishes a household fluorescent and high intensity discharge lamp collection system under this section to manage the lamps as hazardous waste as long as the lamps are managed to avoid breakage and are delivered to a recycling or reclamation facility that removes mercury and other toxic materials contained in the lamps prior to placement of the lamps in solid waste.
(f) If a public utility, cooperative electric association, or municipal utility contracts with a local government unit to provide a collection system under this subdivision, the contract must provide for payment to the local government unit of all the unit's incremental costs of collecting and managing spent lamps.
(g) All the costs incurred by a public utility, cooperative electric association, or municipal utility for promotion and collection of fluorescent and high intensity discharge lamps under this subdivision are conservation improvement spending under this section or section 216B.2411.
Sec. 10. [216B.2411] [CONSERVATION INVESTMENT PROGRAM.]
Subdivision 1. [DEFINITIONS.] (a) The definitions of section 216B.241, subdivision 1, apply to this section.
(b) "Other qualifying energy conservation improvements" means the purchase or installation of a device, method, material, project, or service that either:
(1) is a renewable energy facility utilizing methane or other combustible gases derived from the processing of plant or animal wastes, or biomass fuels such as short-rotation woody or fibrous agricultural crops produced for conversion to useful energy;
(2) increases the ability of a customer to respond to price fluctuations in the wholesale power market and to control the amount and scheduling of energy consumed by the customer:
(i) through the utilization of software or other scheduling services or technology, in addition to the meter provided as part of the customer's electric service; or
(ii) through the installation of a distributed generation facility as described in section 216B.69, subdivision 2, clause (1); or
(3) is a load management activity as described in section 216B.241, subdivision 1, paragraph (h), clause (2).
Subd. 2. [ELECTION.] (a) Each utility providing conservation programs under section 216B.241 may elect to be governed by the provisions of this section in lieu of section 216B.241 by notifying the commissioner in writing by August 1 of each year. The election to provide energy conservation improvements under this section may not be rescinded by the utility without a finding by the commission that there is a good cause to do so.
(b) A public utility with an approved conservation improvement plan under section 216B.241 shall provide a plan to the commissioner with its election notice under paragraph (a), detailing how the utility plans to transition from providing conservation programs under section 216B.241 to providing programs under this section.
(c) Notwithstanding the election made under paragraph (a), each municipal utility and cooperative electric association shall provide the initial evaluation of conservation programs required under subdivision 8, paragraph (b), due by February 1, 2002.
Subd. 3. [INVESTMENT, EXPENDITURE, AND CONTRIBUTION; PUBLIC UTILITY.] (a) Each public utility shall spend and invest for energy conservation improvements under this subdivision the following amounts:
(1) for a public utility that furnishes gas service, 0.7 percent of its annual average gross operating revenues over the previous five years from service provided in the state;
(2) for a public utility that furnishes electric service, 2.0 percent of its annual average gross operating revenues over the previous five years from service provided in the state; and
(3) for a public utility that furnishes electric service and that operates a nuclear-powered electric generating plant within the state, 2.5 percent of its annual average gross operating revenues over the previous five years from service provided in the state.
"Gross operating revenues" do not include revenues from large electric customer facilities exempted by the commissioner under section 216B.241, subdivision 1a, paragraph (b), and the revenues from those facilities shall be deducted when calculating the utility's annual average gross operating revenues.
(b) An energy conservation improvement that is a load management activity described in section 216B.241, subdivision 1, paragraph (h), clause (1), may be used to meet the requirements for energy conservation improvements under this section.
(c) Up to 10 percent of the total amount required to be spent under this section may be spent on other qualifying energy conservation improvements described in subdivision 1, paragraph (b), clauses (1) to (3).
(d) Each public utility subject to subdivision 2 may spend and invest annually up to 15 percent of the total amount required to be spent and invested on energy conservation improvements under this section by the utility on research and development projects that meet the definition of energy conservation improvement in subdivision 1 and that are funded directly by the public utility.
Subd. 4. [CONSERVATION IMPROVEMENT BY COOPERATIVE ASSOCIATION OR MUNICIPALITY.] (a) This subdivision applies to:
(1) a cooperative electric association that generates and transmits electricity to associations that provide electricity at retail including a cooperative electric association not located in this state that serves associations or others in the state;
(2) a municipality that provides electric service to retail customers; and
(3) a municipality with gross operating revenues in excess of $5,000,000 from sales of natural gas to retail customers.
(b) Each cooperative electric association and municipality subject to this subdivision shall spend and invest for energy conservation improvements under this subdivision the following amounts:
(1) for a municipality, 0.7 percent of its annual average gross operating revenues over the previous five years from the sale of gas and 1.5 percent of its annual average gross operating revenues over the previous five years from the sale of electricity; and
(2) for a cooperative electric association, 2.0 percent of its annual average gross operating revenues over the previous five years from service provided in the state.
"Gross operating revenues" do not include revenues from large electric customer facilities exempted by the commissioner under section 216B.241, subdivision 1a, paragraph (b), and the revenues from those facilities shall be deducted when calculating the utility's annual average gross operating revenues.
(c) Each municipality and cooperative association subject to this subdivision shall identify and implement energy conservation improvement spending and investments that are appropriate for the municipality or association. Municipal utilities and electric cooperative associations may agree to form associations or organizations to aggregate their conservation spending obligations and to jointly provide energy conservation services to the customers of the municipal utilities or associations, and shall notify the commissioner in writing of the formation of such an association or organization.
(d) Each municipality and cooperative electric association subject to this subdivision may spend and invest annually up to 15 percent of the total amount required to be spent and invested on energy conservation improvements under this subdivision on research and development projects that meet the definition of energy conservation improvement in subdivision 1 and that are funded directly by the municipality or cooperative electric association.
(e) Up to 10 percent of the total amount required to be spent under this section may be spent on other qualifying energy conservation improvements described in subdivision 1, paragraph (b), clauses (1) and (2).
(f) Load management activities, as described in section 216B.241, subdivision 1, paragraph (h), clauses (1) and (2), may be used to meet the requirements for energy conservation improvements of this subdivision.
(g) A generation and transmission cooperative electric association may include as spending and investment required under this subdivision, conservation improvement spending and investment by cooperative electric associations that provide electric service at retail to consumers and that are served by the generation and transmission association.
Subd. 5. [PROGRAMS.] (a) The commissioner may by rule as resources allow, or by order, establish
standards and criteria for the provision of energy conservation improvements under this section, including standard
programs, to efficiently and effectively provide energy conservation services to each utility's energy consumers on
a nondiscriminatory basis and cost-effective manner and to provide certainty to utilities and associations as to what
constitutes an acceptable energy conservation improvement under this section. The list of standard programs may
include rebates for high-efficiency appliances, rebates or subsidies for high-efficiency lamps, small business energy audits, and building recommissioning. A utility may adhere to this list of programs or may offer other conservation programs not on the list.
(b) Each public utility shall ensure that a portion of the money spent on residential conservation improvement programs is devoted to programs that directly address the needs of renters and low-income persons, in proportion to the amount the utility has historically spent on such programs relative to the utility's annual gross revenues, unless an insufficient number of appropriate programs are available.
(c) A utility, a political subdivision, or a nonprofit or community organization that has suggested an energy conservation improvement program to a public utility, the attorney general acting on behalf of consumers and small business interests, or a utility customer that has suggested a program and is not represented by the attorney general under section 8.33 may petition the commission to modify or discontinue a utility energy conservation improvement program, and the commission may do so if it determines that the program is not sufficiently cost-effective, does not adequately address the residential conservation improvement needs of low-income persons, has a long-range negative effect on one or more classes of customers, or is otherwise not in the public interest. The commission shall reject a petition that, on its face, fails to make a reasonable argument that a program is not in the public interest.
Subd. 6. [ENERGY SAVINGS GOALS.] (a) By August 1, 2001, and every three years thereafter, the commissioner shall develop energy savings goals:
(1) in kilowatts and kilowatt-hours that each public utility providing retail electric service in this state can reasonably be expected to achieve at the level of energy conservation improvement expenditures required under this section; and
(2) in cubic feet of natural gas that each public utility providing retail natural gas service in this state can reasonably be expected to achieve at the level of conservation improvement expenditures required under this section.
(b) In consultation with the commissioner, municipal utilities and cooperative electric associations shall develop and submit energy savings goals to the commissioner by August 1, 2001, and every three years thereafter.
(c) Municipal utilities and electric cooperative associations that agree to aggregate their energy conservation obligations and resources by forming associations or organizations to provide energy conservation services to their customers may develop goals for the association or organization, in lieu of goals for individual members.
Subd. 7. [PLAN AND AUDIT; PUBLIC UTILITIES.] (a) By January 1, 2002, and every two years thereafter, each public utility shall provide the commissioner with the utility's conservation investment plan, detailing the utility's planned energy conservation improvements activities for the next two years, and the anticipated energy savings from those activities. This plan must include a description of the types of activities, the consumer sectors targeted by each activity, and the anticipated energy savings and costs of each activity. The plan must also indicate, for each type of activity, how much additional cost-effective conservation is likely to be achieved in subsequent years. A public utility may request the commissioner to approve or reject the utility's plan prior to implementing the plan. The commissioner may do so if resources permit.
(b) By April 1, 2004, and every two years thereafter, each public utility shall provide a report to the commissioner summarizing the utility's conservation activities and energy savings resulting from those activities under this section. The public utility shall include in the report the results of an independent audit performed by the department or an auditor with experience in the provision of energy conservation and energy efficiency services approved by the commissioner and chosen by the utility. The audit must specify the actual energy savings or increased efficiency in the use of energy within the service territory of the utility that is the result of the spending and investments.
(c) The audit provided under paragraph (b) shall evaluate the cost-effectiveness of the utility's conservation programs. In making this evaluation, the audit shall consider whether the utility's programs:
(1) fairly address each of the utility's consumer classes and market sectors;
(2) use accurate and complete data in calculating costs and energy savings;
(3) identify and target investments and improvements that have a high potential for saving energy;
(4) indicate an adequate commitment to implementing highly cost-effective conservation programs; and
(5) comply with the provisions of this section and associated rules and orders.
An audit must give a negative evaluation if it finds the utility's overall energy conservation program has not been cost-effective or has failed to satisfy any of the criteria. Up to five percent of a utility's conservation spending obligation under this section may be used for program pre-evaluation, research and testing, monitoring, and program audit and evaluation.
(d) Following one or more negative evaluations under paragraph (b), the commission may determine that a utility is not implementing adequate energy conservation programs. In that event, the commission may order the utility to pay into the alternative provider account under subdivision 10:
(1) up to 25 percent of the utility's spending obligation under this section after the first negative evaluation;
(2) up to 50 percent of the utility's conservation spending obligation under this section after the second negative evaluation; and
(3) up to 100 percent of the utility's spending obligation under this section after the third negative evaluation.
The commissioner shall select a third party other than the utility by competitive bid to provide conservation improvements in the utility's service territory.
Subd. 8. [PLAN AND PROGRAM EVALUATION; MUNICIPAL AND COOPERATIVE UTILITIES.] (a) By February 1, 2002, and every two years thereafter, each municipal utility and cooperative electric association shall provide the commissioner with the utility's or association's conservation investment plan for the next two years, detailing the utility's or association's planned energy conservation improvement activities and the anticipated energy savings on a biennial basis. This plan must include a description of the types of activities, the consumer sectors targeted by each, and the anticipated energy savings and costs of each activity. This plan must also indicate, for each type of activity, how much additional cost-effective conservation is likely to be achieved in subsequent years.
(b) With each filing under paragraph (a), each municipal utility or cooperative association shall also provide an evaluation to the commission summarizing the utility's or association's conservation activities and energy savings resulting from those activities under this section. In consultation with the commissioner, the municipal utility or cooperative association shall evaluate its energy and capacity conservation programs, develop plans for future programs, and report its findings to the commission. The evaluation must develop program and performance goals that recognize customer class, utility service area demographics, cost of program delivery, regional economic indicators, and utility load shape. The program evaluation must address:
(1) whether the utility or association has implemented or is implementing cost-effective energy conservation programs and specify the energy and capacity savings within the service territory or association that is the result of conservation improvement programs, using a list of baseline energy and capacity savings assumptions developed in consultation with the department of commerce;
(2) the availability of basic conservation services and programs to customers;
(3) methodologies that best quantify energy savings, cost-effectiveness, and the potential for cost-effective conservation improvements;
(4) the value of local administration of conservation programs in meeting local and statewide needs;
(5) the effect on customer bills;
(6) the role of capacity conservation in meeting utility planning needs and state energy goals;
(7) the ability of energy conservation programs to avoid the need for construction of generation facilities and transmission lines;
(8) whether the utility's or association's programs address all of the following consumer market sectors: farm, residential, commercial, and industrial; and
(9) whether the utility's or association's programs use accurate and auditable data in calculating costs and energy savings.
(c) Municipal utilities and cooperative electric associations that aggregate their energy conservation obligations and resources by forming associations or organizations to provide energy conservation services to their customers may submit overviews, program evaluations, and annual reports jointly.
Subd. 9. [ADDITIONAL CONSERVATION ISSUES.] (a) Nothing in this section prohibits any utility from spending or investing more for energy conservation improvements than is required in this section.
(b) The commission may require a public utility to invest or spend more than is required under this section if the commission finds that additional investments would be cost-effective, and the utility's most recent forecast projects a significant supply deficit to meet demand and energy requirements. If the commission orders the utility to make additional conservation investments under this section, the commission shall provide for financial incentives for these investments under section 216B.16, unless the commission finds that such incentives are not in the public interest.
(c) The commissioner may request the commission to order an audit under subdivision 7, paragraph (b), or an evaluation under subdivision 8, paragraph (b), prior to the regularly scheduled audit or evaluation if the commissioner has reason to believe such an audit or evaluation is in the public interest. The commission shall grant the request if it finds the commissioner has shown sufficient cause to conduct the audit or evaluation. The commission's order may provide specific parameters for the audit or evaluation to ensure that areas of particular concern to the commissioner are addressed.
Subd. 10. [ALTERNATIVE PROVIDER FUND.] (a) An alternative provider fund is created as an account in the state treasury. Money in the fund is appropriated to the commissioner for the purposes provided in this subdivision. Earnings, such as interest, dividends, and any other earnings arising from fund assets, must be credited to the fund.
(b) The commissioner may contract with one or more private entities, following the issuance of request for proposals, to design and implement energy conservation initiatives in the service territory of a public utility that is the subject of a commission order under subdivision 7, paragraph (d). Such certification may not be for a period of longer than five years, but may be renewed. The commissioner shall establish in the contract by order the duties, standards, and procedures related to the operations of the private entity, as well as the procedures and criteria for selecting and certifying the private entity.
(c) Once certified, the private entity shall design and implement energy conservation initiatives. The initiatives must be designed and implemented to efficiently and effectively provide energy conservation services to energy consumers on a nondiscriminatory and cost-effective basis. The entity may provide services directly or under contracts with others, and may solicit and review proposals to implement energy conservation initiatives from any entity, including other private entities, local government units, community organizations, and utilities."
Delete page 33, line 1 to page 47, line 25
Page 66, after line 19, insert:
"Sec. 8. Minnesota Statutes 2000, section 216B.03, is amended to read:
216B.03 [REASONABLE RATE.]
(a) Every rate made, demanded, or received by any public utility, or by any two or more public utilities
jointly, shall must be just and reasonable. Rates shall must not be unreasonably
preferential, or unreasonably prejudicial or discriminatory, but shall must be
sufficient, equitable and consistent in application to a class of consumers. To the maximum reasonable extent, the
commission shall set rates to encourage energy conservation and renewable energy use and to further the goals of
sections 216B.164, 216B.241, 216B.2411, and 216C.05. Any doubt as to reasonableness should be resolved
in favor of the consumer.
(b) For rate-making purposes a public utility may treat two or more municipalities served by it as a single class wherever the populations are comparable in size or the conditions of service are similar.
Sec. 9. Minnesota Statutes 2000, section 216B.16, subdivision 1, is amended to read:
Subdivision 1. [NOTICE.] Unless the commission otherwise orders, no public utility shall change a rate
which that has been duly established under this chapter, except upon 60 days' notice to the
commission. The notice shall must include statements of facts, expert opinions, substantiating
documents, and exhibits, supporting the change requested, and state the change proposed to be made in the rates then
in force and the time when the modified rates will go into effect. If the filing utility does not have an approved
conservation improvement plan on file with the department of public service, it shall also include in its notice an
energy conservation plan pursuant to section 216B.241. The filing utility shall give written notice, as approved
by the commission, of the proposed change to the governing body of each municipality and county in the area
affected. All proposed changes shall must be shown by filing new schedules or shall be
plainly indicated upon schedules on file and in force at the time.
Sec. 10. Minnesota Statutes 2000, section 216B.16, subdivision 6b, is amended to read:
Subd. 6b. [ENERGY CONSERVATION IMPROVEMENT.] (a) Except as otherwise provided in this subdivision,
all investments and expenses of a public utility as defined in section 216B.241, subdivision 1, paragraph (e), incurred
in connection with energy conservation improvements shall under either section 216B.241 or 216B.2411
must be recognized and included by the commission in the determination of just and reasonable rates as if the
investments and expenses were directly made or incurred by the utility in furnishing utility service.
(b) After December 31, 1999, investments and expenses for energy conservation improvements shall
must not be included by the commission in the determination of just and reasonable electric and gas rates
for retail electric and gas service provided to large electric customer facilities that have been exempted by the
commissioner of the department of public service pursuant to section 216B.241, subdivision 1a, paragraph
(b). However, no a public utility shall may not be prevented from recovering its
investment in energy conservation improvements from all customers that were made on or before December 31,
1999, in compliance with the requirements of section 216B.241.
(c) The commission may permit a public utility to file rate schedules providing for annual recovery of the costs
of energy conservation improvements under either section 216B.241 or 216B.2411. These rate schedules
may be applicable to less than all the customers in a class of retail customers if necessary to reflect the differing
minimum spending requirements of section 216B.241, subdivision 1a. After December 31, 1999, the commission
shall allow a public utility, without requiring a general rate filing under this section, to reduce the electric and gas
rates applicable to large electric customer facilities that have been exempted by the commissioner of the
department of public service pursuant to section 216B.241, subdivision 1a, paragraph (b), by an amount that
reflects the elimination of energy conservation improvement investments or expenditures for those facilities required
on or before December 31, 1999. In the event that If the commission has set electric or gas rates
based on the use of an accounting methodology that results in the cost of conservation improvements being recovered
from utility customers over a period of years, the rate reduction may occur in a series of steps to coincide with the
recovery of balances due to the utility for conservation improvements made by the utility on or before December 31,
1999.
Sec. 11. Minnesota Statutes 2000, section 216B.16, subdivision 6c, is amended to read:
Subd. 6c. [INCENTIVE PLAN FOR ENERGY CONSERVATION IMPROVEMENT.] (a) The commission may order public utilities to develop and submit for commission approval incentive plans that describe the method of recovery and accounting for utility conservation expenditures and savings under either section 216B.241 or 216B.2411. In developing the incentive plans the commission shall ensure the effective involvement of interested parties.
(b) In approving incentive plans, the commission shall consider:
(1) whether the plan is likely to increase utility investment in cost-effective energy conservation;
(2) whether the plan is compatible with the interest of utility ratepayers and other interested parties;
(3) whether the plan links the incentive to the utility's performance in achieving cost-effective conservation; and
(4) whether the plan is in conflict with other provisions of this chapter.
(c) The commission may set rates to encourage the vigorous and effective implementation of utility conservation programs. The commission may:
(1) increase or decrease any otherwise allowed rate of return on net investment based upon the utility's skill, efforts, and success in conserving energy;
(2) share between ratepayers and utilities the net savings resulting from energy conservation programs to the extent justified by the utility's skill, efforts, and success in conserving energy; and
(3) compensate the utility for earnings lost as a result of its conservation programs.
Sec. 12. Minnesota Statutes 2000, section 216B.162, subdivision 8, is amended to read:
Subd. 8. [ENERGY EFFICIENCY IMPROVEMENT; EXPENSE RECOVERY.] If the commission approves a
competitive rate or the parties agree to a modified rate, the commission may require the electric utility to provide
the customer with an energy audit and assist in implementing cost-effective energy efficiency improvements to assure
that the customer's use of electricity is efficient. An investment in cost-effective energy conservation improvements
required under this section must be treated as an energy conservation improvement program and included in the
department's determination of significant investments under section 216B.241 or 216B.2411. The
utility shall recover energy conservation improvement expenses in a rate proceeding under section 216B.16 or
216B.17 in the same manner as the commission authorizes for the recovery of conservation expenditures made under
section 216B.241 or 216B.2411.
Sec. 13. Minnesota Statutes 2000, section 216B.164, subdivision 4, is amended to read:
Subd. 4. [PURCHASES; WHEELING; COSTS.] (a) Except as otherwise provided in paragraph (c), this subdivision shall apply to all qualifying facilities having 40-kilowatt capacity or more as well as qualifying facilities as defined in subdivision 3 which elect to be governed by its provisions.
(b) The utility to which the qualifying facility is interconnected shall purchase all energy and capacity made
available by the qualifying facility. The qualifying facility shall be paid the utility's full avoided capacity and energy
costs as negotiated by the parties, as set by the commission, or as determined through competitive bidding approved
by the commission. The full avoided capacity and energy costs to be paid a qualifying facility that generates electric
power by means of a renewable energy source are the utility's least cost renewable energy facility or the bid of a
competing supplier of a least cost renewable energy facility, whichever is lower, unless the commission's resource
plan order, under section 216B.2422, subdivision 2, provides commission determines that the use of
a renewable resource to meet the identified capacity need is not in the public interest.
(c) For all qualifying facilities having 30-kilowatt capacity or more, the utility shall, at the qualifying facility's or the utility's request, provide wheeling or exchange agreements wherever practicable to sell the qualifying facility's output to any other Minnesota utility having generation expansion anticipated or planned for the ensuing ten years. The commission shall establish the methods and procedures to insure that except for reasonable wheeling charges and line losses, the qualifying facility receives the full avoided energy and capacity costs of the utility ultimately receiving the output.
(d) The commission shall set rates for electricity generated by renewable energy."
Page 66, line 21, delete "(a)"
Page 66, delete lines 24 to 29
Page 75, line 11, delete "sections 216B.241 and" and insert "section" and delete "are" and insert ", is"
Renumber the sections in sequence and correct internal references
Amend the title accordingly
The motion prevailed and the amendment was adopted.
The Speaker resumed the Chair.
Kubly and Kalis moved to amend S. F. No. 722, the second unofficial engrossment, as amended, as follows:
Pages 31 and 32, delete section 2 and insert:
"Sec. 2. [216B.169] [RENEWABLE ENERGY.]
Subdivision 1. [DEFINITIONS.] (a) "Renewable energy technology" means a technology that exclusively relies on an energy source that is naturally and sustainably regenerated over a short time and derived directly from the sun, indirectly from the sun, or from moving water or other natural movements and mechanisms of the environment. Renewable energy technologies include solar, wind, hydroelectric with a capacity of less than 60 megawatts, or biomass. For the purpose of this section, "biomass" does not include municipal solid waste. A renewable energy technology may not rely on energy resources derived from fossil fuels or waste products from fossil fuels.
(b) "Electric utility" means a public utility, municipal utility, cooperative electric association, or any other entity providing electric service to retail customers in Minnesota.
Subd. 2. [RENEWABLE ENERGY REQUIREMENTS.] (a) Unless the commission or governing body of a municipal utility or cooperative electric association acts under paragraph (b), each public utility, municipal utility, or cooperative electric association providing electric service to retail consumers in the state must comply with clauses (1) to (3):
(1) commencing in 2005, at least one percent of the electric energy an electric utility provides to its retail customers in Minnesota must be generated by renewable energy technologies and that amount must be increased by one percent each year until 2015;
(2) by 2015 at least 10 percent of the energy each electric utility provides to its retail customers in Minnesota must be generated by renewable energy technologies; and
(3) of the renewable energy technology generation required under clause (2), at least one percent of the energy must be generated by biomass energy technologies by 2010 and two percent by 2015.
(b) The commission or governing body shall review the requirement established in paragraph (a) annually and may decrease the requirement in any year if, for good cause and based upon independent and verifiable analysis, the commission or governing body finds the requirement will:
(1) cause rate increases to retail customers that exceed the benefits of utilizing renewable energy technology; or
(2) jeopardize electric supply reliability.
(c) An action to decrease the requirements of this section by a governing body of a municipal utility or cooperative electric association may be appealed to the voters of a municipality or the members of the cooperative association by a petition signed by five percent or more of the voting-age citizens of the municipality or an association's membership.
Subd. 3. [TRADEABLE CREDITS.] (a) To facilitate compliance with this section, the commission shall, by order, establish a program for tradeable credits for renewable energy under this section. For renewable energy other than biomass energy, the renewable credit program must allow for trading of credits for energy generated from renewable energy generation facilities operational after January 1, 2005. For biomass energy, the credit program shall allow for trading of credits for energy generated by renewable energy generation facilities operational on or after January 1, 2005. The commission shall establish separate prices for biomass renewable energy credits and nonbiomass renewable energy credits.
(b) Upon passage of a renewables portfolio standard in another state that includes the same definition of renewable energy technology and begins at a level commensurate to the existing level of renewables in that state, the department may facilitate the trading of renewable energy credits between parties located in this and that state."
Amend the title accordingly
A roll call was requested and properly seconded.
The question was taken on the Kubly and Kalis amendment and the roll was called. There were 63 yeas and 69 nays as follows:
Those who voted in the affirmative were:
Those who voted in the negative were:
| Abeler | Dehler | Hackbarth | Leppik | Pawlenty | Sykora | |
| Abrams | Dempsey | Harder | Lindner | Pelowski | Tingelstad | |
| Anderson, B. | Dorman | Holberg | Mares | Penas | Vandeveer | |
| Anderson, I. | Eastlund | Holsten | McElroy | Rhodes | Walz | |
| Bishop | Erhardt | Howes | Molnau | Rifenberg | Westrom | |
| Boudreau | Erickson | Jacobson | Mulder | Ruth | Wilkin | |
| Bradley | Finseth | Jennings | Ness | Seagren | Wolf | |
| Buesgens | Fuller | Johnson, J. | Nornes | Seifert | Workman | |
| Cassell | Gerlach | Kielkucki | Olson | Smith | Spk. Sviggum | |
| Clark, J. | Goodno | Knoblach | Osskopp | Stanek | ||
| Daggett | Gunther | Krinkie | Ozment | Stang | ||
| Davids | Haas | Kuisle | Paulsen | Swenson | ||
The motion did not prevail and the amendment was not adopted.
Jennings moved to amend S. F. No. 722, the second unofficial engrossment, as amended, as follows:
Page 11, after line 30, insert:
"Sec. 12. [RECOMMENDATIONS FOR FURTHER STREAMLINING.]
As part of the energy security blueprint due by December 15, 2001, the commissioner, in consultation with the director of state planning, and the members and executive secretary of the public utilities commission, shall provide recommendations and options for further streamlining of the procedures for certificate of need, routing and siting, environmental review, and permitting of energy facilities. The commissioner shall specifically address the advantages and disadvantages of transferring the administration of the power plant siting act, Minnesota Statutes, sections 116C.51 to 116C.69 from the environmental quality board to the public utilities commission, thereby consolidating the necessary review and permitting procedures in a single agency."
Renumber the sections in sequence and correct internal references
Amend the title accordingly
The motion prevailed and the amendment was adopted.
Jennings moved to amend S. F. No. 722, the second unofficial engrossment, as amended, as follows:
Page 49, line 33, after "(5)" insert "for" and after "utility" insert a comma
Page 49, delete lines 34 to 36 and insert "the commission has authority over the activities, services and rates of the joint venture, and may exercise that authority, to the same extent the commission has authority over the activities, services and rates of the investor-owned utility itself."
The motion prevailed and the amendment was adopted.
Jennings moved to amend S. F. No. 722, the second unofficial engrossment, as amended, as follows:
Page 53, line 12, before "The" insert "(a)"
Page 53, line 20, after the period, insert:
"(b) A large electric customer facility as defined in Minnesota Statutes, section 216B.241, subdivision 1, that is exempt from the investment and expenditure requirements of Minnesota Statutes, section 216B.241, by virtue of a contract approved by the public utilities commission prior to April 15, 2001, under Minnesota Statutes, section 216B.162, shall remain exempt from those requirements until April 15, 2006.
(c)"
Page 53, line 20, delete "provision" and insert "section"
Page 53, delete lines 21 to 23 and insert "monthly peak measured demand for three consecutive months exceeds 110 percent of the annual peak measured demand of the facility in the year the exemption was granted."
The motion prevailed and the amendment was adopted.
Peterson moved to amend S. F. No. 722, the second unofficial engrossment, as amended, as follows:
Page 84, after line 9, insert:
"ARTICLE 8
ENERGY INDEPENDENCE TASK FORCE
Section 1. [ENERGY INDEPENDENCE GOAL; TIMELINE.]
(a) Minnesota consumers, especially commercial enterprises involved in farming, forestry products, mining, transportation, product processing, and tourism, rely heavily on the continued availability of energy supplies at a stable and predictable cost. Foreign energy sources cannot be relied upon for either availability or cost. It is therefore appropriate for Minnesota to establish a domestic energy program to ensure that the state is never held hostage to the whims of foreign energy delivery by outside interests.
(b) By July 1, 2030, the state of Minnesota intends to provide at least 50 percent of its energy needs from sources indigenous to the state.
Sec. 2. [TASK FORCE; DUTIES; CREATION.]
(a) The commissioner of commerce, in consultation with the commissioners of agriculture, transportation, and economic development shall oversee the activities of a task force of 21 members whose principal responsibility is to develop an energy policy for the state that will emphasize locally derived and locally developed energy sources to meet the energy demands of the state.
(b) Members of the task force consist of:
(1) the four commissioners identified in paragraph (a) or their designees;
(2) two citizen members appointed by each of the commissioners;
(3) three citizen members appointed by the governor;
(4) three members appointed by the senate rules and administration subcommittee on committees; and
(5) three members appointed by the speaker of the house of representatives.
(c) Terms, compensation, and removal of citizen members of the task force are governed by Minnesota Statutes, section 15.059.
(d) The task force does not have a predetermined expiration date.
Sec. 3. [ALTERNATIVE AND RENEWABLE ENERGY SOURCE DEVELOPMENT.]
(a) The task force shall evaluate options and priorities related to the goal of energy independence. Options must include:
(1) the development and production of energy from alternative, nontraditional, and renewable sources; and
(2) energy conservation measures.
(b) To the maximum extent practicable, the task force shall give priority in energy source development to resources derived from agricultural production and to energy options available in rural parts of the state. These energy sources include, but are not limited to:
(1) alternative diesel engine fuels derived from soybean and other agricultural plant oils or animal fats;
(2) ethanol derived from grains or other agricultural products or byproducts;
(3) methane or other combustible gases derived from the processing of plant or animal wastes;
(4) biomass fuels such as short-rotation woody or fibrous agricultural crops produced for conversion to useful energy; and
(5) further development of the solar, wind, and biomass energy potential in rural areas of the state.
Sec. 4. [ANNUAL REPORTS; RECOMMENDATIONS.]
By February 15, 2002, and February 15 of each year thereafter, the commissioner of commerce shall deliver a summary report to appropriate committees of the legislature on activities and recommendations of the task force, including any recommended changes in law or rule needed to accomplish the state's goal of energy independence."
Amend the title accordingly
A roll call was requested and properly seconded.
The question was taken on the Peterson amendment and the roll was called. There were 58 yeas and 75 nays as follows:
Those who voted in the affirmative were:
| Anderson, I. | Entenza | Hilty | Kubly | Otremba | Solberg | |
| Bakk | Evans | Huntley | Leighton | Paymar | Swapinski | |
| Bernardy | Folliard | Jaros | Lieder | Pelowski | Thompson | |
| Biernat | Gleason | Johnson, R. | Luther | Peterson | Wagenius | |
| Carlson | Goodwin | Johnson, S. | Mariani | Pugh | Walker | |
| Clark, K. | Gray | Juhnke | Marquart | Rukavina | Wasiluk | |
| Davnie | Greiling | Kahn | McGuire | Sertich | Wenzel | |
| Dawkins | Harder | Kalis | Milbert | Skoe | Winter | |
| Dibble | Hausman | Kelliher | Mullery | Skoglund | ||
| Dorn | Hilstrom | Koskinen | Murphy | Slawik | ||
Those who voted in the negative were:
| Abeler | Dorman | Howes | Mahoney | Pawlenty | Tingelstad | |
| Abrams | Eastlund | Jacobson | Mares | Penas | Tuma | |
| Anderson, B. | Erhardt | Jennings | Marko | Rhodes | Vandeveer | |
| Bishop | Erickson | Johnson, J. | McElroy | Rifenberg | Walz | |
| Boudreau | Finseth | Kielkucki | Molnau | Ruth | Westerberg | |
| Bradley | Fuller | Knoblach | Mulder | Schumacher | Westrom | |
| Buesgens | Gerlach | Krinkie | Ness | Seagren | Wilkin | |
| Cassell | Goodno | Kuisle | Nornes | Seifert | Wolf | |
| Clark, J. | Gunther | Larson | Olson | Smith | Workman | |
| Daggett | Haas | Lenczewski | Opatz | Stanek | Spk. Sviggum | |
| Davids | Hackbarth | Leppik | Osskopp | Stang | ||
| Dehler | Holberg | Lindner | Ozment | Swenson | ||
| Dempsey | Holsten | Lipman | Paulsen | Sykora | ||
The motion did not prevail and the amendment was not adopted.
The Speaker called Abrams to the Chair.
Huntley offered an amendment to S. F. No. 722, the second unofficial engrossment, as amended.
Holsten raised a point of order pursuant to rule 4.03, relating to Ways and Means Committee; Budget Resolution; Effect on Expenditure and Revenue Bills, that the Huntley amendment was not in order. Speaker pro tempore Abrams ruled the point of order well taken and the Huntley amendment out of order.
Mariani offered an amendment to S. F. No. 722, the second unofficial engrossment, as amended.
Holsten raised a point of order pursuant to rule 3.21 that the Mariani amendment was not in order. Speaker pro tempore Abrams ruled the point of order well taken and the Mariani amendment out of order.
Ozment moved to amend S. F. No. 722, the second unofficial engrossment, as amended, as follows:
Page 75, after line 9, insert:
"Sec. 9. [ALTERNATIVE AND RENEWABLE ENERGY SOURCE DEVELOPMENT.]
(a) The electric energy task force shall evaluate options and priorities related to the goal of energy independence. Options must include:
(1) the development and production of energy from alternative, nontraditional, and renewable sources; and
(2) energy conservation measures.
(b) To the maximum extent practicable, the task force shall give priority in energy source development to resources derived from agricultural production and to energy options available in rural parts of the state. These energy sources include, but are not limited to:
(1) alternative diesel engine fuels derived from soybean and other agricultural plant oils or animal fats;
(2) ethanol derived from grains or other agricultural products or byproducts;
(3) methane or other combustible gases derived from the processing of plant or animal wastes;
(4) biomass fuels such as short-rotation woody or fibrous agricultural crops produced for conversion to useful energy; and
(5) further development of the solar, wind, and biomass energy potential in rural areas of the state."
Renumber the sections in sequence and correct the internal references
Amend the title accordingly
A roll call was requested and properly seconded.
The question was taken on the Ozment amendment and the roll was called. There were 133 yeas and 0 nays as follows:
Those who voted in the affirmative were:
The motion prevailed and the amendment was adopted.
Wagenius and Hilty moved to amend S. F. No. 722, the second unofficial engrossment, as amended, as follows:
Page 32, after line 27, insert:
"Sec. 2. Minnesota Statutes 2000, section 216B.241, subdivision 1c, is amended to read:
Subd. 1c. [ENERGY-SAVING GOALS REQUIREMENTS.] (a) There is hereby
established an annual energy capacity conservation savings goal of 200 megawatts.
(b) If the commissioner determines that conservation is more cost-effective than building new electricity
supplies, the commissioner shall establish energy-saving goals develop and assign capacity and
energy savings requirements for energy conservation improvement expenditures and each public
utility, cooperative electric association and municipal utility providing electric service consistent with the goal
established in paragraph (a). The commissioner shall evaluate an monitor each utility's energy
conservation improvement program on how well it meets the goals set programs for success in meeting
those requirements.
(c) The commissioner shall allocate the annual capacity savings goal among these utilities based on:
(1) the total revenues of the utility;
(2) the rate of load growth; and
(3) its past conservation activities and the potential for cost-effective conservation initiatives in its service territory.
(d) For the purposes of this section, "cost-effective" means that the cost per unit of conserved energy is less than the cost per unit of electricity from new supplies, over the term of the conservation initiative.
(e) Each utility or association shall incorporate these conservation requirements into the utility's or association's conservation plans under this section or section 216B.2411, and amounts spent to achieve the requirements under this section shall count toward the utility's or association's conservation spending obligations under those sections."
Page 53, after line 23, insert:
"Sec. 8. [ADDITIONAL CONSERVATION.]
As part of the energy security blueprint to be published by the commissioner by December 15, 2001,
the commissioner shall propose to the legislature reasonable and achievable policy initiatives, activities, tax and other
incentives, and requirements that, taken together, could achieve a minimum of 50 megawatts of energy capacity
conservation statewide, in addition to the energy conservation initiatives undertaken under sections 216B.241 or 216B.2411."
Renumber the sections in sequence and correct internal references
Amend the title accordingly
A roll call was requested and properly seconded.
The question was taken on the Wagenius and Hilty amendment and the roll was called. There were 60 yeas and 74 nays as follows:
Those who voted in the affirmative were:
| Abeler | Evans | Jaros | Leighton | Opatz | Slawik | |
| Bernardy | Folliard | Jennings | Lenczewski | Osthoff | Solberg | |
| Biernat | Gleason | Johnson, R. | Lieder | Otremba | Swapinski | |
| Carlson | Goodwin | Johnson, S. | Luther | Paymar | Thompson | |
| Clark, K. | Gray | Kahn | Mariani | Pelowski | Vandeveer | |
| Davnie | Greiling | Kalis | Marquart | Peterson | Wagenius | |
| Dawkins | Hausman | Kelliher | McGuire | Pugh | Walker | |
| Dibble | Hilstrom | Koskinen | Milbert | Sertich | Wasiluk | |
| Dorn | Hilty | Kubly | Mullery | Skoe | Westerberg | |
| Entenza | Huntley | Larson | Murphy | Skoglund | Winter | |
Those who voted in the negative were:
| Abrams | Dempsey | Holberg | Mahoney | Penas | Tingelstad | |
| Anderson, B. | Dorman | Holsten | Mares | Rhodes | Tuma | |
| Anderson, I. | Eastlund | Howes | Marko | Rifenberg | Walz | |
| Bakk | Erhardt | Jacobson | McElroy | Rukavina | Wenzel | |
| Bishop | Erickson | Johnson, J. | Molnau | Ruth | Westrom | |
| Boudreau | Finseth | Juhnke | Mulder | Schumacher | Wilkin | |
| Bradley | Fuller | Kielkucki | Ness | Seagren | Wolf | |
| Buesgens | Gerlach | Knoblach | Nornes | Seifert | Workman | |
| Cassell | Goodno | Krinkie | Olson | Smith | Spk. Sviggum | |
| Clark, J. | Gunther | Kuisle | Osskopp | Stanek | ||
| Daggett | Haas | Leppik | Ozment | Stang | ||
| Davids | Hackbarth | Lindner | Paulsen | Swenson | ||
| Dehler | Harder | Lipman | Pawlenty | Sykora | ||
The motion did not prevail and the amendment was not adopted.
The Speaker resumed the Chair.
Evans, Goodwin, Bernardy, Hilty, Lieder, Kalis and Walker offered an amendment to S. F. No. 722, the second unofficial engrossment, as amended.
POINT OF ORDER
McElroy raised a point of order pursuant to rule 4.03, relating to Ways and Means Committee; Budget Resolution; Effect on Expenditure and Revenue Bills that the Evans et al amendment was not in order. The Speaker ruled the point of order well taken and the Evans et al amendment out of order.
Mariani moved to amend S. F. No. 722, the second unofficial engrossment, as amended, as follows:
Page 3, line 27, before "In" insert "(a)"
Page 3, line 32, after "with" insert "paragraph (b) and"
Page 4, after line 2, insert:
"(b) Consistent with the policy established in paragraph (a), each boiler at a coal-fired electric generating facility in a metropolitan county, as defined in section 473.121, subdivision 4, must be brought into compliance with new source performance standards and maximum achievable control technology standards adopted under the federal Clean Air Act, United States Code, Title 42, section 7401 et seq., by June 30, 2007."
Page 70, after line 31, insert:
"Sec. 6. Minnesota Statutes 2000, section 216B.16, is amended by adding a subdivision to read:
Subd. 6e. [COSTS OF COMPLIANCE RECOVERABLE.] In a determination of a rate-regulated utility's rates under this section, the commission shall recognize and allow recovery of all prudent and reasonable costs incurred by the utility in complying with the requirements of section 216B.013, paragraph (b). Alternatively, the commission may allow the utility to recover those costs by any appropriate mechanism outside of a general rate case, if it finds recovery outside of a general rate case to be consistent with the public interest."
Renumber the sections in sequence and correct internal references
Amend the title accordingly
A roll call was requested and properly seconded.
The question was taken on the Mariani amendment and the roll was called. There were 42 yeas and 87 nays as follows:
Those who voted in the affirmative were:
| Abeler | Entenza | Hilstrom | Kelliher | Marko | Pugh | |
| Bernardy | Folliard | Hilty | Koskinen | McGuire | Skoglund | |
| Biernat | Gleason | Huntley | Larson | Milbert | Slawik | |
| Carlson | Goodwin | Jaros | Lieder | Mullery | Swapinski | |
| Davnie | Gray | Johnson, S. | Luther | Murphy | Wagenius | |
| Dawkins | Greiling | Kahn | Mahoney | Paymar | Wasiluk | |
| Dorn | Hausman | Kalis | Mariani | Peterson | Westerberg | |
Those who voted in the negative were:
The motion did not prevail and the amendment was not adopted.
Hilty moved to amend S. F. No. 722, the second unofficial engrossment, as amended, as follows:
Page 5, line 4, before "The" insert "Subdivision 1. [GENERAL REQUIREMENTS.]"
Page 5, after line 19, insert:
"Subd. 2. [RENEWABLE ENERGY TECHNOLOGIES.] (a) At least one-third of the amount of new generation capacity and energy the commissioner forecasts under subdivision 1 is needed after 2005 to serve Minnesota consumers must be renewable energy generation. For the purposes of this section, renewable energy generation means generation technologies that utilize:
(1) methane or other combustible gases derived from the processing of agricultural plant or animal wastes;
(2) biomass fuels such as short-rotation woody or fibrous agricultural crops produced for conversion to useful energy;
(3) wind, and solar projects; or
(4) hydropower projects of less than 60 megawatts of capacity.
(b) The commission may not approve a certificate of need under section 216B.243, or a power purchase contract of greater than 5 years, and the environmental quality board may not issue a site permit under sections 116C.57 or 116C.575, for any generation project constructed and placed into service after 2005 without a determination by the commissioner that the project is consistent with the requirement of paragraph (a).
(c) Paragraph (b) does not apply:
(1) to a project that the commission, or the governing body of a municipal utility or cooperative electric association determines, based on independent analysis, that its application is not in the public interest; or
(2) after the commission certifies that at least 20 percent of the state's electricity is generated by renewable energy generation."
A roll call was requested and properly seconded.
The question was taken on the Hilty amendment and the roll was called. There were 64 yeas and 68 nays as follows:
Those who voted in the affirmative were:
| Abeler | Entenza | Jaros | Lenczewski | Osthoff | Solberg | |
| Anderson, I. | Evans | Johnson, R. | Lieder | Otremba | Swapinski | |
| Bakk | Folliard | Johnson, S. | Luther | Paymar | Thompson | |
| Bernardy | Gleason | Juhnke | Mariani | Peterson | Wagenius | |
| Biernat | Goodwin | Kahn | Marko | Pugh | Walker | |
| Carlson | Gray | Kalis | Marquart | Rukavina | Wasiluk | |
| Clark, K. | Greiling | Kelliher | McGuire | Schumacher | Wenzel | |
| Davnie | Hausman | Koskinen | Milbert | Sertich | Westerberg | |
| Dawkins | Hilstrom | Kubly | Mullery | Skoe | Winter | |
| Dibble | Hilty | Larson | Murphy | Skoglund | ||
| Dorn | Huntley | Leighton | Opatz | Slawik | ||
Those who voted in the negative were:
| Abrams | Dorman | Holberg | Lipman | Pelowski | Tuma | |
| Anderson, B. | Eastlund | Holsten | Mares | Rhodes | Vandeveer | |
| Bishop | Erhardt | Howes | McElroy | Rifenberg | Walz | |
| Boudreau | Erickson | Jacobson | Molnau | Ruth | Westrom | |
| Bradley | Finseth | Jennings | Mulder | Seagren | Wilkin | |
| Buesgens | Fuller | Johnson, J. | Ness | Seifert | Wolf | |
| Cassell | Gerlach | Kielkucki | Nornes | Smith | Workman | |
| Clark, J. | Goodno | Knoblach | Olson | Stanek | Spk. Sviggum | |
| Daggett | Gunther | Krinkie | Osskopp | Stang | ||
| Davids | Haas | Kuisle | Ozment | Swenson | ||
| Dehler | Hackbarth | Leppik | Paulsen | Sykora | ||
| Dempsey | Harder | Lindner | Pawlenty | Tingelstad | ||
The motion did not prevail and the amendment was not adopted.
Kahn moved to amend S. F. No. 722, the second unofficial engrossment, as amended, as follows:
Page 32, after line 27, insert:
"Sec. 2. Minnesota Statutes 2000, section 216B.241, subdivision 1c, is amended to read:
Subd. 1c. [ENERGY-SAVING GOALS.] (a) If the commissioner determines that conservation is more
cost-effective than building new electricity supplies, the commissioner shall establish energy-saving
goals develop and assign capacity and energy savings goals for energy conservation improvement
expenditures and each public utility, cooperative electric association and municipal utility providing electric
service. The commissioner shall evaluate an monitor each utility's energy conservation
improvement program on how well it meets the goals set programs for success in meeting those
goals.
(b) The commissioner shall establish annual capacity savings goals among utilities based on:
(1) the total revenues of the utility;
(2) the rate of load growth; and
(3) its past conservation activities and the potential for cost-effective conservation initiatives in its service territory.
(c) For the purposes of this section, "cost-effective" means that the cost per unit of conserved energy is less than the cost per unit of electricity from new supplies, over the term of the conservation initiative.
(d) Each utility or association shall incorporate these conservation goals into the utility's or association's conservation plans under this section or section 216B.2411, and amounts spent to achieve the goals under this section shall count toward the utility's or association's conservation spending obligations under those sections."
Page 53, after line 23, insert:
"Sec. 8. [ADDITIONAL CONSERVATION.]
As part of the energy security blueprint to be published by the commissioner by December 15, 2001, the commissioner shall propose to the legislature reasonable and achievable policy initiatives, activities, tax and other incentives, and requirements, in addition to the energy conservation initiatives undertaken under section 216B.241 or 216B.2411."
Renumber the sections in sequence and correct internal references
Amend the title accordingly
A roll call was requested and properly seconded.
The Speaker called Boudreau to the Chair.
The question was taken on the Kahn amendment and the roll was called. There were 63 yeas and 70 nays as follows:
Those who voted in the affirmative were:
| Abeler | Entenza | Jaros | Leppik | Opatz | Swapinski | |
| Anderson, I. | Evans | Jennings | Lieder | Osthoff | Thompson | |
| Bakk | Folliard | Johnson, R. | Luther | Otremba | Wagenius | |
| Bernardy | Gleason | Johnson, S. | Mahoney | Paymar | Walker | |
| Biernat | Goodwin | Kahn | Mariani | Pugh | Wasiluk | |
| Carlson | Gray | Kalis | Marko | Rukavina | Wenzel | |
| Clark, K. | Greiling | Kelliher | Marquart | Sertich | Westerberg | |
| Davnie | Hausman | Koskinen | McGuire | Skoe | Winter | |
| Dawkins | Hilstrom | Larson | Milbert | Skoglund | ||
| Dibble | Hilty | Leighton | Mullery | Slawik | ||
| Dorn | Huntley | Lenczewski | Murphy | Solberg | ||
Those who voted in the negative were:
The motion did not prevail and the amendment was not adopted.
Paymar, Dawkins, Hausman and Entenza offered an amendment to S. F. No. 722, the second unofficial engrossment, as amended.
Davids raised a point of order pursuant to rule 3.21 that the Paymar et al amendment was not in order. Speaker pro tempore Boudreau ruled the point of order well taken and the Paymar et al amendment out of order.
S. F. No. 722, A bill for an act relating to energy; providing for comprehensive energy conservation, production, and regulatory changes; amending Minnesota Statutes 2000, sections 16B.32, subdivision 2; 116C.52, subdivisions 4, 10; 116C.53, subdivisions 2, 3; 116C.57, subdivisions 1, 2, 4, by adding subdivisions; 116C.58; 116C.59, subdivisions 1, 4; 116C.60; 116C.61, subdivisions 1, 3; 116C.62; 116C.63, subdivision 2; 116C.645; 116C.65; 116C.66; 116C.69; 216B.095; 216B.097, subdivision 1; 216B.16, subdivision 15; 216B.241, subdivisions 1, 1a, 1b, 1c, 2; 216B.2421, subdivision 2; 216B.243, subdivisions 3, 4, 8; 216B.62, subdivision 5; 216C.41; proposing coding for new law in Minnesota Statutes, chapters 16B; 116C; 216B; 452; repealing Minnesota Statutes 2000, sections 116C.55, subdivisions 2, 3; 116C.57, subdivisions 3, 5, 5a; 116C.67; 216B.2421, subdivision 3.
The bill was read for the third time, as amended, and placed upon its final passage.
The question was taken on the passage of the bill and the roll was called. There were 99 yeas and 34 nays as follows:
Those who voted in the affirmative were:
| Abeler | Dorn | Jennings | Mahoney | Pelowski | Swenson | |
| Abrams | Eastlund | Johnson, J. | Mares | Penas | Sykora | |
| Anderson, B. | Erhardt | Johnson, R. | Marko | Peterson | Thompson | |
| Anderson, I. | Erickson | Juhnke | Marquart | Rhodes | Tingelstad | |
| Bakk | Finseth | Kalis | McElroy | Rifenberg | Tuma | |
| Bishop | Fuller | Kielkucki | Milbert | Rukavina | Vandeveer | |
| Boudreau | Gerlach | Knoblach | Molnau | Ruth | Walz | |
| Bradley | Goodno | Krinkie | Mulder | Schumacher | Wenzel | |
| Buesgens | Gunther | Kubly | Ness | Seagren | Westerberg | |
| Carlson | Haas | Kuisle | Nornes | Seifert | Westrom | |
| Cassell | Hackbarth | Larson | Olson | Sertich | Wilkin | |
| Clark, J. | Harder | Lenczewski | Opatz | Skoe | Wolf | |
| Daggett | Holberg | Leppik | Osskopp | Slawik | Workman | |
| Davids | Holsten | Lieder | Osthoff | Smith | Spk. Sviggum | |
| Dehler | Howes | Lindner | Ozment | Solberg | ||
| Dempsey | Huntley | Lipman | Paulsen | Stanek | ||
| Dorman | Jacobson | Luther | Pawlenty | Stang | ||
Those who voted in the negative were:
| Bernardy | Entenza | Hausman | Kelliher | Murphy | Wagenius | |
| Biernat | Evans | Hilstrom | Koskinen | Otremba | Walker | |
| Clark, K. | Gleason | Hilty | Leighton | Paymar | Wasiluk | |
| Davnie | Goodwin | Jaros | Mariani | Pugh | Winter | |
| Dawkins | Gray | Johnson, S. | McGuire | Skoglund | ||
| Dibble | Greiling | Kahn | Mullery | Swapinski | ||
The bill was passed, as amended, and its title agreed to.
H. F. No. 94 was reported to the House.
Haas moved to amend H. F. No. 94, the fourth engrossment, as follows:
Page 2, line 7, after "people" insert "intentionally"
Page 3, after line 34, insert:
"Sec. 4. Minnesota Statutes 2000, section 97A.345, is amended to read:
97A.345 [RESTITUTION VALUE OF WILD ANIMALS.]
Subdivision 1. [PURPOSE; REPORT.] (a) The commissioner may, by rules adopted under chapter
14, prescribe the dollar value to the state of species of wild animals. The value may restitution values
established under this section reflect the value to other persons to legally take the wild animal, the replacement
cost, or the intrinsic value to the state of the wild animals. Species of wild animals with similar values may be
grouped together.
(b) The value of a wild animal under the rules adopted by the commissioner this section is prima
facie evidence of a wild animal's value under section 97A.341.
(c) The commissioner shall report annually to the legislature the amount of restitution collected under section 97A.341 and the manner in which the funds were expended.
Subd. 2. [GAME BIRDS.] The restitution values for game bird species are as follows:
(1) turkey (wild), $400;
(2) pheasant, $50;
(3) quail, $50;
(4) chukar partridge, $50;
(5) gray partridge, $50;
(6) ruffed grouse, $50;
(7) sharp-tailed grouse, $50;
(9) greater prairie chicken, $500;
(10) American woodcock, $50;
(11) common snipe, $50;
(12) sora, Virginia rails, $50;
(13) gallinules, $50;
(14) coot, $25;
(15) ducks and mergansers, except canvasback, $50;
(16) canvasback, $100;
(17) geese, $50;
(18) tundra swan, $200; and
(19) trumpeter swan, $1,200.
Subd. 3. [BIG GAME ANIMALS.] (a) Except as provided in paragraph (b), the restitution values for big game species are as follows:
(1) deer, $500;
(2) elk, $1,000;
(3) caribou, $1,000;
(4) moose, $1,000;
(5) pronghorn antelope, $500; and
(6) black bear, $400.
(b) The restitution values for deer, elk, moose, and bear may be increased to twice the amount listed in this subdivision if the animal is a trophy animal.
Subd. 4. [SMALL GAME.] The restitution values for small game species other than game birds are as follows:
(1) cottontail rabbit, $20;
(2) jack rabbit, $20;
(3) snowshoe hare, $20;
(4) fox and gray squirrel, $20;
(5) red and gray fox, $30;
(7) badger, $100;
(8) otter, $100;
(9) pine marten, $100;
(10) fisher, $100;
(11) mink, $30;
(12) raccoon, $30;
(13) beaver, $30;
(14) muskrat, $30;
(15) opossum, $30;
(16) bobcat, $100;
(17) lynx, $500; and
(18) cougar, $1,000.
Subd. 5. [ENDANGERED ANIMAL SPECIES.] The restitution values for endangered animal species are as follows:
(1) mammals and birds, $4,000; and
(2) all other animals, $2,000.
Subd. 6. [THREATENED ANIMAL SPECIES.] The restitution values for threatened animal species are as follows:
(1) mammals and birds, $2,000; and
(2) all other animals, $500.
Subd. 7. [GRAY WOLVES.] The restitution value for gray wolves is $1,400.
Subd. 8. [FISH.] (a) Except as provided in subdivision 9 for fish species that do not have a designated quality size, or for fish that have a total length equal to or less than the designated quality size, the restitution value is the base value shown in the following table. For fish that have a length that exceeds the designated quality size, the restitution value is the base value plus $10 for every inch over the quality size.
Base Quality size
Value in inches
(1) walleye $30 22
(2) sauger 3015
(3) northern pike 3032
(4) black bass (largemouth,
(5) sunfish (bluegill, pumpkinseed,
green sunfish, orange spotted
sunfish, longear sunfish,
warmouth, hybrid sunfish) 5 8
(6) white and black crappie 5 11
(7) yellow perch 1010
(8) rock bass 5 8
(9) white bass, yellow bass 5 9
(10) channel catfish 10 26
(11) flathead catfish 25 28
(12) chinook salmon 50 28
(13) coho, Atlantic salmon 30 20
(14) kokanee, pink, other salmon 30 17
(15) lake trout 5022
(16) splake 5015
(17) brook trout 3017
(18) brown trout 3021
(19) rainbow (steelhead) trout 30 23
(20) paddlefish 500
(21) lake sturgeon 500
(22) shovelnose sturgeon 200
(23) sturgeon hybrids same value as
morphologically
nearest parent
(b) The restitution values for muskellunge are as follows:
(1) 0 to less than 30 inches, $40;
(2) 30 to less than 40 inches, $200;
(3) 40 to less than 50 inches, $500; and
(4) 50 inches and over, $1,000 plus $100 for each inch over 50 inches.
Subd. 9. [FINGERLINGS.] The restitution value for fish listed in subdivision 8 that are less than four inches in length is $1 per fish.
Subd. 10. [MINNOWS.] The restitution values for minnows are as follows:
(1) cyprinidae, fair market value at time of violation;
(2) umbridae, 50 cents a pound;
(3) catostomidae, 50 cents a pound;
(4) bullhead (seven inches or less), 50 cents a pound;
(5) cisco (seven inches or less), 50 cents a pound;
(6) lake white fish (seven inches or less), $1 a pound;
(7) goldeyes and mooneyes (seven inches or less), 50 cents a pound; and
(8) leeches, fair market value at time of violation."
Page 4, delete lines 1 to 4 and insert:
"Subdivision 1. [SEIZURE.] An"
Page 6, line 9, delete everything after "license" and insert "upon payment of a temporary reinstatement fee of"
Page 6, line 10, delete everything before "$1,000"
Page 6, line 12, delete everything after the period
Page 6, delete lines 13 to 15
Page 8, delete lines 2 to 12
Renumber the sections in sequence and correct internal references
Amend the title accordingly
A roll call was requested and properly seconded.
Haas moved to amend the Haas amendment to H. F. No. 94, the fourth engrossment, as follows:
Page 2, line 29, after the period, insert:
"(c) "Trophy animal" means:
(1) for deer, elk, and moose as an animal with antlers that meet or exceed the score specified in items (i) to (iv) when measured using the Boone and Crockett Club's official scoring system for North American big game trophies (Nesbitt, W.H. and J. Reneau, eds., Records of North American Big Game, Ninth Edition, The Boone and Crockett Club, Dumfries, VA, 1988, 498 pp.). This scoring system is incorporated by reference:
(i) white-tailed deer (typical), score of 135;
(ii) white-tailed deer (nontypical), score of 160;
(iii) moose, score of 145; and
(iv) elk, score of 260; and
(2) for black bear as an animal with a skull that meets or exceeds a score of 20 using the Boone and Crockett Club's official scoring system for North American big game trophies (id.).
(d) For the purposes of this definition, the antlers or skulls may be measured at any time; no drying period is required."
Page 4, delete lines 32 to 34
Page 5, line 11, before "An" insert "(a)"
Page 5, after line 17, insert:
"Page 8, line 17, delete "and""
Renumber the sections in sequence and correct the internal references
Amend the title accordingly
The motion prevailed and the amendment to the amendment was adopted.
The question recurred on the Haas amendment, as amended, and the roll was called. There were 13 yeas and 121 nays as follows:
Those who voted in the affirmative were:
| Abeler | Evans | Haas | Osthoff | Wagenius | |
| Clark, K. | Greiling | Jennings | Ozment | ||
| Davids | Gunther | McGuire | Paymar | ||
Those who voted in the negative were:
| Abrams | Eastlund | Jacobson | Lipman | Pelowski | Sykora | |
| Anderson, B. | Entenza | Jaros | Luther | Penas | Thompson | |
| Anderson, I. | Erhardt | Johnson, J. | Mahoney | Peterson | Tingelstad | |
| Bakk | Erickson | Johnson, R. | Mares | Pugh | Tuma | |
| Bernardy | Finseth | Johnson, S. | Mariani | Rhodes | Vandeveer | |
| Biernat | Folliard | Juhnke | Marko | Rifenberg | Walker | |
| Bishop | Fuller | Kahn | Marquart | Rukavina | Walz | |
| Boudreau | Gerlach | Kalis | McElroy | Ruth | Wasiluk | |
| Bradley | Gleason | Kelliher | Milbert | Schumacher | Wenzel | |
| Buesgens | Goodno | Kielkucki | Molnau | Seagren | Westerberg | |
| Carlson | Goodwin | Knoblach | Mulder | Seifert | Westrom | |
| Cassell | Gray | Koskinen | Mullery | Sertich | Wilkin | |
| Clark, J. | Hackbarth | Krinkie | Murphy | Skoe | Winter | |
| Daggett | Harder | Kubly | Ness | Skoglund | Wolf | |
| Davnie | Hausman | Kuisle | Nornes | Slawik | Workman | |
| Dawkins | Hilstrom | Larson | Olson | Smith | Spk. Sviggum | |
| Dehler | Hilty | Leighton | Opatz | Solberg | ||
| Dempsey | Holberg | Lenczewski | Osskopp | Stanek | ||
| Dibble | Holsten | Leppik | Otremba | Stang | ||
| Dorman | Howes | Lieder | Paulsen | Swapinski | ||
| Dorn | Huntley | Lindner | Pawlenty | Swenson | ||
The motion did not prevail and the amendment, as amended, was not adopted.
Kalis was excused for the remainder of today's session.
H. F. No. 94, A bill for an act relating to natural resources; establishing penalties for gross overlimit violations of fish and game laws; setting certain restitution values; providing criminal penalties; amending Minnesota Statutes 2000, sections 97A.225, subdivision 1; 97A.255, by adding a subdivision; 97A.421, subdivision 5, by adding a subdivision; 97C.505, by adding a subdivision; proposing coding for new law in Minnesota Statutes, chapter 97A.
The bill was read for the third time and placed upon its final passage.
The question was taken on the passage of the bill and the roll was called. There were 38 yeas and 95 nays as follows:
Those who voted in the affirmative were:
| Abeler | Dorman | Hilstrom | Lindner | Ozment | Sykora | |
| Abrams | Entenza | Huntley | Lipman | Paulsen | Tuma | |
| Bishop | Greiling | Jennings | McGuire | Pawlenty | Wagenius | |
| Bradley | Gunther | Kelliher | Molnau | Paymar | ||
| Clark, J. | Haas | Knoblach | Mulder | Rhodes | ||
| Davids | Harder | Lenczewski | Osskopp | Seagren | ||
| Dawkins | Hausman | Leppik | Osthoff | Stanek | ||
Those who voted in the negative were:
| Anderson, B. | Eastlund | Howes | Luther | Penas | Swenson | |
| Anderson, I. | Erhardt | Jacobson | Mahoney | Peterson | Thompson | |
| Bakk | Erickson | Jaros | Mares | Pugh | Tingelstad | |
| Bernardy | Evans | Johnson, J. | Mariani | Rifenberg | Vandeveer | |
| Biernat | Finseth | Johnson, R. | Marko | Rukavina | Walker | |
| Boudreau | Folliard | Johnson, S. | Marquart | Ruth | Walz | |
| Buesgens | Fuller | Juhnke | McElroy | Schumacher | Wasiluk | |
| Carlson | Gerlach | Kahn | Milbert | Seifert | Wenzel | |
| Cassell | Gleason | Kielkucki | Mullery | Sertich | Westerberg | |
| Clark, K. | Goodno | Koskinen | Murphy | Skoe | Westrom | |
| Daggett | Goodwin | Krinkie | Ness | Skoglund | Wilkin | |
| Davnie | Gray | Kubly | Nornes | Slawik | Winter | |
| Dehler | Hackbarth | Kuisle | Olson | Smith | Wolf | |
| Dempsey | Hilty | Larson | Opatz | Solberg | Workman | |
| Dibble | Holberg | Leighton | Otremba | Stang | Spk. Sviggum | |
| Dorn | Holsten | Lieder | Pelowski | Swapinski | ||
The bill was not passed.
S. F. No. 1397 was reported to the House.
Wilkin moved to amend S. F. No. 1397 as follows:
Page 9, line 27, before the semicolon, insert "or paid by a fiscal agent, fiscal intermediary, or employer of record"
Page 9, line 28, after "not" insert "otherwise"
The motion prevailed and the amendment was adopted.
Goodno moved to amend S. F. No. 1397, as amended, as follows:
Page 1, after line 15, insert:
"ARTICLE 1
BACKGROUND STUDIES FOR LICENSED PROGRAMS"
Page 38, after line 18, insert:
"Sec. 21. [EFFECTIVE DATE]
This act shall not take effect if 2001 S. F. No. 2361 is enacted.
ARTICLE 2
HEALTH DEPARTMENT
Section 1. Minnesota Statutes 2000, section 103I.101, subdivision 6, is amended to read:
Subd. 6. [FEES FOR VARIANCES.] The commissioner shall charge a nonrefundable application fee of
$120 $150 to cover the administrative cost of processing a request for a variance or modification
of rules adopted by the commissioner under this chapter.
Sec. 2. Minnesota Statutes 2000, section 103I.112, is amended to read:
103I.112 [FEE EXEMPTIONS FOR STATE AND LOCAL GOVERNMENT.]
(a) The commissioner of health may not charge fees required under this chapter to a federal agency, state agency, or a local unit of government or to a subcontractor performing work for the state agency or local unit of government.
(b) "Local unit of government" means a statutory or home rule charter city, town, county, or soil and water conservation district, watershed district, an organization formed for the joint exercise of powers under section 471.59, a board of health or community health board, or other special purpose district or authority with local jurisdiction in water and related land resources management.
Sec. 3. Minnesota Statutes 2000, 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 well, $120 $150, which includes the state core function fee;
(2) for a well sealing, $20 $30 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 $20 $30; and
(3) for construction of a dewatering well, $120 $150, which includes the state core function fee,
for each well except a dewatering project comprising five or more wells shall be assessed a single fee of $600
$750 for the wells recorded on the notification.
Sec. 4. Minnesota Statutes 2000, 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 well that is not in use under a maintenance permit, $100 $125 annually;
(2) for construction of a monitoring well, $120 $150, which includes the state core function fee;
(3) for a monitoring well that is unsealed under a maintenance permit, $100 $125 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
$120 $150, 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 $100
$125 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 wells, $120
$150, which includes the state core function fee;
(6) for a vertical heat exchanger, $120 $150;
(7) for a dewatering well that is unsealed under a maintenance permit, $100 $125 annually for
each well, except a dewatering project comprising more than five wells shall be issued a single permit for
$500 $625 annually for wells recorded on the permit; and
(8) for excavating holes for the purpose of installing elevator shafts, $120 $150 for each hole.
Sec. 5. Minnesota Statutes 2000, 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 $20 $30 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 $17.50 $27.50 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.
Sec. 6. Minnesota Statutes 2000, section 103I.525, subdivision 2, is amended to read:
Subd. 2. [APPLICATION FEE.] The application fee for a well contractor's license is $50 $75.
The commissioner may not act on an application until the application fee is paid.
Sec. 7. Minnesota Statutes 2000, section 103I.525, subdivision 6, is amended to read:
Subd. 6. [LICENSE FEE.] The fee for a well contractor's license is $250, except the fee for an individual well
contractor's license is $50 $75.
Sec. 8. Minnesota Statutes 2000, section 103I.525, subdivision 8, is amended to read:
Subd. 8. [RENEWAL.] (a) A licensee must file an application and a renewal application fee to renew the license by the date stated in the license.
(b) The renewal application fee shall be set by the commissioner under section 16A.1285 for a well
contractor's license is $250.
(c) The renewal application must include information that the applicant has met continuing education requirements established by the commissioner by rule.
(d) At the time of the renewal, the commissioner must have on file all properly completed well reports, well sealing reports, reports of excavations to construct elevator shafts, well permits, and well notifications for work conducted by the licensee since the last license renewal.
Sec. 9. Minnesota Statutes 2000, section 103I.525, subdivision 9, is amended to read:
Subd. 9. [INCOMPLETE OR LATE RENEWAL.] If a licensee fails to submit all information required for renewal in subdivision 8 or submits the application and information after the required renewal date:
(1) the licensee must include an additional a late fee set by the commissioner of
$75; and
(2) the licensee may not conduct activities authorized by the well contractor's license until the renewal application, renewal application fee, late fee, and all other information required in subdivision 8 are submitted.
Sec. 10. Minnesota Statutes 2000, section 103I.531, subdivision 2, is amended to read:
Subd. 2. [APPLICATION FEE.] The application fee for a limited well/boring contractor's license is $50
$75. The commissioner may not act on an application until the application fee is paid.
Sec. 11. Minnesota Statutes 2000, section 103I.531, subdivision 6, is amended to read:
Subd. 6. [LICENSE FEE.] The fee for a limited well/boring contractor's license is $50 $75.
Sec. 12. Minnesota Statutes 2000, section 103I.531, subdivision 8, is amended to read:
Subd. 8. [RENEWAL.] (a) A person must file an application and a renewal application fee to renew the limited well/boring contractor's license by the date stated in the license.
(b) The renewal application fee shall be set by the commissioner under section 16A.1285 for a limited
well/boring contractor's license is $75.
(c) The renewal application must include information that the applicant has met continuing education requirements established by the commissioner by rule.
(d) At the time of the renewal, the commissioner must have on file all properly completed well sealing reports, well permits, vertical heat exchanger permits, and well notifications for work conducted by the licensee since the last license renewal.
Sec. 13. Minnesota Statutes 2000, section 103I.531, subdivision 9, is amended to read:
Subd. 9. [INCOMPLETE OR LATE RENEWAL.] If a licensee fails to submit all information required for renewal in subdivision 8 or submits the application and information after the required renewal date:
(1) the licensee must include an additional a late fee set by the commissioner of
$75; and
(2) the licensee may not conduct activities authorized by the limited well/boring contractor's license until the renewal application, renewal application fee, and late fee, and all other information required in subdivision 8 are submitted.
Sec. 14. Minnesota Statutes 2000, section 103I.535, subdivision 2, is amended to read:
Subd. 2. [APPLICATION FEE.] The application fee for an elevator shaft contractor's license is $50
$75. The commissioner may not act on an application until the application fee is paid.
Sec. 15. Minnesota Statutes 2000, section 103I.535, subdivision 6, is amended to read:
Subd. 6. [LICENSE FEE.] The fee for an elevator shaft contractor's license is $50 $75.
Sec. 16. Minnesota Statutes 2000, section 103I.535, subdivision 8, is amended to read:
Subd. 8. [RENEWAL.] (a) A person must file an application and a renewal application fee to renew the license by the date stated in the license.
(b) The renewal application fee shall be set by the commissioner under section 16A.1285 for an
elevator shaft contractor's license is $75.
(c) The renewal application must include information that the applicant has met continuing education requirements established by the commissioner by rule.
(d) At the time of renewal, the commissioner must have on file all reports and permits for elevator shaft work conducted by the licensee since the last license renewal.
Sec. 17. Minnesota Statutes 2000, section 103I.535, subdivision 9, is amended to read:
Subd. 9. [INCOMPLETE OR LATE RENEWAL.] If a licensee fails to submit all information required for renewal in subdivision 8 or submits the application and information after the required renewal date:
(1) the licensee must include an additional a late fee set by the commissioner of
$75; and
(2) the licensee may not conduct activities authorized by the elevator shaft contractor's license until the renewal application, renewal application fee, and late fee, and all other information required in subdivision 8 are submitted.
Sec. 18. Minnesota Statutes 2000, section 103I.541, subdivision 2b, is amended to read:
Subd. 2b. [APPLICATION FEE.] The application fee for a monitoring well contractor registration is $50
$75. The commissioner may not act on an application until the application fee is paid.
Sec. 19. Minnesota Statutes 2000, section 103I.541, subdivision 4, is amended to read:
Subd. 4. [RENEWAL.] (a) A person must file an application and a renewal application fee to renew the registration by the date stated in the registration.
(b) The renewal application fee shall be set by the commissioner under section 16A.1285 for a
monitoring well contractor's registration is $75.
(c) The renewal application must include information that the applicant has met continuing education requirements established by the commissioner by rule.
(d) At the time of the renewal, the commissioner must have on file all well reports, well sealing reports, well permits, and notifications for work conducted by the registered person since the last registration renewal.
Sec. 20. Minnesota Statutes 2000, section 103I.541, subdivision 5, is amended to read:
Subd. 5. [INCOMPLETE OR LATE RENEWAL.] If a registered person submits a renewal application after the required renewal date:
(1) the registered person must include an additional a late fee set by the commissioner
of $75; and
(2) the registered person may not conduct activities authorized by the monitoring well contractor's registration until the renewal application, renewal application fee, late fee, and all other information required in subdivision 4 are submitted.
Sec. 21. Minnesota Statutes 2000, section 103I.545, is amended to read:
103I.545 [REGISTRATION OF DRILLING MACHINES REQUIRED.]
Subdivision 1. [DRILLING MACHINE.] (a) A person may not use a drilling machine such as a cable tool, rotary tool, hollow rod tool, or auger for a drilling activity requiring a license or registration under this chapter unless the drilling machine is registered with the commissioner.
(b) A person must apply for the registration on forms prescribed by the commissioner and submit a $50
$75 registration fee.
(c) A registration is valid for one year.
Subd. 2. [PUMP HOIST.] (a) A person may not use a machine such as a pump hoist for an activity requiring a license or registration under this chapter to repair wells or borings, seal wells or borings, or install pumps unless the machine is registered with the commissioner.
(b) A person must apply for the registration on forms prescribed by the commissioner and submit a $50
$75 registration fee.
(c) A registration is valid for one year.
[EFFECTIVE DATE.] This section is effective July 1, 2002.
Sec. 22. Minnesota Statutes 2000, section 121A.15, subdivision 6, is amended to read:
Subd. 6. [SUSPENSION OF IMMUNIZATION REQUIREMENT; MODIFICATION TO SCHEDULE.] (a) The commissioner of health, on finding that an immunization required pursuant to this section is not necessary to protect the public's health, may suspend for one year the requirement that children receive that immunization.
(b) During portions of the year in which the legislature is not meeting in regular or special session, the
commissioner of health may modify the immunization requirements of this section. A modification made under this
paragraph must be part of the current immunization recommendations of each of the following organizations: the
United States Public Health Service's Advisory Committee on Immunization Practices, the American Academy of
Family Physicians, and the American Academy of Pediatrics. The commissioner shall modify the immunization requirements through rulemaking using the expedited process in section 14.389. A rule adopted under this paragraph shall be in effect until the adjournment of the next regular legislative session held after the rule is adopted. The commissioner shall report to the legislature on any rules adopted under this paragraph during the previous calendar year. Such reports are due by January 15 of the year following the calendar year in which the rule is adopted, except that if a rule is adopted in January, a report on that rule is due by February 15 of that year.
Sec. 23. Minnesota Statutes 2000, section 135A.14, is amended by adding a subdivision to read:
Subd. 7. [MODIFICATIONS TO SCHEDULE.] During portions of the year in which the legislature is not meeting in regular or special session, the commissioner of health may modify the immunization requirements of this section. A modification made under this subdivision must be part of the current immunization recommendations of each of the following organizations: the United States Public Health Service's Advisory Committee on Immunization Practices, the American Academy of Family Physicians, and the American Academy of Pediatrics. The commissioner shall modify the immunization requirements through rulemaking using the expedited process in section 14.389. A rule adopted under this subdivision shall be in effect until the adjournment of the next regular legislative session held after the rule is adopted. The commissioner shall report to the legislature on any rules adopted under this subdivision during the previous calendar year. Such reports are due by January 15 of the year following the calendar year in which the rule is adopted, except that if a rule is adopted in January, a report on that rule is due by February 15 of that year.
Sec. 24. [144.0751] [HEALTH STANDARDS.]
When establishing or revising safe drinking water or air quality standards, the commissioner shall take into account only peer-reviewed, scientifically acceptable information which includes a reasonable margin of safety in setting the standards to adequately protect the health of infants, children, and adults by taking into consideration each of the following specific risks:
(1) reproductive development and function;
(2) respiratory function;
(3) immunologic suppression or hypersensitization;
(4) development of the brain and nervous system;
(5) endocrine (hormonal) function;
(6) cancer;
(7) general infant and child development; and
(8) any other important health outcomes identified by the commissioner.
Sec. 25. Minnesota Statutes 2000, section 144.1202, subdivision 4, is amended to read:
Subd. 4. [AGREEMENT; CONDITIONS OF IMPLEMENTATION.] (a) An agreement entered into before
August 2, 2002 2003, must remain in effect until terminated under the Atomic Energy Act of 1954,
United States Code, title 42, section 2021, paragraph (j). The governor may not enter into an initial agreement with
the Nuclear Regulatory Commission after August 1, 2002 2003. If an agreement is not entered into
by August 1, 2002 2003, any rules adopted under this section are repealed effective August 1,
2002 2003.
(b) An agreement authorized under subdivision 1 must be approved by law before it may be implemented.
Sec. 26. [144.1205] [RADIOACTIVE MATERIAL; SOURCE AND SPECIAL NUCLEAR MATERIAL; FEES; INSPECTION.]
Subdivision 1. [APPLICATION AND LICENSE RENEWAL FEE.] When a license is required for radioactive material or source or special nuclear material by a rule adopted under section 144.1202, subdivision 2, an application fee according to subdivision 4 must be paid upon initial application for a license. The licensee must renew the license 60 days before the expiration date of the license by paying a license renewal fee equal to the application fee under subdivision 4. The expiration date of a license is the date set by the United States Nuclear Regulatory Commission before transfer of the licensing program under section 144.1202 and thereafter as specified by rule of the commissioner of health.
Subd. 2. [ANNUAL FEE.] A licensee must pay an annual fee at least 60 days before the anniversary date of the issuance of the license. The annual fee is an amount equal to 80 percent of the application fee under subdivision 4, rounded to the nearest whole dollar.
Subd. 3. [FEE CATEGORIES; INCORPORATION OF FEDERAL LICENSING CATEGORIES.] (a) Fee categories under this section are equivalent to the licensing categories used by the United States Nuclear Regulatory Commission under Code of Federal Regulations, title 10, parts 30 to 36, 39, 40, 70, 71, and 150, except as provided in paragraph (b).
(b) The category of "Academic, small" is the type of license required for the use of radioactive materials in a teaching institution. Radioactive materials are limited to ten radionuclides not to exceed a total activity amount of one curie.
Subd. 4. [APPLICATION FEE.] A licensee must pay an application fee as follows:
Radioactive material, Application U.S. Nuclear Regulatory
source and fee Commission licensing
special material category as reference
Type A broadscope $20,000 Medical institution type A
Type B broadscope $15,000 Research and development
type B
Type C broadscope $10,000 Academic type C
Medical use $4,000 Medical
Medical institution
Medical private practice
Mobile nuclear
medical laboratory $4,000 Mobile medical laboratory
Medical special use
sealed sources $6,000 Teletherapy
High dose rate remote
afterloaders
Stereotactic
radiosurgery devices
In vitro testing $2,300 In vitro testing
laboratories
Measuring gauge,
sealed sources $2,000 Fixed gauges
Portable gauges
Analytical instruments
Measuring systems - other
Gas chromatographs $1,200 Gas chromatographs
Manufacturing and
distribution $14,700 Manufacturing and
Distribution only $8,800 Distribution of
radioactive material
for commercial use only
Other services $1,500 Other services
Nuclear medicine
pharmacy $4,100 Nuclear pharmacy
Waste disposal $9,400 Waste disposal service
prepackage
Waste disposal service
processing/repackage
Waste storage only $7,000 To receive and store
radioactive material waste
Industrial
radiography $8,400 Industrial radiography
fixed location
Industrial radiography
portable/temporary sites
Irradiator -
self-shielded $4,100 Irradiators self-shielded
less than 10,000 curies
Irradiator -
less than 10,000 Ci $7,500 Irradiators less than
10,000 curies
Irradiator -
more than 10,000 Ci $11,500 Irradiators greater than
10,000 curies
Research and
development,
no distribution $4,100 Research and development
Radioactive material
possession only $1,000 By-product possession only
Source material $1,000 Source material shielding
Special nuclear
material, less than
200 grams $1,000 Special nuclear material
plutonium-neutron sources
less than 200 grams
Pacemaker
manufacturing $1,000 Pacemaker by-product
and/or special nuclear
material - medical
institution
General license
distribution $2,100 General license
distribution
General license
distribution, exempt $1,500 General license
distribution -
certain exempt items
Academic, small $1,000 Possession limit of ten
radionuclides, not to
exceed a total of one curie
of activity
Veterinary $2,000 Veterinary use
Well logging $5,000 Well logging
Subd. 5. [PENALTY FOR LATE PAYMENT.] An annual fee or a license renewal fee submitted to the commissioner after the due date specified by rule must be accompanied by an additional amount equal to 25 percent of the fee due.
Subd. 6. [INSPECTIONS.] The commissioner of health shall make periodic safety inspections of the radioactive material and source and special nuclear material of a licensee. The commissioner shall prescribe the frequency of safety inspections by rule.
Subd. 7. [RECOVERY OF REINSPECTION COST.] If the commissioner finds serious violations of public health standards during an inspection under subdivision 6, the licensee must pay all costs associated with subsequent reinspection of the source. The costs shall be the actual costs incurred by the commissioner and include, but are not limited to, labor, transportation, per diem, materials, legal fees, testing, and monitoring costs.
Subd. 8. [RECIPROCITY FEE.] A licensee submitting an application for reciprocal recognition of a materials license issued by another agreement state or the United States Nuclear Regulatory Commission for a period of 180 days or less during a calendar year must pay one-half of the application fee specified under subdivision 4. For a period of 181 days or more, the licensee must pay the entire application fee under subdivision 4.
Subd. 9. [FEES FOR LICENSE AMENDMENTS.] A licensee must pay a fee to amend a license as follows:
(1) to amend a license requiring no license review including, but not limited to, facility name change or removal of a previously authorized user, no fee;
(2) to amend a license requiring review including, but not limited to, addition of isotopes, procedure changes, new authorized users, or a new radiation safety officer, $200; and
(3) to amend a license requiring review and a site visit including, but not limited to, facility move or addition of processes, $400.
[EFFECTIVE DATE.] This section is effective July 1, 2002.
Sec. 27. Minnesota Statutes 2000, section 144.122, is amended to read:
144.122 [LICENSE, PERMIT, AND SURVEY FEES.]
(a) The state commissioner of health, by rule, may prescribe reasonable procedures and fees for filing with the commissioner as prescribed by statute and for the issuance of original and renewal permits, licenses, registrations, and certifications issued under authority of the commissioner. The expiration dates of the various licenses, permits, registrations, and certifications as prescribed by the rules shall be plainly marked thereon. Fees may include application and examination fees and a penalty fee for renewal applications submitted after the expiration date of the previously issued permit, license, registration, and certification. The commissioner may also prescribe, by rule, reduced fees for permits, licenses, registrations, and certifications when the application therefor is submitted during the last three months of the permit, license, registration, or certification period. Fees proposed to be prescribed in the rules shall be first approved by the department of finance. All fees proposed to be prescribed in rules shall be reasonable. The fees shall be in an amount so that the total fees collected by the commissioner will, where practical, approximate the cost to the commissioner in administering the program. All fees collected shall be deposited in the state treasury and credited to the state government special revenue fund unless otherwise specifically appropriated by law for specific purposes.
(b) The commissioner may charge a fee for voluntary certification of medical laboratories and environmental laboratories, and for environmental and medical laboratory services provided by the department, without complying with paragraph (a) or chapter 14. Fees charged for environment and medical laboratory services provided by the department must be approximately equal to the costs of providing the services.
(c) The commissioner may develop a schedule of fees for diagnostic evaluations conducted at clinics held by the services for children with handicaps program. All receipts generated by the program are annually appropriated to the commissioner for use in the maternal and child health program.
(d) The commissioner, for fiscal years 1996 and beyond, shall set license fees for hospitals and nursing
homes that are not boarding care homes at the following levels:
Joint Commission on Accreditation of Healthcare
Organizations (JCAHO hospitals) $1,017
$7,055
Non-JCAHO hospitals $762 plus $34 per bed
$4,680 plus $234 per bed
Nursing home
$78 plus $19 per bed
$183 plus $91 per bed
For fiscal years 1996 and beyond, The commissioner shall set license fees for outpatient surgical centers,
boarding care homes, and supervised living facilities at the following levels:
Outpatient surgical centers $517
$1,512
Boarding care homes $78 plus $19 per bed
$183 plus $91 per bed
Supervised living facilities
$78 plus $19 per bed
$183 plus $91 per bed.
(e) Unless prohibited by federal law, the commissioner of health shall charge applicants the following fees to cover the cost of any initial certification surveys required to determine a provider's eligibility to participate in the Medicare or Medicaid program:
Prospective payment surveys for $ 900
hospitals
Swing bed surveys for nursing homes $1,200
Psychiatric hospitals $1,400
Rural health facilities $1,100
Portable X-ray providers $ 500
Home health agencies $1,800
Outpatient therapy agencies $ 800
End stage renal dialysis providers $2,100
Independent therapists $ 800
Comprehensive rehabilitation $1,200
outpatient facilities
Hospice providers $1,700
Ambulatory surgical providers $1,800
Hospitals $4,200
Other provider categories or Actual surveyor costs:
additional resurveys required average surveyor cost x
to complete initial certification number of hours for the
These fees shall be submitted at the time of the application for federal certification and shall not be refunded. All fees collected after the date that the imposition of fees is not prohibited by federal law shall be deposited in the state treasury and credited to the state government special revenue fund.
Sec. 28. Minnesota Statutes 2000, section 144.148, subdivision 2, is amended to read:
Subd. 2. [PROGRAM.] (a) The commissioner of health shall award rural hospital capital improvement grants to eligible rural hospitals. Except as provided in paragraph (b), A grant shall not exceed $300,000 per hospital. Prior to the receipt of any grant, the hospital must certify to the commissioner that at least one-quarter of the grant amount, which may include in-kind services, is available for the same purposes from nonstate resources.
(b) A grant shall not exceed $1,500,000 per eligible rural hospital that also satisfies the following criteria:
(1) is the only hospital in a county;
(2) has 25 or fewer licensed hospital beds with a net hospital operating margin not greater than an average of two percent over the three fiscal years prior to application;
(3) is located in a medically underserved community (MUC) or a health professional shortage area (HPSA);
(4) is located near a migrant worker employment site and regularly treats significant numbers of migrant workers and their families; and
(5) has not previously received a grant under this section prior to July 1, 1999.
Sec. 29. Minnesota Statutes 2000, section 144.226, subdivision 4, is amended to read:
Subd. 4. [VITAL RECORDS SURCHARGE.] In addition to any fee prescribed under subdivision 1, there is a
nonrefundable surcharge of $3 $2 for each certified and noncertified birth or death record, and for
a certification that the record cannot be found. The local or state registrar shall forward this amount to the state
treasurer to be deposited into the state government special revenue fund. This surcharge shall not be charged under
those circumstances in which no fee for a birth or death record is permitted under subdivision 1, paragraph (a).
This surcharge requirement expires June 30, 2002.
Sec. 30. Minnesota Statutes 2000, section 144.551, subdivision 1, is amended to read:
Subdivision 1. [RESTRICTED CONSTRUCTION OR MODIFICATION.] (a) The following construction or modification may not be commenced:
(1) any erection, building, alteration, reconstruction, modernization, improvement, extension, lease, or other acquisition by or on behalf of a hospital that increases the bed capacity of a hospital, relocates hospital beds from one physical facility, complex, or site to another, or otherwise results in an increase or redistribution of hospital beds within the state; and
(2) the establishment of a new hospital.
(b) This section does not apply to:
(1) construction or relocation within a county by a hospital, clinic, or other health care facility that is a national referral center engaged in substantial programs of patient care, medical research, and medical education meeting state and national needs that receives more than 40 percent of its patients from outside the state of Minnesota;
(2) a project for construction or modification for which a health care facility held an approved certificate of need on May 1, 1984, regardless of the date of expiration of the certificate;
(3) a project for which a certificate of need was denied before July 1, 1990, if a timely appeal results in an order reversing the denial;
(4) a project exempted from certificate of need requirements by Laws 1981, chapter 200, section 2;
(5) a project involving consolidation of pediatric specialty hospital services within the Minneapolis-St. Paul metropolitan area that would not result in a net increase in the number of pediatric specialty hospital beds among the hospitals being consolidated;
(6) a project involving the temporary relocation of pediatric-orthopedic hospital beds to an existing licensed hospital that will allow for the reconstruction of a new philanthropic, pediatric-orthopedic hospital on an existing site and that will not result in a net increase in the number of hospital beds. Upon completion of the reconstruction, the licenses of both hospitals must be reinstated at the capacity that existed on each site before the relocation;
(7) the relocation or redistribution of hospital beds within a hospital building or identifiable complex of buildings provided the relocation or redistribution does not result in: (i) an increase in the overall bed capacity at that site; (ii) relocation of hospital beds from one physical site or complex to another; or (iii) redistribution of hospital beds within the state or a region of the state;
(8) relocation or redistribution of hospital beds within a hospital corporate system that involves the transfer of beds from a closed facility site or complex to an existing site or complex provided that: (i) no more than 50 percent of the capacity of the closed facility is transferred; (ii) the capacity of the site or complex to which the beds are transferred does not increase by more than 50 percent; (iii) the beds are not transferred outside of a federal health systems agency boundary in place on July 1, 1983; and (iv) the relocation or redistribution does not involve the construction of a new hospital building;
(9) a construction project involving up to 35 new beds in a psychiatric hospital in Rice county that primarily serves adolescents and that receives more than 70 percent of its patients from outside the state of Minnesota;
(10) a project to replace a hospital or hospitals with a combined licensed capacity of 130 beds or less if: (i) the new hospital site is located within five miles of the current site; and (ii) the total licensed capacity of the replacement hospital, either at the time of construction of the initial building or as the result of future expansion, will not exceed 70 licensed hospital beds, or the combined licensed capacity of the hospitals, whichever is less;
(11) the relocation of licensed hospital beds from an existing state facility operated by the commissioner of human services to a new or existing facility, building, or complex operated by the commissioner of human services; from one regional treatment center site to another; or from one building or site to a new or existing building or site on the same campus;
(12) the construction or relocation of hospital beds operated by a hospital having a statutory obligation to provide
hospital and medical services for the indigent that does not result in a net increase in the number of hospital beds;
or
(13) a construction project involving the addition of up to 31 new beds in an existing nonfederal hospital in Beltrami county; or
(14) a construction project involving the addition of up to eight new beds in an existing nonfederal hospital in Otter Tail county with 100 licensed acute care beds.
Sec. 31. [144.585] [HOSPITAL CHARITY CARE AID.]
Subdivision 1. [PURPOSE.] The purpose of charity care aid is to help offset excess charity care burdens at Minnesota acute care, short-term hospitals.
Subd. 2. [DEFINITIONS.] (a) For purposes of this section, the terms in this subdivision have the meanings given to them.
(b) "Charity care" is the dollar amount of charity care adjustments as determined under subdivision 3.
(c) "Cost-to-charge ratio" means a hospital's total operating expenses over the sum of gross patient revenue and other operating revenue, as reported to the commissioner of health under rules adopted under sections 144.695 to 144.703. The commissioner shall use the most recently available data to calculate the cost-to-charge ratio.
Subd. 3. [CHARITY CARE REPORTING.] (a) For a hospital to report amounts as charity care adjustments, the hospital:
(1) must generate and record a charge;
(2) have a policy on the provision of charity care and must communicate the policy to the public;
(3) have made a reasonable effort to identify a third party payer, encourage the patient to enroll in public programs, and should, to the extent possible, aid the patient in the enrollment process; and
(4) ensure that the patient meets the charity care criteria of this subdivision, which must be consistent with statewide income standards set out in paragraph (c).
(b) In determining whether to classify care as charity care, the hospital must consider the following:
(1) charity care may include services which the provider is obligated to render independently of the ability to collect;
(2) charity care may include care provided to low-income patients who meet the charity care income standards under paragraph (c) and have partial coverage, but are unable to pay the remainder of their medical bills. This does not apply to that portion of the bill which has been determined to be the patient's responsibility after a partial charity care classification;
(3) charity care may include care provided to low-income patients who may qualify for a public health insurance program and meet the statewide eligibility criteria for charity care, but who do not complete the application process for public insurance despite the facility's best efforts;
(4) charity care may include care to individuals whose eligibility for charity care was determined through third party services employed by the hospital for information gathering purposes only;
(5) charity care may not include contractual allowances, which is the difference between gross charges and payments received under contractual arrangements with insurance companies and payers;
(6) charity care may not include bad debt;
(7) charity care may not include what may be perceived as underpayments for operating public programs;
(8) charity care may not include cases which are paid through a charitable contribution through a third party or facility-related foundation;
(9) charity care may not include unreimbursed costs of basic or clinical research and of professional education and training;
(10) charity care may not include professional courtesy discounts;
(11) charity care may not include community service or outreach activities; and
(12) charity care may not include services for patients against whom collection actions where taken which result in a credit report.
(c) The hospital must use the income standards in this paragraph for determining charity care eligibility for reporting purposes. The hospital does not need to make a patient asset determination in order to apply charity care income standards.
(1) Care to a patient with a family income at or below 150 percent of the Federal Poverty Guideline (FPG) may be reported as full charity care or free care.
(2) The hospital's share of discounted charges for care to a patient with family income below 275 percent of the FPG qualifies for classification as charity care. The following sliding fee schedules apply:
income as charges paid corresponding
% of FPG by patient charity care
151-200% 20% 80%
201-225% 40% 60%
226-250% 60% 40%
251-275% 80% 20%
(3) Care to a patient is considered medical hardship when qualified medical expenses, as defined for the purposes of federal income tax deductibility, exceeds 30 percent of family income. Qualified medical expenses may be counted as charity care in the amount that exceeds 30 percent of family income. This clause applies even if the patient's family income exceeds the charity care income standards in clauses (1) and (2).
Subd. 4. [APPLICATION.] To be eligible for funds under this section, hospitals must submit an application to the commissioner of health by the deadline established by the commissioner. Applications must meet the criteria as established by the commissioner, but must contain:
(1) the dollar amount of charity care in the previous year, as defined in subdivision 3, paragraphs (b) and (c);
(2) a list with the most common diagnoses for which charity care is provided; and
(3) descriptive aggregate statistics of the characteristics of patients who receive charity care.
Subd. 5. [ALLOCATION OF FUNDS.] A hospital's share of the available charity care aid is equal to that hospital's share of charity care relative to the total charity care provided by applicants.
Sec. 32. Minnesota Statutes 2000, section 144.98, subdivision 3, is amended to read:
Subd. 3. [FEES.] (a) An application for certification under subdivision 1 must be accompanied by the biennial fee specified in this subdivision. The fees are for:
(1) nonrefundable base certification fee, $500 $1,200; and
(2) test category certification fees:
Test Category Certification Fee
Clean water program bacteriology $200 $600
Safe drinking water program bacteriology $600
Clean water program inorganic chemistry,
fewer than four constituents $100 $600
Safe drinking water program inorganic chemistry,
four or more constituents $300 $600
Clean water program chemistry metals,
fewer than four constituents $200 $800
Safe drinking water program chemistry metals,
four or more constituents $500 $800
Resource conservation and recovery program
chemistry metals $800
Clean water program volatile organic compounds $600 $1,200
Safe drinking water program
volatile organic compounds $1,200
Resource conservation and recovery program
volatile organic compounds $1,200
Underground storage tank program
volatile organic compounds $1,200
Clean water program other organic compounds $600 $1,200
Safe drinking water program other organic compounds $1,200
Resource conservation and recovery program
other organic compounds $1,200
(b) The total biennial certification fee is the base fee plus the applicable test category fees. The biennial
certification fee for a contract laboratory is 1.5 times the total certification fee.
(c) Laboratories located outside of this state that require an on-site survey will be assessed an additional
$1,200 $2,500 fee.
(d) Fees must be set so that the total fees support the laboratory certification program. Direct costs of the certification service include program administration, inspections, the agency's general support costs, and attorney general costs attributable to the fee function.
(e) A change fee shall be assessed if a laboratory requests additional analytes or methods at any time other than when applying for or renewing its certification. The change fee is equal to the test category certification fee for the analyte.
(f) A variance fee shall be assessed if a laboratory requests and is granted a variance from a rule adopted under this section. The variance fee is $500 per variance.
(g) Refunds or credits shall not be made for analytes or methods requested but not approved.
(h) Certification of a laboratory shall not be awarded until all fees are paid.
Sec. 33. Minnesota Statutes 2000, section 144A.44, subdivision 1, is amended to read:
Subdivision 1. [STATEMENT OF RIGHTS.] A person who receives home care services has these rights:
(1) the right to receive written information about rights in advance of receiving care or during the initial evaluation visit before the initiation of treatment, including what to do if rights are violated;
(2) the right to receive care and services according to a suitable and up-to-date plan, and subject to accepted medical or nursing standards, to take an active part in creating and changing the plan and evaluating care and services;
(3) the right to be told in advance of receiving care about the services that will be provided, the disciplines that will furnish care, the frequency of visits proposed to be furnished, other choices that are available, and the consequences of these choices including the consequences of refusing these services;
(4) the right to be told in advance of any change in the plan of care and to take an active part in any change;
(5) the right to refuse services or treatment;
(6) the right to know, in advance, any limits to the services available from a provider, and the provider's grounds for a termination of services;
(7) the right to know in advance of receiving care whether the services are covered by health insurance, medical assistance, or other health programs, the charges for services that will not be covered by Medicare, and the charges that the individual may have to pay;
(8) the right to know what the charges are for services, no matter who will be paying the bill;
(9) the right to know that there may be other services available in the community, including other home care services and providers, and to know where to go for information about these services;
(10) the right to choose freely among available providers and to change providers after services have begun, within the limits of health insurance, medical assistance, or other health programs;
(11) the right to have personal, financial, and medical information kept private, and to be advised of the provider's policies and procedures regarding disclosure of such information;
(12) the right to be allowed access to records and written information from records in accordance with section 144.335;
(13) the right to be served by people who are properly trained and competent to perform their duties;
(14) the right to be treated with courtesy and respect, and to have the patient's property treated with respect;
(15) the right to be free from physical and verbal abuse;
(16) the right to reasonable, advance notice of changes in services or charges, including at least ten days' advance notice of the termination of a service by a provider, except in cases where:
(i) the recipient of services engages in conduct that alters the conditions of employment as specified in the employment contract between the home care provider and the individual providing home care services, or creates an abusive or unsafe work environment for the individual providing home care services; or
(ii) an emergency for the informal caregiver or a significant change in the recipient's condition has resulted in service needs that exceed the current service provider agreement and that cannot be safely met by the home care provider;
(17) the right to a coordinated transfer when there will be a change in the provider of services;
(18) the right to voice grievances regarding treatment or care that is, or fails to be, furnished, or regarding the lack of courtesy or respect to the patient or the patient's property;
(19) the right to know how to contact an individual associated with the provider who is responsible for handling problems and to have the provider investigate and attempt to resolve the grievance or complaint;
(20) the right to know the name and address of the state or county agency to contact for additional information or assistance; and
(21) the right to assert these rights personally, or have them asserted by the patient's family or guardian when the patient has been judged incompetent, without retaliation.
Sec. 34. Minnesota Statutes 2000, section 144A.4605, subdivision 4, is amended to read:
Subd. 4. [LICENSE REQUIRED.] (a) A housing with services establishment registered under chapter 144D that is required to obtain a home care license must obtain an assisted living home care license according to this section or a class A or class E license according to rule. A housing with services establishment that obtains a class E license under this subdivision remains subject to the payment limitations in sections 256B.0913, subdivision 5, paragraph (h), and 256B.0915, subdivision 3, paragraph (g).
(b) A board and lodging establishment registered for special services as of December 31, 1996, and also registered as a housing with services establishment under chapter 144D, must deliver home care services according to sections 144A.43 to 144A.48, and may apply for a waiver from requirements under Minnesota Rules, parts 4668.0002 to 4668.0240, to operate a licensed agency under the standards of section 157.17. Such waivers as may be granted by the department will expire upon promulgation of home care rules implementing section 144A.4605.
(c) An adult foster care provider licensed by the department of human services and registered under chapter 144D may continue to provide health-related services under its foster care license until the promulgation of home care rules implementing this section.
(d) An assisted living home care provider licensed under this section must comply with the disclosure provisions of section 325F.691 to the extent they are applicable.
Sec. 35. Minnesota Statutes 2000, section 144D.03, subdivision 2, is amended to read:
Subd. 2. [REGISTRATION INFORMATION.] The establishment shall provide the following information to the commissioner in order to be registered:
(1) the business name, street address, and mailing address of the establishment;
(2) the name and mailing address of the owner or owners of the establishment and, if the owner or owners are not natural persons, identification of the type of business entity of the owner or owners, and the names and addresses of the officers and members of the governing body, or comparable persons for partnerships, limited liability corporations, or other types of business organizations of the owner or owners;
(3) the name and mailing address of the managing agent, whether through management agreement or lease agreement, of the establishment, if different from the owner or owners, and the name of the on-site manager, if any;
(4) verification that the establishment has entered into an elderly housing with services contract, as required in section 144D.04, with each resident or resident's representative;
(5) verification that the establishment is complying with the requirements of section 325F.691, if applicable;
(5) (6) the name and address of at least one natural person who shall be responsible for dealing
with the commissioner on all matters provided for in sections 144D.01 to 144D.06, and on whom personal service
of all notices and orders shall be made, and who shall be authorized to accept service on behalf of the owner or
owners and the managing agent, if any; and
(6) (7) the signature of the authorized representative of the owner or owners or, if the owner or
owners are not natural persons, signatures of at least two authorized representatives of each owner, one of which
shall be an officer of the owner.
Personal service on the person identified under clause (5) (6) by the owner or owners in the
registration shall be considered service on the owner or owners, and it shall not be a defense to any action that
personal service was not made on each individual or entity. The designation of one or more individuals under this
subdivision shall not affect the legal responsibility of the owner or owners under sections 144D.01 to 144D.06.
Sec. 36. Minnesota Statutes 2000, section 144D.04, subdivision 2, is amended to read:
Subd. 2. [CONTENTS OF CONTRACT.] An elderly housing with services contract, which need not be entitled as such to comply with this section, shall include at least the following elements in itself or through supporting documents or attachments:
(1) name, street address, and mailing address of the establishment;
(2) the name and mailing address of the owner or owners of the establishment and, if the owner or owners is not a natural person, identification of the type of business entity of the owner or owners;
(3) the name and mailing address of the managing agent, through management agreement or lease agreement, of the establishment, if different from the owner or owners;
(4) the name and address of at least one natural person who is authorized to accept service on behalf of the owner or owners and managing agent;
(5) statement describing the registration and licensure status of the establishment and any provider providing health-related or supportive services under an arrangement with the establishment;
(6) term of the contract;
(7) description of the services to be provided to the resident in the base rate to be paid by resident;
(8) description of any additional services available for an additional fee from the establishment directly or through arrangements with the establishment;
(9) fee schedules outlining the cost of any additional services;
(10) description of the process through which the contract may be modified, amended, or terminated;
(11) description of the establishment's complaint resolution process available to residents including the toll-free complaint line for the office of ombudsman for older Minnesotans;
(12) the resident's designated representative, if any;
(13) the establishment's referral procedures if the contract is terminated;
(14) criteria used by the establishment to determine who may continue to reside in the elderly housing with services establishment;
(15) billing and payment procedures and requirements;
(16) statement regarding the ability of residents to receive services from service providers with whom the establishment does not have an arrangement; and
(17) statement regarding the availability of public funds for payment for residence or services in the establishment.
Sec. 37. Minnesota Statutes 2000, section 144D.04, subdivision 3, is amended to read:
Subd. 3. [CONTRACTS IN PERMANENT FILES.] Elderly housing with services contracts and related documents executed by each resident or resident's representative shall be maintained by the establishment in files from the date of execution until three years after the contract is terminated. The contracts and the written disclosures required under section 325F.691, if applicable, shall be made available for on-site inspection by the commissioner upon request at any time.
Sec. 38. Minnesota Statutes 2000, section 144D.06, is amended to read:
144D.06 [OTHER LAWS.]
A housing with services establishment shall obtain and maintain all other licenses, permits, registrations, or other governmental approvals required of it in addition to registration under this chapter. A housing with services establishment is subject to the provisions of section 325F.691 and chapter 504B.
Sec. 39. [145.4241] [DEFINITIONS.]
Subdivision 1. [APPLICABILITY.] As used in sections 145.4241 to 145.4246, the following terms have the meaning given them.
Subd. 2. [ABORTION.] "Abortion" includes an act, procedure, or use of any instrument, medicine, or drug which is supplied or prescribed for or administered to a woman known to be pregnant with the intention to terminate the pregnancy with an intention other than to increase the probability of live birth, to preserve the life or health of the child after live birth, or to remove a dead fetus.
Subd. 3. [ATTEMPT TO PERFORM AN ABORTION.] "Attempt to perform an abortion" means an act, or an omission of a statutorily required act, that, under the circumstances as the actor believes them to be, constitutes a substantial step in a course of conduct planned to culminate in the performance of an abortion in Minnesota in violation of sections 145.4241 to 145.4246.
Subd. 4. [MEDICAL EMERGENCY.] "Medical emergency" means any condition that, on the basis of the physician's good faith clinical judgment, complicates the medical condition of a pregnant female to the extent that:
(1) an immediate abortion of her pregnancy is necessary to avert her death; or
(2) a 24-hour delay in performing an abortion creates a serious risk of substantial injury or impairment of a major bodily function.
Subd. 5. [PHYSICIAN.] "Physician" means a person licensed under chapter 147.
Subd. 6. [PROBABLE GESTATIONAL AGE OF THE FETUS.] "Probable gestational age of the fetus" means what will, in the judgment of the physician, with reasonable probability, be the gestational age of the fetus at the time the abortion is planned to be performed.
Sec. 40. [145.4242] [INFORMED CONSENT.]
(a) No abortion shall be performed in this state except with the voluntary and informed consent of the female upon whom the abortion is to be performed. Except in the case of a medical emergency, consent to an abortion is voluntary and informed only if the female is told the following, by telephone or in person, by the physician who is to perform the abortion, the referring physician, a registered nurse, or a licensed practical nurse, at least 24 hours prior to the abortion:
(1) the particular medical risks associated with the particular abortion procedure to be employed including, when medically accurate, the risks of infection, hemorrhage, breast cancer, danger to subsequent pregnancies, and infertility;
(2) the probable gestational age of the fetus at the time the abortion is to be performed;
(3) the medical risks associated with carrying to term;
(4) that medical assistance benefits may be available for prenatal care, childbirth, and neonatal care;
(5) that the father is liable to assist in the support of her child except under certain circumstances, even in instances when the father has offered to pay for the abortion;
(6) the availability of a toll-free number and Web site that can provide information on support services during pregnancy and while the child is dependent and offer alternatives to abortion; and
(7) that she has the right to review the printed materials described in section 145.4243, and the printed materials are available on the state Web site.
(b) The physician or the physician's agent shall orally inform the female that the materials have been provided by the state of Minnesota and that they describe the unborn child and list agencies that offer alternatives to abortion.
(c) The physician or the physician's agent shall orally inform the female of the Web site address and toll-free number.
(d) If the female chooses to view the materials, they shall either be given to her at least 24 hours before the abortion or mailed to her at least 72 hours before the abortion by first class mail, or at the woman's request, by certified mail, restricted delivery to addressee, which means the postal employee may only deliver the mail to the addressee. The envelope used by the physician shall not identify the name of the physician or the physician's clinic or business.
(e) If a physical examination, tests, or the availability of other information to the physician subsequently indicates, in the medical judgment of the physician, a revision of the information previously supplied to the patient, that revised information may be communicated to the patient at any time prior to the performance of the abortion.
Sec. 41. [145.4243] [PRINTED INFORMATION.]
Subdivision 1. [MATERIALS.] (a) Within 90 days after the effective date of sections 145.4241 to 145.4246, the department of health shall cause to be published, in English and in each language that is the primary language of two percent or more of the state's population, the printed materials described in paragraphs (b) and (c) in such a way as to ensure that the information is easily comprehensible.
(b) The materials must be designed to inform the female of the probable anatomical and physiological characteristics of the fetus at two-week gestational increments from the time when a female can be known to be pregnant to full term, including any relevant information on the possibility of the fetus' survival and pictures or drawings representing the development of the fetus at two-week gestational increments, provided that any such pictures or drawings must contain the dimensions of the fetus and must be realistic and appropriate for the stage of pregnancy depicted. The materials must be objective, nonjudgmental, and designed to convey only accurate scientific information about the fetus at the various gestational ages.
(c) The materials must contain objective information describing the methods of abortion procedures commonly employed, the medical risks commonly associated with each procedure, the possible detrimental psychological effects of abortion, and the medical risks commonly associated with carrying a child to term.
Subd. 2. [TYPEFACE; AVAILABILITY.] The materials referred to in this section must be printed in a typeface large enough to be clearly legible. The materials required under this section must be available from the department of health upon request and in appropriate number to any person, facility, or hospital at no cost.
Sec. 42. [145.4244] [PROCEDURE IN CASE OF MEDICAL EMERGENCY.]
When a medical emergency compels the performance of an abortion, the physician shall inform the female, prior to the abortion if possible, of the medical indications supporting the physician's judgment that an abortion is necessary to avert her death or that a 24-hour delay in conformance with section 145.4242 creates a serious risk of substantial injury or impairment of a major bodily function.
Sec. 43. [145.4245] [TOLL-FREE TELEPHONE NUMBER AND WEB SITE.]
Subdivision 1. [RIGHT TO KNOW.] All pregnant women have the right to know information about resources available to assist them and their families. The commissioner of health shall establish and maintain a statewide toll-free telephone number available seven days a week to provide information and referrals to local community resources to assist women and families through pregnancy and childbirth and while the child is dependent.
Subd. 2. [INFORMATION.] The toll-free telephone number must provide information regarding community resources on the following topics:
(1) information regarding avoiding unplanned pregnancies;
(2) prenatal care, including the need for an initial risk screening and assessment;
(3) adoption;
(4) health education, including the importance of good nutrition during pregnancy and the risks associated with alcohol and tobacco use during pregnancy;
(5) available social services, including medical assistance benefits for prenatal care, childbirth, and neonatal care;
(6) legal assistance in obtaining child support; and
(7) community support services and other resources to enhance family strengths and reduce the possibility of family violence.
Subd. 3. [WEB SITE.] The commissioner shall design and maintain a secure Web site to provide the information described under subdivision 2 and section 145.4243 with a minimum resolution of 72 PPI. The Web site shall provide the toll-free information and referral telephone number described under subdivision 2.
Sec. 44. [145.4246] [ENFORCEMENT PENALTIES.]
Subdivision 1. [STANDING.] A person with standing may maintain an action against the performance or attempted performance of abortions in violation of section 145.4242. Those with standing are:
(1) a woman upon whom an abortion in violation of section 145.4242 has been performed or attempted to be performed; and
(2) the parent of an unemancipated minor upon whom an abortion in violation of section 145.4242 has been, is about to be, or was attempted to be performed; and
(3) attorney general of the state of Minnesota.
Subd. 2. [INJUNCTIONS.] Parties bringing actions against the performance or attempted performance of abortions in violation of section 145.4242 may seek temporary restraining orders, preliminary injunctions, and injunctions related only to the physician or facility where the violation occurred in accordance with the Rules of Civil Procedure. Persons with standing must bring any actions within six months of the date of the performed or attempted performance of abortions in violation of section 145.4242.
Subd. 3. [CONTEMPT.] Any person knowingly violating the terms of an injunction against the performance or attempted performance of abortions in violation of section 145.4242 is subject to civil contempt, and shall be fined no more than $1,000 for the first violation, no more than $5,000 for the second violation, no more than $10,000 for the third violation, and for each successive violation an amount sufficient to deter future violations. The fine shall be the exclusive penalty for a violation. Each performance or attempted performance of abortion in violation of section 145.4242 is a separate violation. No fine shall be assessed against the woman on whom an abortion is performed or attempted.
Subd. 4. [REALLOCATION OF THE FINE.] Any fines collected under this section must be sent to a special account at the Minnesota department of health to be used for materials cited in section 145.4243.
Sec. 45. [145.4247] [CUMULATIVE RIGHTS.]
The provisions of sections 145.4241 to 145.4246 are cumulative with existing law regarding an individual's right to consent to medical treatment and shall not impair any existing right any patient may have under the common law or statutes of this state.
Sec. 46. Minnesota Statutes 2000, section 145.881, subdivision 2, is amended to read:
Subd. 2. [DUTIES.] The advisory task force shall meet on a regular basis to perform the following duties:
(a) review and report on the health care needs of mothers and children throughout the state of Minnesota;
(b) review and report on the type, frequency and impact of maternal and child health care services provided to mothers and children under existing maternal and child health care programs, including programs administered by the commissioner of health;
(c) establish, review, and report to the commissioner a list of program guidelines and criteria which the advisory task force considers essential to providing an effective maternal and child health care program to low income populations and high risk persons and fulfilling the purposes defined in section 145.88;
(d) review staff recommendations of the department of health regarding maternal and child health grant awards before the awards are made;
(e) make recommendations to the commissioner for the use of other federal and state funds available to meet maternal and child health needs;
(f) make recommendations to the commissioner of health on priorities for funding the following maternal and
child health services: (1) prenatal, delivery and postpartum care, (2) comprehensive health care for children,
especially from birth through five years of age, (3) adolescent health services, (4) family planning services, (5)
preventive dental care, (6) special services for chronically ill and handicapped children and (7) any other services
which promote the health of mothers and children; and
(g) make recommendations to the commissioner of health on the process to distribute, award and administer the maternal and child health block grant funds; and
(h) review the measures that are used to define the variables of the funding distribution formula in section 145.882, subdivision 4a, every two years and make recommendations to the commissioner of health for changes based upon principles established by the advisory task force for this purpose.
Sec. 47. Minnesota Statutes 2000, section 145.882, is amended by adding a subdivision to read:
Subd. 4a. [ALLOCATION TO COMMUNITY HEALTH BOARDS.] (a) Federal maternal and child health block grant money remaining after distributions made under subdivision 2 and money appropriated for allocation to community health boards must be allocated according to paragraphs (b) to (d) to community health boards as defined in section 145A.02, subdivision 5.
(b) All community health boards must receive 95 percent of the funding awarded to them for the 1998-1999 funding cycle. If the amount of state and federal funding available is less than 95 percent of the amount awarded to community health boards for the 1998-1999 funding cycle, the available funding must be apportioned to reflect a proportional decrease for each recipient.
(c) The federal and state funding remaining after distributions made under paragraph (b) must be allocated to each community health board based on the following three variables:
(1) 25 percent based on the maternal and child population in the area served by the community health board;
(2) 50 percent based on the following factors, as determined by averaging the data available for the three most recent years:
(i) the proportion of infants in the area served by the community health board whose weight at birth was less than 2,500 grams;
(ii) the proportion of mothers in the area served by the community health board who received inadequate or no prenatal care;
(iii) the proportion of births in the area served by the community health board to women under age 19; and
(iv) the proportion of births in the area served by the community health board to American Indian women and women of color; and
(3) 25 percent based on the income of the maternal and child population in the area served by the community health board.
(d) Each variable must be expressed as a city or county score consisting of the city or county frequency of each variable in relation to the statewide frequency of the variable. A total score for each city or county jurisdiction must be computed by totaling the scores of the three variables. Each community health board must be allocated an amount equal to the total score obtained for the city, county, or counties in its area multiplied by the amount of money available.
Sec. 48. Minnesota Statutes 2000, section 145.882, subdivision 7, is amended to read:
Subd. 7. [USE OF BLOCK GRANT MONEY.] (a) Maternal and child health block grant money
allocated to a community health board or community health services area under this section must be used for
qualified programs for high risk and low-income individuals. Block grant money must be used for programs that:
(1) specifically address the highest risk populations, particularly low-income and minority groups with a high rate
of infant mortality and children with low birth weight, by providing services, including excluding
prepregnancy family planning services, calculated to produce measurable decreases in infant mortality rates,
instances of children with low birth weight, and medical complications associated with pregnancy and childbirth,
including infant mortality, low birth rates, and medical complications arising from chemical abuse by a mother
during pregnancy;
(2) specifically target pregnant women whose age, medical condition, maternal history, or chemical abuse substantially increases the likelihood of complications associated with pregnancy and childbirth or the birth of a child with an illness, disability, or special medical needs;
(3) specifically address the health needs of young children who have or are likely to have a chronic disease or disability or special medical needs, including physical, neurological, emotional, and developmental problems that arise from chemical abuse by a mother during pregnancy;
(4) provide family planning and preventive medical care, excluding prepregnancy family planning
services, for specifically identified target populations, such as minority and low-income teenagers, in a manner
calculated to decrease the occurrence of inappropriate pregnancy and minimize the risk of complications
associated with pregnancy and childbirth; or
(5) specifically address the frequency and severity of childhood injuries and other child and adolescent health
problems in high-risk target populations by providing services, excluding prepregnancy family
planning services, calculated to produce measurable decreases in mortality and morbidity. However, money
may be used for this purpose only if the community health board's application includes program components for the
purposes in clauses
(1) to (4) in the proposed geographic service area and the total expenditure for injury-related programs under this clause does not exceed ten percent of the total allocation under subdivision 3.
(b) Maternal and child health block grant money may be used for purposes other than the purposes listed in
this subdivision only under the following conditions:
(1) the community health board or community health services area can demonstrate that existing programs
fully address the needs of the highest risk target populations described in this subdivision; or
(2) the money is used to continue projects that received funding before creation of the maternal and child
health block grant in 1981.
(c) Projects that received funding before creation of the maternal and child health block grant in 1981, must
be allocated at least the amount of maternal and child health special project grant funds received in 1989, unless (1)
the local board of health provides equivalent alternative funding for the project from another source; or (2) the local
board of health demonstrates that the need for the specific services provided by the project has significantly decreased
as a result of changes in the demographic characteristics of the population, or other factors that have a major impact
on the demand for services. If the amount of federal funding to the state for the maternal and child health block
grant is decreased, these projects must receive a proportional decrease as required in subdivision 1. Increases in
allocation amounts to local boards of health under subdivision 4 may be used to increase funding levels for these
projects.
Sec. 49. Minnesota Statutes 2000, section 145.885, subdivision 2, is amended to read:
Subd. 2. [ADDITIONAL REQUIREMENTS FOR COMMUNITY BOARDS OF HEALTH.] Applications by
community health boards as defined in section 145A.02, subdivision 5, under section 145.882, subdivision 3
4a, must also contain a summary of the process used to develop the local program, including evidence that
the community health board notified local public and private providers of the availability of funding through the
community health board for maternal and child health services; a list of all public and private agency requests for
grants submitted to the community health board indicating which requests were included in the grant application;
and an explanation of how priorities were established for selecting the requests to be included in the grant
application. The community health board shall include, with the grant application, a written statement of the criteria
to be applied to public and private agency requests for funding.
Sec. 50. Minnesota Statutes 2000, section 145.924, is amended to read:
145.924 [AIDS PREVENTION GRANTS.]
Subdivision 1. [GRANT AWARDS.] (a) The commissioner may award grants to boards of health as defined in section 145A.02, subdivision 2, state agencies, state councils, or nonprofit corporations to provide evaluation and counseling services to populations at risk for acquiring human immunodeficiency virus infection, including, but not limited to, minorities, adolescents, intravenous drug users, and homosexual men.
(b) The commissioner may award grants to agencies experienced in providing services to communities of color, for the design of innovative outreach and education programs for targeted groups within the community who may be at risk of acquiring the human immunodeficiency virus infection, including intravenous drug users and their partners, adolescents, gay and bisexual individuals and women. Grants shall be awarded on a request for proposal basis and shall include funds for administrative costs. Priority for grants shall be given to agencies or organizations that have experience in providing service to the particular community which the grantee proposes to serve; that have policymakers representative of the targeted population; that have experience in dealing with issues relating to HIV/AIDS; and that have the capacity to deal effectively with persons of differing sexual orientations. For purposes of this paragraph, the "communities of color" are: the American-Indian community; the Hispanic community; the African-American community; and the Asian-Pacific community.
(c) All state grants awarded under this section subdivision for programs targeted to adolescents
shall include the promotion of abstinence from sexual activity and drug use.
Subd. 2. [OUTCOMES.] The commissioner, in consultation with boards of health, agencies, councils, and nonprofit organizations involved in human immunodeficiency virus infection prevention efforts shall establish measurable outcomes to determine the effectiveness of the grants provided under this section in reducing the number of people who acquire human immunodeficiency virus, the rates of infection, and average numbers of sexual partners for populations served by grants funded under this section.
Subd. 3. [EVALUATION.] (a) Using the outcomes established according to subdivision 2, the commissioner shall conduct a biennial evaluation of activities funded under this section. The evaluation must include:
(1) the effect of these activities on the number of people who acquire human immunodeficiency virus and the rates of infection;
(2) the effect of these activities on average numbers of sexual partners for populations served by grants funded under this section; and
(3) a longitudinal tracking of outcomes for targeted populations who are served under subdivision 1, paragraphs (a) and (b).
(b) Grant recipients shall cooperate with the commissioner in the evaluation and shall provide the commissioner with the information needed to conduct the evaluation. Beginning January 15, 2003, the results of each evaluation must be submitted to the chairs of the policy and finance committees in the house and senate with jurisdiction over health and human services.
Sec. 51. Minnesota Statutes 2000, section 145.925, subdivision 1, is amended to read:
Subdivision 1. [ELIGIBLE ORGANIZATIONS; PURPOSE.] The commissioner of health may make special
grants to cities, counties, tribal governments, or groups of cities or, counties, or
nonprofit corporations or tribal governments to provide prepregnancy family planning services.
targeted to low-income and minority populations. A city, county, tribal government, or group of cities, counties,
or tribal governments that receives a grant is responsible for ensuring that the grant funds are used for services
targeted to low-income and minority populations, and must establish a goal for reducing specific pregnancy rates
in the service area. In determining populations to serve and services to provide, a city, county, tribal government,
or group of cities, counties, or tribal governments must consider the spacing of pregnancies in low-income and
minority populations in the service area, teen birth rates in the service area, and the needs of populations of color
in the service area. A city, county, tribal government, or group of cities, counties, or tribal governments may contract
for the provision of prepregnancy family planning services using grant funds provided under this section only if the
contract is specifically authorized by the governing body of the city, county, or tribal government that is contracting
for the services.
Any organization or an affiliate of an organization which provides abortions, promotes abortions, or directly refers for abortions, shall be ineligible to receive funds under this subdivision.
Sec. 52. Minnesota Statutes 2000, section 145.925, subdivision 1a, is amended to read:
Subd. 1a. [FAMILY PLANNING SERVICES; DEFINED.] "Family planning services" means counseling by
trained personnel regarding family planning; distribution of information relating to family planning, referral to
licensed physicians or local health agencies for consultation, examination, medical treatment, genetic counseling,
and prescriptions for the purpose of family planning; and the distribution of family planning products, such as charts,
thermometers, drugs, medical preparations, and contraceptive devices. Family planning services do not include
services that, directly or indirectly, encourage, counsel, refer, or provide abortions or abortion referrals. For
purposes of sections 145A.01 to 145A.14, family planning shall mean voluntary action by individuals to prevent or
aid conception but does not include the performance, or make referrals for encouragement of voluntary
termination of pregnancy services that, directly or indirectly, encourage, counsel, refer, or provide abortions
or abortion referrals.
Sec. 53. [145.9257] [TEEN PREGNANCY PREVENTION.]
Subdivision 1. [GOAL.] It is the goal of the state to reduce teen pregnancy rates by 24 percent by 2006. To do so, the commissioner of health shall establish a grant program to reduce the rates of unintended teen pregnancies in the state. If this goal of reducing teen pregnancy rates by 24 percent is not met by December 31, 2006, this section expires June 30, 2007. No funds awarded under this section may be used for medical services or family planning services or for services that, directly or indirectly, encourage, counsel, refer, or provide abortions or abortion referrals.
Any organization or an affiliate of an organization which provides abortions, promotes abortions, or directly refers for abortions, shall be ineligible to receive funds under this section.
Subd. 2. [STATE-COMMUNITY PARTNERSHIPS; PLAN.] The commissioner, in consultation with the commissioner of children, families, and learning; the commissioner of human services; the maternal and child health advisory task force under section 145.881; the Indian affairs council under section 3.922; the council on affairs of Chicano/Latino people under section 3.9223; the council on Black Minnesotans under section 3.9225; the council on Asian-Pacific Minnesotans under section 3.9226; community health boards as defined in section 145A.02; tribal governments; nonprofit community organizations; and others interested in teen pregnancy prevention, shall develop and implement a comprehensive, coordinated plan to reduce the number of teen pregnancies.
Subd. 3. [MEASURABLE OUTCOMES.] The commissioner, in consultation with the commissioners and community partners listed in subdivision 2, shall establish measurable outcomes to achieve the goal specified in subdivision 1 and to determine the effectiveness of the grants provided under this section in reducing teen pregnancies. The development of measurable outcomes must be completed before any funds are distributed under this section.
Subd. 4. [STATEWIDE ASSESSMENT.] The commissioner shall use and enhance current statewide assessments of teen pregnancy risk behaviors and attitudes among youth to establish a baseline to measure the statewide effect of teen pregnancy prevention activities. To the extent feasible, the commissioner shall conduct the assessment so that the results may be compared to national data.
Subd. 5. [PROCESS.] The commissioner, in consultation with the commissioners and community partners listed in subdivision 2, shall develop the criteria and procedures used to allocate grants under this section. In developing the criteria, the commissioner shall establish an administrative cost limit for grant recipients. At the time a grant is awarded, the commissioner shall provide a grant recipient with information on the outcomes established according to subdivision 3.
Subd. 6. [TEEN PREGNANCY PREVENTION DISPARITY GRANTS.] (a) The commissioner shall award competitive grants to eligible applicants for projects to reduce disparities in unintended teen pregnancy rates for American Indians and populations of color, as compared with unintended teen pregnancy rates for whites.
(b) No funds awarded under this subdivision may be used for medical services or family planning services or for services that, directly or indirectly, encourage, counsel, refer, or provide abortions or abortion referrals.
Any organization or an affiliate of an organization which provides abortions, promotes abortions, or directly refers for abortions, shall be ineligible to receive funds under this subdivision.
(c) Eligible applicants may include, but are not limited to, nonprofit organizations, school districts, faith-based organizations, community health boards, and tribal governments. Applicants must submit proposals to the commissioner. A proposal must specify the strategies to be implemented and must take into account the need for a coordinated, statewide teen pregnancy prevention effort. Strategies may include youth development programs, after-school enrichment programs, youth mentoring programs, academic support programs, and abstinence until marriage education programs.
(d) The commissioner shall give priority to applicants who demonstrate that their proposed project:
(1) emphasizes abstinence until marriage;
(2) is research-based or based on proven, effective strategies;
(3) is designed to coordinate with related youth risk behavior reduction activities;
(4) involves youth and parents in the project's development and implementation;
(5) reflects racially and ethnically appropriate approaches; and
(6) will be implemented through or with persons or community-based organizations that reflect the race or ethnicity of the population to be reached.
Subd. 7. [HIGH-RISK COMMUNITY TEEN PREGNANCY PREVENTION GRANTS.] (a) The commissioner shall award grants to communities that have significant risk factors for teen pregnancies, that currently have in place youth development programs, and that are interested in expanding existing efforts to prevent teen pregnancies.
(b) No funds awarded under this subdivision may be used for medical services or family planning services or for services that, directly or indirectly, encourage, counsel, refer, or provide abortions or abortion referrals.
Any organization or an affiliate of an organization which provides abortions, promotes abortions, or directly refers for abortions, shall be ineligible to receive funds under this subdivision.
(c) To be eligible for a grant under this subdivision, an applicant must be a tribal government or a community health board as defined in section 145A.02. Applicants must submit proposals to the commissioner. A proposal must specify the strategies to be implemented. Strategies may include, but are not limited to, youth development programs, youth mentoring programs, academic support programs, and abstinence until marriage education programs. Applicants must demonstrate that a proposed project:
(1) emphasizes abstinence until marriage;
(2) is research-based or based on proven, effective strategies;
(3) is designed to coordinate with related youth risk behavior reduction activities;
(4) involves youth and parents in the project's development and implementation;
(5) reflects racially and ethnically appropriate approaches; and
(6) will be implemented through or with persons or community-based organizations that reflect the race or ethnicity of the population to be reached.
(d) Grants may be awarded to up to 15 community health boards and three tribal governments based on areas having the highest risk factors for teen pregnancies. The commissioner shall award grants based on the following risk factors:
(1) the proportion of teens in the applicant's service area who are sexually active;
(2) the proportion of births to teens in the applicant's service area; and
(3) the proportion of births to teens who are American Indian or of a population of color in the applicant's service area.
Subd. 8. [ADOLESCENT PARENT GRANTS.] The commissioner shall transfer funds to the commissioner of children, families, and learning to increase the number of adolescent parent grants currently provided by the commissioner of children, families, and learning under section 124D.33.
Subd. 9. [COORDINATION.] The commissioner shall coordinate the projects and initiatives funded under this section with other efforts at the local, state, and national levels to avoid duplication and promote complementary efforts.
Subd. 10. [EVALUATION.] Using the outcomes established according to subdivision 3, the commissioner shall conduct a biennial evaluation of the impact of each teen pregnancy prevention initiative in this section. Grant recipients and the commissioner of children, families, and learning shall cooperate with the commissioner in the evaluation and shall provide the commissioner with the information needed to conduct the evaluation.
Subd. 11. [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 projects funded under this section and the results of the biennial evaluation.
Sec. 54. [145.9268] [COMMUNITY CLINIC GRANTS.]
Subdivision 1. [DEFINITION.] For purposes of this section, "eligible community clinic" means:
(1) a clinic that provides services under conditions as defined in Minnesota Rules, part 9505.0255 or 9505.0380, and utilizes a sliding fee scale to determine eligibility for charity care;
(2) an Indian tribal government or Indian health service unit; or
(3) a consortium of clinics comprised of entities under clause (1) or (2).
Subd. 2. [GRANTS AUTHORIZED.] The commissioner of health shall award grants to eligible community clinics to improve the ongoing viability of Minnesota's clinic-based safety net providers. Grants shall be awarded to support the capacity of eligible community clinics to serve low-income populations, reduce current or future uncompensated care burdens, or provide for improved care delivery infrastructure.
Subd. 3. [ALLOCATION OF GRANTS.] (a) To receive a grant under this section, an eligible community clinic 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.
(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 project for which grant funds will be used;
(2) a description of the problem the proposed project will address; and
(3) a description of achievable objectives, a workplan, and a timeline for project completion.
(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 according to paragraph (e), the commissioner shall establish criteria including, but not limited to: the priority level of the project; the applicant's thoroughness and clarity in describing the problem; a description of the applicant's proposed project; the manner in which the applicant will demonstrate the effectiveness of the project; and evidence of efficiencies and effectiveness gained through collaborative efforts. The commissioner may also take into account other relevant factors, including, but not limited to, the percentage for which uninsured patients represent the applicant's patient base. During application review, the commissioner may request additional information about a proposed project, including information on project cost. Failure to provide the information requested disqualifies an applicant.
(d) A grant awarded to an eligible community clinic may not exceed $300,000 per eligible community clinic. For an applicant applying as a consortium of clinics, a grant may not exceed $300,000 per clinic included in the consortium. The commissioner has discretion over the number of grants awarded.
(e) In determining which eligible community clinics will receive grants under this section, the commissioner shall give preference to those grant applications that show evidence of collaboration with other eligible community clinics, hospitals, health care providers, or community organizations. In addition, the commissioner shall give priority, in declining order, to grant applications for projects that:
(1) establish, update, or improve information, data collection, or billing systems;
(2) procure, modernize, remodel, or replace equipment used an the delivery of direct patient care at a clinic;
(3) provide improvements for care delivery, such as increased translation and interpretation services;
(4) provide a direct offset to expenses incurred for charity care services; or
(5) other projects determined by the commissioner to improve the ability of applicants to provide care to the vulnerable populations they serve.
Subd. 4. [EVALUATION.] The commissioner of health shall evaluate the overall effectiveness of the grant program. The commissioner shall collect progress reports to evaluate the grant program from the eligible community clinics receiving grants.
Sec. 55. [145.928] [ELIMINATING HEALTH DISPARITIES.]
Subdivision 1. [GOAL; ESTABLISHMENT.] It is the goal of the state, by 2010, to decrease by 50 percent the disparities in infant mortality rates and adult and child immunization rates for American Indians and populations of color, as compared with rates for whites. To do so and to achieve other measurable outcomes, the commissioner of health shall establish a program to close the gap in the health status of American Indians and populations of color as compared with whites in the following priority areas: infant mortality, breast and cervical cancer screening, HIV/AIDS and sexually transmitted infections, adult and child immunizations, cardiovascular disease, diabetes, and accidental injuries and violence. If this goal of reducing disparities in infant mortality rates and adult and child immunization rates is not met by December 31, 2010, this section expires June 30, 2011.
Subd. 2. [STATE-COMMUNITY PARTNERSHIPS; PLAN.] The commissioner, in partnership with culturally-based community organizations; the Indian affairs council under section 3.922; the council on affairs of Chicano/Latino people under section 3.9223; the council on Black Minnesotans under section 3.9225; the council on Asian-Pacific Minnesotans under section 3.9226; community health boards as defined in section 145A.02; and tribal governments, shall develop and implement a comprehensive, coordinated plan to reduce health disparities in the health disparity priority areas identified in subdivision 1.
Subd. 3. [MEASURABLE OUTCOMES.] The commissioner, in consultation with the community partners listed in subdivision 2, shall establish measurable outcomes to achieve the goal specified in subdivision 1 and to determine the effectiveness of the grants and other activities funded under this section in reducing health disparities in the priority areas identified in subdivision 1. The development of measurable outcomes must be completed before any funds are distributed under this section.
Subd. 4. [STATEWIDE ASSESSMENT.] The commissioner shall enhance current data tools to ensure a statewide assessment of the risk behaviors associated with the health disparity priority areas identified in subdivision 1. The statewide assessment must be used to establish a baseline to measure the effect of activities funded under this section. To the extent feasible, the commissioner shall conduct the assessment so that the results may be compared to national data.
Subd. 5. [TECHNICAL ASSISTANCE.] The commissioner shall provide the necessary expertise to grant applicants to ensure that submitted proposals are likely to be successful in reducing the health disparities identified in subdivision 1. The commissioner shall provide grant recipients with guidance and training on best or most promising strategies to use to reduce the health disparities identified in subdivision 1. The commissioner shall also assist grant recipients in the development of materials and procedures to evaluate local community activities.
Subd. 6. [PROCESS.] (a) The commissioner, in consultation with the community partners listed in subdivision 2, shall develop the criteria and procedures used to allocate grants under this section. In developing the criteria, the commissioner shall establish an administrative cost limit for grant recipients. At the time a grant is awarded, the commissioner must provide a grant recipient with information on the outcomes established according to subdivision 3.
(b) A grant recipient must coordinate its activities to reduce health disparities with other entities receiving funds under this section that are in the grant recipient's service area.
Subd. 7. [COMMUNITY GRANT PROGRAM; IMMUNIZATION RATES AND INFANT MORTALITY RATES.] (a) The commissioner shall award grants to eligible applicants for local or regional projects and initiatives directed at reducing health disparities in one or both of the following priority areas:
(1) decreasing racial and ethnic disparities in infant mortality rates; or
(2) increasing adult and child immunization rates in nonwhite racial and ethnic populations.
(b) The commissioner may award up to 20 percent of the funds available as planning grants. Planning grants must be used to address such areas as community assessment, coordination activities, and development of community supported strategies.
(c) Eligible applicants may include, but are not limited to, faith-based organizations, social service organizations, community nonprofit organizations, community health boards, tribal governments, and community clinics. Applicants must submit proposals to the commissioner. A proposal must specify the strategies to be implemented to address one or both of the priority areas listed in paragraph (a) and must be targeted to achieve the outcomes established according to subdivision 3.
(d) The commissioner shall give priority to applicants who demonstrate that their proposed project or initiative:
(1) is supported by the community the applicant will serve;
(2) is research-based or based on promising strategies;
(3) is designed to complement other related community activities;
(4) utilizes strategies that positively impact both priority areas;
(5) reflects racially and ethnically appropriate approaches; and
(6) will be implemented through or with community-based organizations that reflect the race or ethnicity of the population to be reached.
Subd. 8. [COMMUNITY GRANT PROGRAM; OTHER HEALTH DISPARITIES.] (a) The commissioner shall award grants to eligible applicants for local or regional projects and initiatives directed at reducing health disparities in one or more of the following priority areas:
(1) decreasing racial and ethnic disparities in morbidity and mortality rates from breast and cervical cancer;
(2) decreasing racial and ethnic disparities in morbidity and mortality rates from HIV/AIDS and sexually transmitted infections;
(3) decreasing racial and ethnic disparities in morbidity and mortality rates from cardiovascular disease;
(4) decreasing racial and ethnic disparities in morbidity and mortality rates from diabetes; or
(5) decreasing racial and ethnic disparities in morbidity and mortality rates from accidental injuries or violence.
(b) The commissioner may award up to 20 percent of the funds available as planning grants. Planning grants must be used to address such areas as community assessment, determining community priority areas, coordination activities, and development of community supported strategies.
(c) Eligible applicants may include, but are not limited to, faith-based organizations, social service organizations, community nonprofit organizations, community health boards, tribal governments, and community clinics. Applicants shall submit proposals to the commissioner. A proposal must specify the strategies to be implemented to address one or more of the priority areas listed in paragraph (a) and must be targeted to achieve the outcomes established according to subdivision 3.
(d) The commissioner shall give priority to applicants who demonstrate that their proposed project or initiative:
(1) is supported by the community the applicant will serve;
(2) is research-based or based on promising strategies;
(3) is designed to complement other related community activities;
(4) utilizes strategies that positively impact more than one priority area;
(5) reflects racially and ethnically appropriate approaches; and
(6) will be implemented through or with community-based organizations that reflect the race or ethnicity of the population to be reached.
Subd. 9. [REFUGEE AND IMMIGRANT HEALTH.] (a) The commissioner shall distribute funds to community health boards for health screening and follow-up services for tuberculosis for refugees. Funds shall be distributed based on the following formula:
(1) $1,500 per refugee with pulmonary tuberculosis in the community health board's service area;
(2) $500 per refugee with extrapulmonary tuberculosis in the community health board's service area;
(3) $500 per month of directly observed therapy provided by the community health board for each uninsured refugee with pulmonary or extrapulmonary tuberculosis; and
(4) $50 per refugee in the community health board's service area.
(b) Payments must be made at the end of each state fiscal year. The amount paid per tuberculosis case, per month of directly observed therapy, and per refugee must be proportionately increased or decreased to fit the actual amount appropriated for that fiscal year.
Subd. 10. [COORDINATION.] The commissioner shall coordinate the projects and initiatives funded under this section with other efforts at the local, state, or national level to avoid duplication and promote complementary efforts.
Subd. 11. [EVALUATION.] Using the outcomes established according to subdivision 3, the commissioner shall conduct a biennial evaluation of the community grant programs under subdivisions 7 and 8. Grant recipients shall cooperate with the commissioner in the evaluation and shall provide the commissioner with the information needed to conduct the evaluation.
Subd. 12. [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 local community projects and community health board activities funded under this section. The report must include information on grant recipients, activities conducted using grant funds, and evaluation data and outcome measures if available.
Sec. 56. Minnesota Statutes 2000, section 145A.15, subdivision 1, is amended to read:
Subdivision 1. [ESTABLISHMENT.] (a) The commissioner of health shall expand the current grant program to fund additional projects designed to prevent child abuse and neglect and reduce juvenile delinquency by promoting positive parenting, resiliency in children, and a healthy beginning for children by providing early intervention services for families in need. Grant dollars shall be available to train paraprofessionals to provide in-home intervention services and to allow public health nurses to do case management of services. The grant program shall provide early intervention services for families in need and will include:
(1) expansion of current public health nurse and family aide home visiting programs and public health home visiting projects which prevent child abuse and neglect, prevent juvenile delinquency, and build resiliency in children;
(2) early intervention to promote a healthy and nurturing beginning;
(3) distribution of educational and public information programs and materials in hospital maternity divisions, well-baby clinics, obstetrical clinics, and community clinics; and
(4) training of home visitors in skills necessary for comprehensive home visiting which promotes a healthy and nurturing beginning for the child.
(b) No new grants shall be awarded under this section after June 30, 2001. Grant contracts awarded and in effect under this section as of July 1, 2001, shall continue until their expiration date.
Sec. 57. Minnesota Statutes 2000, section 145A.15, is amended by adding a subdivision to read:
Subd. 5. [EXPIRATION.] This section expires June 30, 2003.
Sec. 58. Minnesota Statutes 2000, section 145A.16, subdivision 1, is amended to read:
Subdivision 1. [ESTABLISHMENT.] The commissioner shall establish a grant program to fund universally offered home visiting programs designed to serve all live births in designated geographic areas. The commissioner shall designate the geographic area to be served by each program. At least one program must provide home visiting services to families within the seven-county metropolitan area, and at least one program must provide home visiting services to families outside the metropolitan area. The purpose of the program is to strengthen families and to promote positive parenting and healthy child development. No new grants shall be awarded under this section after June 30, 2001. Competitive grant contracts awarded and in effect under this section as of July 1, 2001, shall expire December 31, 2003.
Sec. 59. Minnesota Statutes 2000, section 145A.16, is amended by adding a subdivision to read:
Subd. 10. [EXPIRATION.] This section expires December 31, 2003.
Sec. 60. [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 a healthy beginning for children in families at or below 200 percent
of the federal poverty guidelines, prevent child abuse and neglect, reduce juvenile delinquency, promote positive
parenting and resiliency in children, and promote family health and economic self-sufficiency. 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 for child abuse, neglect, or juvenile delinquency. Programs must give priority for services to families considered to be in need of services, including but not limited to 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; or
(8) insufficient financial resources to meet family needs.
Subd. 2. [ALLOCATION OF FUNDS.] The commissioner shall distribute funds available under this section to community health boards, as defined in section 145A.02, and to tribal governments. Funds shall be distributed to community health boards as follows: (1) each community health board shall receive an allocation of $25,000 per year; and (2) remaining funds available to community health boards shall be distributed according to the formula in section 256J.625, subdivision 3. The commissioner, in consultation with tribal governments, shall establish a formula for distributing funds to tribal governments.
Subd. 3. [REQUIREMENTS FOR PROGRAMS; PROCESS.] (a) 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 must:
(1) use either a broad community-based or selective community-based 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 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) recruit home visitors who will represent, to the extent possible, the races, cultures, and languages spoken by families that may be served;
(6) train and supervise home visitors in accordance with the requirements established under subdivision 4;
(7) maximize resources and minimize duplication by coordinating activities with local social and human services organizations, education organizations, and other appropriate governmental entities and community-based organizations and agencies; and
(8) utilize appropriate racial and ethnic approaches to providing home visiting services.
(b) 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.
(c) 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 by a public health nurse. The requirements for nurses must be consistent with chapter 148. Training must include child development, positive parenting techniques, and diverse cultural practices in child rearing and family systems.
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 MEASURES.] The commissioner shall establish outcomes 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; and
(4) any additional qualitative goals and quantitative measures established by the commissioner.
Subd. 7. [EVALUATION.] Using the qualitative goals and quantitative outcome 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 in subdivision 1 and by the commissioner. 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. 61. Minnesota Statutes 2000, section 157.16, subdivision 3, is amended to read:
Subd. 3. [ESTABLISHMENT FEES; DEFINITIONS.] (a) The following fees are required for food and beverage service establishments, hotels, motels, lodging establishments, and resorts licensed under this chapter. Food and beverage service establishments must pay the highest applicable fee under paragraph (e), clause (1), (2), (3), or (4),
and establishments serving alcohol must pay the highest applicable fee under paragraph (e), clause (6) or (7). The license fee for new operators previously licensed under this chapter for the same calendar year is one-half of the appropriate annual license fee, plus any penalty that may be required. The license fee for operators opening on or after October 1 is one-half of the appropriate annual license fee, plus any penalty that may be required. The fees in paragraphs (b), (c), and (d) effective until June 30, 2001, shall be phased up as specified in section 64 to the fee amounts effective beginning July 1, 2004. Notwithstanding section 16A.1285, in fiscal years 2002, 2003, and 2004, the commissioner shall regulate food and beverage service establishments, hotels, motels, lodging establishments, and resorts with the fees collected for that purpose.
(b) All food and beverage service establishments, except special event food stands, and all hotels, motels, lodging establishments, and resorts shall pay an annual base fee of $100 until June 30, 2001. Effective July 1, 2004, the annual base fee shall be $145.
(c) A special event food stand shall pay a flat fee of $30 annually until June 30, 2001. Effective July 1, 2004, the annual flat fee shall be $35. "Special event food stand" means a fee category where food is prepared or served in conjunction with celebrations, county fairs, or special events from a special event food stand as defined in section 157.15.
(d) In addition to the base fee in paragraph (b), each food and beverage service establishment, other than a special event food stand, and each hotel, motel, lodging establishment, and resort shall pay an additional annual fee for each fee category as specified in this paragraph:
(1) Limited food menu selection, $30 until June 30, 2001. Effective July 1, 2004, the annual fee shall be $40. "Limited food menu selection" means a fee category that provides one or more of the following:
(i) prepackaged food that receives heat treatment and is served in the package;
(ii) frozen pizza that is heated and served;
(iii) a continental breakfast such as rolls, coffee, juice, milk, and cold cereal;
(iv) soft drinks, coffee, or nonalcoholic beverages; or
(v) cleaning for eating, drinking, or cooking utensils, when the only food served is prepared off site.
(2) Small establishment, including boarding establishments, $55 until June 30, 2001. Effective July 1, 2004, the annual fee shall be $75. "Small establishment" means a fee category that has no salad bar and meets one or more of the following:
(i) possesses food service equipment that consists of no more than a deep fat fryer, a grill, two hot holding containers, and one or more microwave ovens;
(ii) serves dipped ice cream or soft serve frozen desserts;
(iii) serves breakfast in an owner-occupied bed and breakfast establishment;
(iv) is a boarding establishment; or
(v) meets the equipment criteria in clause (3), item (i) or (ii), and has a maximum patron seating capacity of not more than 50.
(3) Medium establishment, $150 until June 30, 2001. Effective July 1, 2004, the annual fee shall be $210. "Medium establishment" means a fee category that meets one or more of the following:
(i) possesses food service equipment that includes a range, oven, steam table, salad bar, or salad preparation area;
(ii) possesses food service equipment that includes more than one deep fat fryer, one grill, or two hot holding containers; or
(iii) is an establishment where food is prepared at one location and served at one or more separate locations.
Establishments meeting criteria in clause (2), item (v), are not included in this fee category.
(4) Large establishment, $250 until June 30, 2001. Effective July 1, 2004, the annual fee shall be $350. "Large establishment" means either:
(i) a fee category that (A) meets the criteria in clause (3), items (i) or (ii), for a medium establishment, (B) seats more than 175 people, and (C) offers the full menu selection an average of five or more days a week during the weeks of operation; or
(ii) a fee category that (A) meets the criteria in clause (3), item (iii), for a medium establishment, and (B) prepares and serves 500 or more meals per day.
(5) Other food and beverage service, including food carts, mobile food units, seasonal temporary food stands, and seasonal permanent food stands, $30 until June 30, 2001. Effective July 1, 2004, the annual fee shall be $40.
(6) Beer or wine table service, $30 until June 30, 2001. Effective July 1, 2004, the annual fee shall be $40. "Beer or wine table service" means a fee category where the only alcoholic beverage service is beer or wine, served to customers seated at tables.
(7) Alcoholic beverage service, other than beer or wine table service, $75 until June 30, 2001. Effective July 1, 2004, the annual fee shall be $105.
"Alcohol beverage service, other than beer or wine table service" means a fee category where alcoholic mixed drinks are served or where beer or wine are served from a bar.
(8) Until June 30, 2001, lodging per sleeping accommodation unit, $4, including hotels, motels, lodging establishments, and resorts, up to a maximum of $400. Effective July 1, 2004, lodging per sleeping accommodation unit, $6, including hotels, motels, lodging establishments, and resorts, up to a maximum of $600. "Lodging per sleeping accommodation unit" means a fee category including the number of guest rooms, cottages, or other rental units of a hotel, motel, lodging establishment, or resort; or the number of beds in a dormitory.
(9) First public swimming pool, $100 until June 30, 2001; each additional public swimming pool, $50 until June 30, 2001. Effective July 1, 2004, first public swimming pool, $140; each additional public swimming pool, $80. "Public swimming pool" means a fee category that has the meaning given in Minnesota Rules, part 4717.0250, subpart 8.
(10) First spa, $50 until June 30, 2001; each additional spa, $25 until June 30, 2001. Effective July 1, 2004, first spa, $80; each additional spa, $40. "Spa pool" means a fee category that has the meaning given in Minnesota Rules, part 4717.0250, subpart 9.
(11) Private sewer or water, $30 until June 30, 2001. Effective July 1, 2004, private sewer or water, $40. "Individual private water" means a fee category with a water supply other than a community public water supply as defined in Minnesota Rules, chapter 4720. "Individual private sewer" means a fee category with an individual sewage treatment system which uses subsurface treatment and disposal.
(e) A fee is not required for a food and beverage service establishment operated by a school as defined in
sections 120A.05, subdivisions 9, 11, 13, and 17 and 120A.22.
(f) A fee of $150 for review of the construction plans must accompany the initial license application for
food and beverage service establishments, hotels, motels, lodging establishments, or resorts.
(g) (f) When existing food and beverage service establishments, hotels, motels, lodging
establishments, or resorts are extensively remodeled, a fee of $150 must be submitted with the remodeling plans.
(h) (g) Seasonal temporary food stands and special event food stands are not required to submit
construction or remodeling plans for review.
Sec. 62. Minnesota Statutes 2000, section 157.22, is amended to read:
157.22 [EXEMPTIONS.]
This chapter shall not be construed to apply to:
(1) interstate carriers under the supervision of the United States Department of Health and Human Services;
(2) any building constructed and primarily used for religious worship;
(3) any building owned, operated, and used by a college or university in accordance with health regulations promulgated by the college or university under chapter 14;
(4) any person, firm, or corporation whose principal mode of business is licensed under sections 28A.04 and 28A.05, is exempt at that premises from licensure as a food or beverage establishment; provided that the holding of any license pursuant to sections 28A.04 and 28A.05 shall not exempt any person, firm, or corporation from the applicable provisions of this chapter or the rules of the state commissioner of health relating to food and beverage service establishments;
(5) family day care homes and group family day care homes governed by sections 245A.01 to 245A.16;
(6) nonprofit senior citizen centers for the sale of home-baked goods; and
(7) food not prepared at an establishment and brought in by individuals attending a potluck event for consumption at the potluck event. An organization sponsoring a potluck event under this clause may advertise the potluck event to the public through any means. Individuals who are not members of an organization sponsoring a potluck event under this clause may attend the potluck event and consume the food at the event. Licensed food establishments cannot be sponsors of potluck events. Potluck event food shall not be brought into a licensed food establishment kitchen; and
(8) a home school in which a child is provided instruction at home.
Sec. 63. [325F.691] [DISCLOSURE OF SPECIAL CARE STATUS REQUIRED.]
Subdivision 1. [PERSONS TO WHOM DISCLOSURE IS REQUIRED.] Housing with services establishments, as defined in sections 144D.01 to 144D.07, that secure, segregate, or provide a special program or special unit for residents with a diagnosis of probable Alzheimer's disease or a related disorder or that advertise, market, or otherwise promote the establishment as providing specialized care for Alzheimer's disease or a related disorder are considered a "special care unit." All special care units shall provide a written disclosure to the following:
(1) the commissioner of health, if requested;
(2) the office of ombudsman for older Minnesotans; and
(3) each person seeking placement within a residence, or the person's authorized representative, before an agreement to provide the care is entered into.
Subd. 2. [CONTENT.] Written disclosure shall include, but is not limited to, the following:
(1) a statement of the overall philosophy and how it reflects the special needs of residents with Alzheimer's disease or other dementias;
(2) the criteria for determining who may reside in the special care unit;
(3) the process used for assessment and establishment of the service plan or agreement, including how the plan is responsive to changes in the resident's condition;
(4) staffing credentials, job descriptions, and staff duties and availability, including any training specific to dementia;
(5) physical environment as well as design and security features that specifically address the needs of residents with Alzheimer's disease or other dementias;
(6) frequency and type of programs and activities for residents of the special care unit;
(7) involvement of families in resident care and availability of family support programs;
(8) fee schedules for additional services to the residents of the special care unit; and
(9) a statement that residents will be given a written notice 30 days prior to changes in the fee schedule.
Subd. 3. [DUTY TO UPDATE.] Substantial changes to disclosures must be reported to the parties listed in subdivision 1 at the time the change is made.
Subd. 4. [REMEDY.] The attorney general may seek the remedies set forth in section 8.31 for repeated and intentional violations of this section. However, no private right of action may be maintained as provided under section 8.31, subdivision 3a.
Sec. 64. [ESTABLISHMENT FEES DURING TRANSITION PERIOD.]
For fiscal years 2002, 2003, and 2004, the following fees shall apply to food and beverage service establishments, hotels, motels, lodging establishments, and resorts for which fees are established under Minnesota Statutes, section 157.16, subdivision 3, paragraphs (b), (c), and (d):
Fiscal Year Fiscal Year Fiscal Year
Fee Category 2002 2003 2004
Annual base fee, all $111.25 $122.50 $133.75
food and beverage
service establishments
except special event
food stands and all
hotels, motels, lodging
establishments, and
resorts
Special event food $31.25 $32.50 $33.75
stand
Establishment with $32.50 $35.00 $37.50
limited food menu
selection
Small establishment $60.00 $65.00 $70.00
Medium establishment $165.00 $180.00 $195.00
Large establishment $275.00 $300.00 $325.00
Other food and $32.50 $35.00 $37.50
beverage service
Beer or wine table $32.50 $35.00 $37.50
service
Alcoholic beverage $82.50 $90.00 $97.50
service other than
beer or wine table
service
Lodging per sleeping $4.50 per $5.00 per $5.50 per
accommodation unit, unit, $450 unit, $500 unit, $550
up to a specified maximum maximum maximum
maximum
First public $110.00 $120.00 $130.00
swimming pool
Each additional $57.50 $65.00 $72.50
public swimming pool
First spa $57.50 $65.00 $72.50
Each additional spa $28.75 $32.50 $36.25
Private sewer or $32.50 $35.00 $37.50
water
Sec. 65. [RECOMMENDATIONS; INCENTIVES FOR MAGNET HOSPITALS.]
The commissioner of health shall develop recommendations for incentives that may be implemented to increase the number of magnet hospitals in Minnesota. These recommendations must be reported by December 1, 2001 to the chairs of the house and senate committees with jurisdiction over health and human services policy and finance issues.
Sec. 66. [STUDY; REIMBURSEMENT FOR CERTAIN ANTI-TOBACCO USE EDUCATION ACTIVITIES.]
The commissioner of health, in consultation with persons who have had laryngectomies to treat larynx cancer, who use artificial larynxes for communication, and who engage in anti-tobacco use education activities, shall study and develop recommendations establishing a program to reimburse these persons for mileage and other costs associated with traveling to schools in the state to educate students about the health risks of tobacco use. The recommendations must include proposals for reimbursement levels, a funding source, expenses for which persons may be reimbursed, and persons eligible for reimbursement. The recommendations must be reported to the chairs of the policy and finance committees in the House and Senate with jurisdiction over health and human services issues by January 15, 2002.
Sec. 67. [STUDY; EFFECTS OF NURSE STAFFING SHORTAGES.]
The commissioner of health, in consultation with consumers, representatives of the Minnesota nurses association, and representatives of the Minnesota hospital and healthcare partnership, shall study and identify the effects of nurse staffing shortages in health care facilities on patient care and patient safety. The results of this study shall be reported by December 1, 2001 to the chairs of the house and senate committees with jurisdiction over health and human services policy issues.
Sec. 68. [REPEALER.]
(a) Minnesota Statutes 2000, sections 145.882, subdivisions 3 and 4; and 145.927, are repealed.
(b) Minnesota Statutes 2000, section 144.148, subdivision 8, is repealed.
[EFFECTIVE DATE.] Paragraph (b) of this section is effective the day following final enactment.
ARTICLE 3
HEALTH CARE
Section 1. Minnesota Statutes 2000, 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:
(1) 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:
(a) require county agency participation in training and technical assistance programs to promote compliance with statutes, rules, federal laws, regulations, and policies governing human services;
(b) 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;
(c) develop a quality control program or other monitoring program to review county performance and accuracy of benefit determinations;
(d) 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;
(e) 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;
(f) make contracts with and grants to public and private agencies and organizations, both profit and nonprofit, and individuals, using appropriated funds; and
(g) 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.
(2) 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.
(3) Administer and supervise all child welfare activities; promote the enforcement of laws protecting handicapped, 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.
(4) Administer and supervise all noninstitutional service to handicapped persons, including those who are visually impaired, hearing impaired, or physically impaired or otherwise handicapped. 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.
(5) 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.
(6) 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.
(7) Establish and maintain any administrative units reasonably necessary for the performance of administrative functions common to all divisions of the department.
(8) 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 mentally retarded. For children under the guardianship of the commissioner whose interests would be best served by adoptive placement, the commissioner may contract with a licensed child-placing 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 programs, unless the replacement is agreed to by the county board and the appropriate exclusive bargaining representative 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.
(9) Act as coordinating referral and informational center on requests for service for newly arrived immigrants coming to Minnesota.
(10) 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.
(11) 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.
(12) 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:
(a) 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.
(b) A comprehensive plan, including estimated project costs, shall be approved by the legislative advisory commission and filed with the commissioner of administration.
(13) 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.
(14) 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:
(a) 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.
(b) Notwithstanding the provisions of paragraph (a), 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 paragraph (a), 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 paragraph (a).
(15) 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.
(16) 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.
(17) Have the authority to establish and enforce the following county reporting requirements:
(a) 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.
(b) 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.
(c) If the required reports are not received by the deadlines established in clause (b), 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.
(d) 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.
(e) 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.
(f) The commissioner may not delay payments, withhold funds, or require repayment under paragraph (c) or (e) 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 paragraph (c) or (e), the county board may appeal the action according to sections 14.57 to 14.69.
(g) Counties subject to withholding of funds under paragraph (c) or forfeiture or repayment of funds under paragraph (e) shall not reduce or withhold benefits or services to clients to cover costs incurred due to actions taken by the commissioner under paragraph (c) or (e).
(18) 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.
(19) 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.
(20) 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.
(21) 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 basic rebate as defined for purposes of the federal rebate program in United States Code, title 42, section 1396r-8(c)(1). This basic rebate shall be applied to single-source
and multiple-source drugs. 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.
(22) 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.
(22) (23) 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.
(23) (24) 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.
(24) (25) Incorporate cost reimbursement claims from First Call Minnesota into the federal cost
reimbursement claiming processes of the department according to federal law, rule, and regulations. Any
reimbursement received is appropriated to the commissioner and shall be disbursed to First Call Minnesota according
to normal department payment schedules.
(25) (26) 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.
Sec. 2. Minnesota Statutes 2000, section 256.955, subdivision 2b, is amended to read:
Subd. 2b. [ELIGIBILITY.] Effective July 1, 2002, an individual satisfying the following requirements and the requirements described in subdivision 2, paragraph (d), is eligible for the prescription drug program:
(1) is under 65 years of age; and
(2) is eligible as a qualified Medicare beneficiary according to section 256B.057, subdivision 3 or 3a, or is eligible under section 256B.057, subdivision 3 or 3a, and is also eligible for medical assistance or general assistance medical care with a spenddown as defined in section 256B.056, subdivision 5.
Sec. 3. [256.956] [PURCHASING ALLIANCE STOP-LOSS FUND.]
Subdivision 1. [DEFINITIONS.] For purposes of this section, the following definitions apply:
(a) "Commissioner" means the commissioner of human services.
(b) "Health plan" means a policy, contract, or certificate issued by a health plan company to a qualifying purchasing alliance. Any health plan issued to the members of a qualifying purchasing alliance must meet the requirements of chapter 62L.
(c) "Health plan company" means:
(1) a health carrier as defined under section 62A.011, subdivision 2;
(2) a community integrated service network operating under chapter 62N; or
(3) an accountable provider network operating under chapter 62T.
(d) "Qualifying employer" means an employer who:
(1) is a member of a qualifying purchasing alliance;
(2) has at least one employee but no more than ten employees or is a sole proprietor or farmer;
(3) did not offer employer-subsidized health care coverage to its employees for at least 12 months prior to joining the purchasing alliance; and
(4) is offering health coverage through the purchasing alliance to all employees who work at least 20 hours per week unless the employee is eligible for Medicare.
For purposes of this subdivision, "employer-subsidized health coverage" means health coverage for which the employer pays at least 50 percent of the cost of coverage for the employee.
(e) "Qualifying enrollee" means an employee of a qualifying employer or the employee's dependent covered by a health plan.
(f) "Qualifying purchasing alliance" means a purchasing alliance as defined in section 62T.01, subdivision 2, that:
(1) meets the requirements of chapter 62T;
(2) services a geographic area located in outstate Minnesota, excluding the city of Duluth; and
(3) is organized and operating before May 1, 2001.
The criteria used by the qualifying purchasing alliance for membership must be approved by the commissioner of health. A qualifying purchasing alliance may begin enrolling qualifying employers after July 1, 2001, with enrollment ending by December 31, 2003.
Subd. 2. [CREATION OF ACCOUNT.] A purchasing alliance stop-loss fund account is established in the general fund. The commissioner shall use the money to establish a stop-loss fund from which a health plan company may receive reimbursement for claims paid for qualifying enrollees. The account consists of money appropriated by the legislature. Money from the account must be used for the stop-loss fund.
Subd. 3. [REIMBURSEMENT.] (a) A health plan company may receive reimbursement from the fund for 90 percent of the portion of the claim that exceeds $30,000 but not of the portion that exceeds $100,000 in a calendar year for a qualifying enrollee.
(b) Claims shall be reported and funds shall be distributed on a calendar-year basis. Claims shall be eligible for reimbursement only for the calendar year in which the claims were paid.
(c) Once claims paid on behalf of a qualifying enrollee reach $100,000 in a given calendar year, no further claims may be submitted for reimbursement on behalf of that enrollee in that calendar year.
Subd. 4. [REQUEST PROCESS.] (a) Each health plan company must submit a request for reimbursement from the fund on a form prescribed by the commissioner. Requests for payment must be submitted no later than April 1 following the end of the calendar year for which the reimbursement request is being made, beginning April 1, 2002.
(b) The commissioner may require a health plan company to submit claims data as needed in connection with the reimbursement request.
Subd. 5. [DISTRIBUTION.] (a) The commissioner shall calculate the total claims reimbursement amount for all qualifying health plan companies for the calendar year for which claims are being reported and shall distribute the stop-loss funds on an annual basis.
(b) In the event that the total amount requested for reimbursement by the health plan companies for a calendar year exceeds the funds available for distribution for claims paid by all health plan companies during the same calendar year, the commissioner shall provide for the pro rata distribution of the available funds. Each health plan company shall be eligible to receive only a proportionate amount of the available funds as the health plan company's total eligible claims paid compares to the total eligible claims paid by all health plan companies.
(c) In the event that funds available for distribution for claims paid by all health plan companies during a calendar year exceed the total amount requested for reimbursement by all health plan companies during the same calendar year, any excess funds shall be reallocated for distribution in the next calendar year.
Subd. 6. [DATA.] Upon the request of the commissioner, each health plan company shall furnish such data as the commissioner deems necessary to administer the fund. The commissioner may require that such data be submitted on a per enrollee, aggregate, or categorical basis. Any data submitted under this section shall be classified as private data or nonpublic data as defined in section 13.02.
Subd. 7. [DELEGATION.] The commissioner may delegate any or all of the commissioner's administrative duties to another state agency or to a private contractor.
Subd. 8. [REPORT.] The commissioner of commerce, in consultation with the office of rural health and the qualifying purchasing alliances, shall evaluate the extent to which the purchasing alliance stop-loss fund increases the availability of employer-subsidized health care coverage for residents residing in the geographic areas served by the qualifying purchasing alliances. A preliminary report must be submitted to the legislature by February 15, 2003, and a final report must be submitted by February 15, 2004.
Subd. 9. [SUNSET.] This section shall expire January 1, 2005.
Sec. 4. [256.958] [RETIRED DENTIST PROGRAM.]
Subdivision 1. [PROGRAM.] The commissioner of human services shall establish a program to reimburse a retired dentist for the dentist's license fee and for the cost of malpractice insurance in exchange for the dentist providing 100 hours of dental services on a volunteer basis within a 12-month period at a community dental clinic or a dental training clinic located at a Minnesota state college or university.
Subd. 2. [DOCUMENTATION.] Upon completion of the required hours, the retired dentist shall submit to the commissioner the following:
(1) documentation of service provided;
(2) the cost of malpractice insurance for the 12-month period; and
(3) the cost of the license.
Subd. 3. [REIMBURSEMENT.] Upon receipt of the information described in subdivision 2, the commissioner shall provide reimbursement to the retired dentist for the cost of malpractice insurance for the previous 12-month period and the cost of the license.
Sec. 5. Minnesota Statutes 2000, section 256.9657, subdivision 2, is amended to read:
Subd. 2. [HOSPITAL SURCHARGE.] (a) Effective October 1, 1992, each Minnesota hospital except facilities of the federal Indian Health Service and regional treatment centers shall pay to the medical assistance account a surcharge equal to 1.4 percent of net patient revenues excluding net Medicare revenues reported by that provider to the health care cost information system according to the schedule in subdivision 4.
(b) Effective July 1, 1994, the surcharge under paragraph (a) is increased to 1.56 percent.
(c) Notwithstanding the Medicare cost finding and allowable cost principles, the hospital surcharge is not an allowable cost for purposes of rate setting under sections 256.9685 to 256.9695.
Sec. 6. Minnesota Statutes 2000, section 256.969, subdivision 2b, is amended to read:
Subd. 2b. [OPERATING PAYMENT RATES.] In determining operating payment rates for admissions occurring on or after the rate year beginning January 1, 1991, and every two years after, or more frequently as determined by the commissioner, the commissioner shall obtain operating data from an updated base year and, within the limits of available appropriations, establish operating payment rates per admission for each hospital based on the cost-finding methods and allowable costs of the Medicare program in effect during the base year. Rates under the general assistance medical care, medical assistance, and MinnesotaCare programs shall not be rebased to more current data on January 1, 1997. The base year operating payment rate per admission is standardized by the case mix index and adjusted by the hospital cost index, relative values, and disproportionate population adjustment. The cost and charge data used to establish operating rates shall only reflect inpatient services covered by medical assistance and shall not include property cost information and costs recognized in outlier payments.
Sec. 7. Minnesota Statutes 2000, section 256.969, is amended by adding a subdivision to read:
Subd. 26. [GREATER MINNESOTA PAYMENT ADJUSTMENT AFTER JUNE 30, 2001.] (a) For admissions occurring after June 30, 2001, the commissioner shall pay all medical assistance inpatient fee-for-service admissions for the diagnosis-related groups specified in paragraph (b) at hospitals located outside of the seven-county metropolitan area at the higher of:
(1) the hospital's current payment rate for the diagnostic category to which the diagnosis-related group belongs, exclusive of disproportionate population adjustments received under subdivision 9 and hospital payment adjustments received under subdivision 23; or
(2) the rate in clause (1) plus a proportion of the difference between the current average payment rate for that diagnostic category for hospitals located within the seven-county metropolitan area, exclusive of disproportionate population adjustments received under subdivision 9 and hospital payment adjustments received under subdivision 23, and the current rate in clause (1). This proportion shall be 12.5 percent for the fiscal year beginning July 1, 2001, and shall increase by 12.5 percentage points for each of the next seven fiscal years, such that the proportion is 100 percent for the fiscal year beginning July 1, 2008.
(b) The reimbursement increases provided in paragraph (a) apply to the following diagnosis-related groups as they fall within the diagnostic categories:
(1) 370 C-section with complicating diagnosis;
(2) 371 C-section without complicating diagnosis;
(3) 372 vaginal delivery with complicating diagnosis;
(4) 373 vaginal delivery without complicating diagnosis;
(5) 386 extreme immaturity, weight greater than 1,500 grams;
(6) 388 full-term neonates with other problems;
(7) 390 prematurity without major problems;
(8) 391 normal newborn case;
(9) 385 neonate, died or transferred to another health care facility;
(10) 425 acute adjustment reaction and psychosocial dysfunctioning;
(11) 430 psychosis;
(12) 431 childhood mental disorders; and
(13) 164-167 appendectomy.
Sec. 8. Minnesota Statutes 2000, section 256B.04, is amended by adding a subdivision to read:
Subd. 1b. [CONTRACT FOR SERVICES FOR AMERICAN INDIAN CHILDREN.] Notwithstanding subdivision 1, the commissioner may contract with federally recognized Indian tribes with a reservation in Minnesota for the provision of early and periodic screening, diagnosis, and treatment administrative services for American Indian children, according to Code of Federal Regulations, title 42, section 441, subpart B, and Minnesota Rules, part 9505.1693 et seq., when the tribe chooses to provide such services. For purposes of this subdivision, "American Indian" has the meaning given to persons to whom services will be provided for in Code of Federal Regulations, title 42, section 36.12. Notwithstanding Minnesota Rules, part 9505.1748, subpart 1, the commissioner, the local agency, and the tribe may contract with any entity for the provision of early and periodic screening, diagnosis, and treatment administrative services.
[EFFECTIVE DATE.] This section is effective the day following final enactment.
Sec. 9. Minnesota Statutes 2000, section 256B.055, subdivision 3a, is amended to read:
Subd. 3a. [MFIP-S FAMILIES; FAMILIES ELIGIBLE UNDER PRIOR AFDC RULES.] (a)
Beginning January 1, 1998, or on the date that MFIP-S is implemented in counties, medical assistance may be
paid for a person receiving public assistance under the MFIP-S program. Beginning July 1, 2002, medical
assistance may be paid for a person who would have been eligible, but for excess income or assets, under the state's
AFDC plan in effect as of July 16, 1996, with the base AFDC standard increased by three percent effective July 1,
2000.
(b) Beginning January 1, 1998, July 1, 2002, medical assistance may be paid for a person who
would have been eligible for public assistance under the income and resource assets standards,
or who would have been eligible but for excess income or assets, under the state's AFDC plan in effect as of July
16, 1996, as required by the Personal Responsibility and Work Opportunity Reconciliation Act of 1996
(PRWORA), Public Law Number 104-193 with the base AFDC rate increased by three percent effective July
1, 2000.
[EFFECTIVE DATE.] This section is effective July 1, 2002.
Sec. 10. Minnesota Statutes 2000, section 256B.056, subdivision 1a, is amended to read:
Subd. 1a. [INCOME AND ASSETS GENERALLY.] Unless specifically required by state law or rule or federal law or regulation, the methodologies used in counting income and assets to determine eligibility for medical assistance for persons whose eligibility category is based on blindness, disability, or age of 65 or more years, the methodologies for the supplemental security income program shall be used. Effective upon federal approval, for children eligible under section 256B.055, subdivision 12, or for home and community-based waiver services whose eligibility for medical assistance is determined without regard to parental income, child support payments, including any payments made by an obligor in satisfaction of or in addition to a temporary or permanent order for child support, social security payments, and other benefits for basic needs are not counted as income. For families and children, which includes all other eligibility categories, the methodologies under the state's AFDC plan in effect as of July 16, 1996, as required by the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), Public Law Number 104-193, shall be used. Effective upon federal approval, in-kind contributions to, and payments made on behalf of, a recipient, by an obligor, in satisfaction of or in addition to a temporary or permanent order for child support or maintenance, shall be considered income to the recipient. For these purposes, a "methodology" does not include an asset or income standard, or accounting method, or method of determining effective dates.
Sec. 11. Minnesota Statutes 2000, section 256B.056, subdivision 3, is amended to read:
Subd. 3. [ASSET LIMITATIONS.] To be eligible for medical assistance, a person must not individually own more than $3,000 in assets, or if a member of a household with two family members, husband and wife, or parent and child, the household must not own more than $6,000 in assets, plus $200 for each additional legal dependent. In addition to these maximum amounts, an eligible individual or family may accrue interest on these amounts, but they must be reduced to the maximum at the time of an eligibility redetermination. The accumulation of the clothing and personal needs allowance according to section 256B.35 must also be reduced to the maximum at the time of the eligibility redetermination. The value of assets that are not considered in determining eligibility for medical assistance is the value of those assets excluded under the AFDC state plan as of July 16, 1996, as required by the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), Public Law Number 104-193, for families and children, and the supplemental security income program for aged, blind, and disabled persons, with the following exceptions:
(a) Household goods and personal effects are not considered.
(b) Capital and operating assets of a trade or business that the local agency determines are necessary to the person's ability to earn an income are not considered.
(c) Motor vehicles are excluded to the same extent excluded by the supplemental security income program.
(d) Assets designated as burial expenses are excluded to the same extent excluded by the supplemental security income program.
(e) Effective upon federal approval, for a person who no longer qualifies as an employed person with a disability due to loss of earnings, assets allowed while eligible for medical assistance under section 256B.057, subdivision 9, are not considered for 12 months, beginning with the first month of ineligibility as an employed person with a disability, to the extent that the person's total assets remain within the allowed limits of section 256B.057, subdivision 9, paragraph (b).
Sec. 12. Minnesota Statutes 2000, section 256B.056, subdivision 4, is amended to read:
Subd. 4. [INCOME.] (a) To be eligible for medical assistance, a person eligible under section 256B.055,
subdivision subdivisions 7, 7a, and 12, not receiving supplemental security income
program payments, and may have income up to the following specified percentages of the federal poverty
guidelines for the family size effective on April 1 of each year:
(1) 80 percent, effective July 1, 2002;
(2) 90 percent, effective July 1, 2003;
(3) 100 percent, effective July 1, 2004.
Increases in benefits under title II of the Social Security Act shall not be counted as income for purposes of this subdivision until the first day of the second full month following publication of the change in the federal poverty guidelines.
(b) To be eligible for medical assistance, families and children may have an income up to 133-1/3 percent of the AFDC income standard in effect under the July 16, 1996, AFDC state plan. Effective July 1, 2000, the base AFDC standard in effect on July 16, 1996, shall be increased by three percent. Effective January 1, 2000, and each successive January, recipients of supplemental security income may have an income up to the supplemental security income standard in effect on that date.
(c) Effective July 1, 2002, to be eligible for medical assistance, families and children may have an income up to 100 percent of the federal poverty guidelines for the family size effective on April 1 of each year.
(d) In computing income to determine eligibility of persons under paragraphs (a) to (c) who are not residents of long-term care facilities, the commissioner shall disregard increases in income as required by Public Law Numbers 94-566, section 503; 99-272; and 99-509. Veterans aid and attendance benefits and Veterans Administration unusual medical expense payments are considered income to the recipient.
Sec. 13. Minnesota Statutes 2000, section 256B.056, subdivision 5, is amended to read:
Subd. 5. [EXCESS INCOME.] A person who has excess income is eligible for medical assistance if the person has expenses for medical care that are more than the amount of the person's excess income, computed by deducting incurred medical expenses from the excess income to reduce the excess to the income standard specified in subdivision 4, except that if federal authorization to use the standard in subdivision 4 is not obtained, the medically needy standard for purposes of a spenddown shall be 133 and 1/3 percent of the AFDC income standard in effect under the July 16, 1996, AFDC state plan, increased by three percent. The person shall elect to have the medical expenses deducted at the beginning of a one-month budget period or at the beginning of a six-month budget period. The commissioner shall allow persons eligible for assistance on a one-month spenddown basis under this subdivision to elect to pay the monthly spenddown amount in advance of the month of eligibility to the state agency in order to maintain eligibility on a continuous basis. If the recipient does not pay the spenddown amount on or before the 20th of the month, the recipient is ineligible for this option for the following month. The local agency shall code the Medicaid Management Information System (MMIS) to indicate that the recipient has elected this option. The state agency shall convey recipient eligibility information relative to the collection of the spenddown to providers through the Electronic Verification System (EVS). A recipient electing advance payment must pay the state agency the monthly spenddown amount on or before the 20th of the month in order to be eligible for this option in the following month.
Sec. 14. Minnesota Statutes 2000, section 256B.057, subdivision 9, is amended to read:
Subd. 9. [EMPLOYED PERSONS WITH DISABILITIES.] (a) Medical assistance may be paid for a person who is employed and who:
(1) meets the definition of disabled under the supplemental security income program;
(2) is at least 16 but less than 65 years of age;
(3) meets the asset limits in paragraph (b); and
(4) pays a premium, if required, under paragraph (c).
Any spousal income or assets shall be disregarded for purposes of eligibility and premium determinations.
(b) For purposes of determining eligibility under this subdivision, a person's assets must not exceed $20,000, excluding:
(1) all assets excluded under section 256B.056;
(2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans, Keogh plans, and pension plans; and
(3) medical expense accounts set up through the person's employer.
(c) A person whose earned and unearned income is equal to or greater than 200 100
percent of federal poverty guidelines for the applicable family size must pay a premium to be eligible for medical
assistance under this subdivision. The premium shall be equal to ten percent of based on
the person's gross earned and unearned income above 200 percent of federal poverty guidelines for
and the applicable family size up to the cost of coverage, using a sliding fee scale established
by the commissioner which begins at one percent of income at 100 percent of the federal poverty guidelines and
gradually increases to 7.5 percent of income for those with incomes at or above 300 percent of the federal poverty
guidelines.
(d) A person's eligibility and premium shall be determined by the local county agency. Premiums must be paid to the commissioner. All premiums are dedicated to the commissioner.
(e) Any required premium shall be determined at application and redetermined annually at recertification or when a change in income or family size occurs.
(f) Premium payment is due upon notification from the commissioner of the premium amount required. Premiums may be paid in installments at the discretion of the commissioner.
(g) Nonpayment of the premium shall result in denial or termination of medical assistance unless the person demonstrates good cause for nonpayment. Good cause exists if the requirements specified in Minnesota Rules, part 9506.0040, subpart 7, items B to D, are met. Nonpayment shall include payment with a returned, refused, or dishonored instrument. The commissioner may require a guaranteed form of payment as the only means to replace a returned, refused, or dishonored instrument.
[EFFECTIVE DATE.] This section is effective September 1, 2001.
Sec. 15. Minnesota Statutes 2000, section 256B.057, is amended by adding a subdivision to read:
Subd. 10. [CERTAIN PERSONS NEEDING TREATMENT FOR BREAST OR CERVICAL CANCER.] (a) Medical assistance may be paid for a person who:
(1) has been screened for breast or cervical cancer by the Minnesota breast and cervical cancer control program, and program funds have been used to pay for the person's screening;
(2) according to the person's treating health professional, needs treatment, including diagnostic services necessary to determine the extent and proper course of treatment, for breast or cervical cancer, including precancerous conditions and early stage cancer;
(3) meets the income eligibility guidelines for the Minnesota breast and cervical cancer control program;
(4) is under age 65;
(5) is not otherwise eligible for medical assistance under United States Code, title 42, section 1396(a)(10)(A)(i); and
(6) is not otherwise covered under creditable coverage, as defined under United States Code, title 42, section 300gg(c).
(b) Medical assistance provided for an eligible person under this subdivision shall be limited to services provided during the period that the person receives treatment for breast or cervical cancer.
(c) A person meeting the criteria in paragraph (a) is eligible for medical assistance without meeting the eligibility criteria relating to income and assets in section 256B.056, subdivisions 1a to 5b.
Sec. 16. Minnesota Statutes 2000, section 256B.0625, subdivision 3b, is amended to read:
Subd. 3b. [TELEMEDICINE CONSULTATIONS.] (a) Medical assistance covers telemedicine
consultations. Telemedicine consultations must be made via two-way, interactive video or store-and-forward
technology. Store-and-forward technology includes telemedicine consultations that do not occur in real time via
synchronous transmissions, and that do not require a face-to-face encounter with the patient for all or any part of
any such telemedicine consultation. The patient record must include a written opinion from the consulting physician
providing the telemedicine consultation. A communication between two physicians that consists solely of a
telephone conversation is not a telemedicine consultation. Coverage is limited to three telemedicine consultations
per recipient per calendar week. Telemedicine consultations shall be paid at the full allowable rate.
(b) This subdivision expires July 1, 2001.
Sec. 17. Minnesota Statutes 2000, section 256B.0625, is amended by adding a subdivision to read:
Subd. 5a. [INTENSIVE EARLY INTERVENTION BEHAVIOR THERAPY SERVICES FOR CHILDREN WITH AUTISM SPECTRUM DISORDERS.] (a) [COVERAGE.] Medical assistance covers home-based intensive early intervention behavior therapy for children with autism spectrum disorders. Children with autism spectrum disorder, and their custodial parents or foster parents, may access other covered services to treat autism spectrum disorder, and are not required to receive intensive early intervention behavior therapy services under this subdivision. Intensive early intervention behavior therapy does not include coverage for services to treat developmental disorders of language, early onset psychosis, Rett's disorder, selective mutism, social anxiety disorder, stereotypic movement disorder, dementia, obsessive compulsive disorder, schizoid personality disorder, avoidant personality disorder, or reactive attachment disorder. If a child with autism spectrum disorder is diagnosed to have one or more of these conditions, intensive early intervention behavior therapy includes coverage only for services necessary to treat the autism spectrum disorder.
(b) [PURPOSE OF INTENSIVE EARLY INTERVENTION BEHAVIOR THERAPY SERVICES (IEIBTS).] The purpose of IEIBTS is to improve the child's behavioral functioning, to prevent development of challenging behaviors, to eliminate autistic behaviors, to reduce the risk of out-of-home placement, and to establish independent typical functioning in language and social behavior. The procedures used to accomplish these goals are based upon research in applied behavior analysis.
(c) [ELIGIBLE CHILDREN.] A child is eligible to initiate IEIBTS if, the child meets the additional eligibility criteria in paragraph (d) and in a diagnostic assessment by a mental health professional who is not under the employ of the service provider, the child:
(1) is found to have an autism spectrum disorder;
(2) has a current IQ of either untestable, or at least 30;
(3) if nonverbal, initiated behavior therapy by 42 months of age;
(4) if verbal, initiated behavior therapy by 48 months of age; or
(5) if having an IQ of at least 50, initiated behavior therapy by 84 months of age.
To continue in IEIBTS, at least one of the child's custodial parents or foster parents must participate in an average of at least five hours of documented behavior therapy per week for six months, and consistently implement behavior therapy recommendations 24 hours a day. To continue after six-month individualized treatment plan (ITP) reviews, the child must show documented progress toward mastery of six-month benchmark behavior objectives. The maximum number of months during which services may be billed is 54. If significant progress towards treatment goals has not been achieved after 24 months of treatment, treatment must be discontinued.
(d) [ADDITIONAL ELIGIBILITY CRITERIA.] A child is eligible to initiate IEIBTS if:
(1) in medical and diagnostic assessments by medical and mental health professionals, it is determined that the child does not have severe or profound mental retardation;
(2) an accurate assessment of the child's hearing has been performed, including audiometry if the brain stem auditory evokes response;
(3) a blood lead test has been performed prior to initiation of treatment; and
(4) an EEG or neurologic evaluation is done, prior to initiation of treatment, if the child has a history of staring spells or developmental regression.
(e) [COVERED SERVICES.] The focus of IEIBTS must be to treat the principal diagnostic features of the autism spectrum disorder. All IEIBTS must be delivered by a team of practitioners under the consistent supervision of a single clinical supervisor. A mental health professional must develop the ITP for IEIBTS. The ITP must include six-month benchmark behavior objectives. All behavior therapy must be based upon research in applied behavior analysis, with an emphasis upon positive reinforcement of carefully task-analyzed skills for optimum rates of progress. All behavior therapy must be consistently applied and generalized throughout the 24-hour day and seven-day week by all of the child's regular care providers. When placing the child in school activities, a majority of the peers must have no mental health diagnosis, and the child must have sufficient social skills to succeed with 80 percent of the school activities. Reactive consequences, such as redirection, correction, positive practice, or time-out, must be used only when necessary to improve the child's success when proactive procedures alone have not been effective. IEIBTS must be delivered by a team of behavior therapy practitioners who are employed under the direction of the same agency. The team may deliver up to 200 billable hours per year of direct clinical supervisor services, up to 750 billable hours per year of senior behavior therapist services, and up to 1,800 billable hours per year of direct behavior therapist services. A one-hour clinical review meeting for the child, parents, and staff must be scheduled 50 weeks a year, at which behavior therapy is reviewed and planned. At least one-quarter of the annual clinical supervisor billable hours shall consist of on-site clinical meeting time. At least one-half of the annual senior behavior therapist billable hours shall consist of direct services to the child or parents. All of the behavioral therapist billable hours shall consist of direct on-site services to the child or parents. None of the senior behavior therapist billable hours or behavior therapist billable hours shall consist of clinical meeting time. If there is any regression of the autistic spectrum disorder after 12 months of therapy, a neurologic consultation must be performed.
(f) [PROVIDER QUALIFICATIONS.] The provider agency must be capable of delivering consistent applied behavior analysis (ABA)-based behavior therapy in the home. The site director of the agency must be a mental health professional certified as a behavior analyst by the Association for Behavior Analysis. Each clinical supervisor must be certified as a behavior analyst by the Association for Behavior Analysis.
(g) [SUPERVISION REQUIREMENTS.] (1) Each behavior therapist practitioner must be continuously supervised while in the home until the practitioner has mastered competencies for independent practice. Each behavior therapist must have mastered three credits of academic content and practice in an ABA sequence at an accredited university. A college degree or minimum hours of experience are not required. Each behavior therapist must continue training through weekly direct observation by the senior behavior therapist, through demonstrated performance in clinical meetings with the clinical supervisor, and annual training in ABA.
(2) Each senior behavior therapist practitioner must have mastered the senior behavior therapy competencies, completed one year of practice as a behavior therapist, and six months of co-therapy training with another senior behavior therapist or have an equivalent amount of experience in ABA. Each senior behavior therapist must have mastered 12 credits of academic content and practice in an ABA sequence at an accredited university. Each senior behavior therapist must continue training through demonstrated performance in clinical meetings with the clinical supervisor, and annual training in ABA.
(3) Each clinical supervisor practitioner must have mastered the clinical supervisor and family consultation competencies, completed two years of practice as a senior behavior therapist and one year of co-therapy training with another clinical supervisor, or equivalent experience in ABA. Each clinical supervisor must continue training through annual training in ABA.
(h) [PLACE OF SERVICE.] IEIBTS are provided primarily in the child's home and community. Services may be provided in the child's natural school or preschool classroom, home of a relative, natural recreational setting, or day care.
(i) [PRIOR AUTHORIZATION REQUIREMENTS.] Prior authorization shall be required for services provided after 200 hours of clinical supervisor, 750 hours of senior behavior therapist, or 1,800 hours of behavior therapist services per year.
(j) [PAYMENT RATES.] The following payment rates apply:
(1) for an IEIBTS clinical supervisor practitioner under supervision of a mental health professional, the lower of the submitted charge or $137 per hour unit;
(2) for an IEIBTS senior behavior therapist practitioner under supervision of a mental health professional, the lower of the submitted charge or $56 per hour unit; or
(3) for an IEIBTS behavior therapist practitioner under supervision of a mental health professional, the lower of the submitted charge or $19 per hour unit.
An IEIBTS practitioner may receive payment for travel time which exceeds 50 minutes one-way. The maximum payment allowed will be $0.51 per minute for up to a maximum of 300 hours per year.
For any week during which the above charges are made to medical assistance, payments for the following services are excluded: supervising mental health professional hours and personal care attendant, home-based mental health, family-community support, or mental health behavioral aide hours.
(k) [REPORT.] The commissioner shall collect evidence of the effectiveness of intensive early intervention behavior therapy services and present a report to the legislature by July 1, 2006.
[EFFECTIVE DATE.] This section is effective January 1, 2002.
Sec. 18. Minnesota Statutes 2000, section 256B.0625, subdivision 13, is amended to read:
Subd. 13. [DRUGS.] (a) Medical assistance covers drugs, except for fertility drugs when specifically used to enhance fertility, if prescribed by a licensed practitioner and dispensed by a licensed pharmacist, by a physician enrolled in the medical assistance program as a dispensing physician, or by a physician or a nurse practitioner
employed by or under contract with a community health board as defined in section 145A.02, subdivision 5, for the purposes of communicable disease control. The commissioner, after receiving recommendations from professional medical associations and professional pharmacist associations, shall designate a formulary committee to advise the commissioner on the names of drugs for which payment is made, recommend a system for reimbursing providers on a set fee or charge basis rather than the present system, and develop methods encouraging use of generic drugs when they are less expensive and equally effective as trademark drugs. The formulary committee shall consist of nine members, four of whom shall be physicians who are not employed by the department of human services, and a majority of whose practice is for persons paying privately or through health insurance, three of whom shall be pharmacists who are not employed by the department of human services, and a majority of whose practice is for persons paying privately or through health insurance, a consumer representative, and a nursing home representative. Committee members shall serve three-year terms and shall serve without compensation. Members may be reappointed once.
(b) 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. The formulary committee shall review and recommend drugs which require prior authorization. The formulary committee may recommend drugs for prior authorization directly to the commissioner, as long as opportunity for public input is provided. Prior authorization may be requested by the commissioner based on medical and clinical criteria before certain drugs are eligible for payment. Before a drug may be considered for prior authorization at the request of the commissioner:
(1) the drug formulary committee must develop criteria to be used for identifying drugs; the development of these criteria is not subject to the requirements of chapter 14, but the formulary committee shall provide opportunity for public input in developing criteria;
(2) the drug formulary committee must hold a public forum and receive public comment for an additional 15 days; and
(3) the commissioner must provide information to the formulary committee on the impact that placing the drug on prior authorization will have on the quality of patient care and information regarding whether the drug is subject to clinical abuse or misuse. Prior authorization may be required by the commissioner before certain formulary drugs are eligible for payment. The formulary shall not include:
(i) drugs or products for which there is no federal funding;
(ii) over-the-counter drugs, except for antacids, acetaminophen, family planning products, aspirin, insulin, products for the treatment of lice, vitamins for adults with documented vitamin deficiencies, vitamins for children under the age of seven and pregnant or nursing women, and any other over-the-counter drug identified by the commissioner, in consultation with the drug formulary committee, as necessary, appropriate, and cost-effective for the treatment of certain specified chronic diseases, conditions or disorders, and this determination shall not be subject to the requirements of chapter 14;
(iii) anorectics, except that medically necessary anorectics shall be covered for a recipient previously diagnosed as having pickwickian syndrome and currently diagnosed as having diabetes and being morbidly obese;
(iv) drugs for which medical value has not been established; and
(v) 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.
The commissioner shall publish conditions for prohibiting payment for specific drugs after considering the formulary committee's recommendations. An honorarium of $100 per meeting and reimbursement for mileage shall be paid to each committee member in attendance.
(c) The basis for determining the amount of payment shall be the lower of the actual acquisition costs of the drugs plus a fixed dispensing fee; the maximum allowable cost set by the federal government or by the commissioner plus the fixed dispensing fee; or the usual and customary price charged to the public. The pharmacy dispensing fee shall be $3.65, except that the dispensing fee for intravenous solutions which must be compounded by the pharmacist shall be $8 per bag, $14 per bag for cancer chemotherapy products, and $30 per bag for total parenteral nutritional products dispensed in one liter quantities, or $44 per bag for total parenteral nutritional products dispensed in quantities greater than one liter. Actual acquisition cost includes quantity and other special discounts except time and cash discounts. The actual acquisition cost of a drug shall be estimated by the commissioner, at average wholesale price minus nine percent, except that where a drug has had its wholesale price reduced as a result of the actions of the National Association of Medicaid Fraud Control Units, the estimated actual acquisition cost shall be the reduced average wholesale price, without the nine percent deduction. The maximum allowable cost of a multisource drug may be set by the commissioner and it shall be comparable to, but no higher than, the maximum amount paid by other third-party payors in this state who have maximum allowable cost programs. The commissioner shall set maximum allowable costs for multisource drugs that are not on the federal upper limit list as described in United States Code, title 42, chapter 7, section 1396r-8(e), the Social Security Act, and Code of Federal Regulations, title 42, part 447, section 447.332. Establishment of the amount of payment for drugs shall not be subject to the requirements of the Administrative Procedure Act. An additional dispensing fee of $.30 may be added to the dispensing fee paid to pharmacists for legend drug prescriptions dispensed to residents of long-term care facilities when a unit dose blister card system, approved by the department, is used. Under this type of dispensing system, the pharmacist must dispense a 30-day supply of drug. The National Drug Code (NDC) from the drug container used to fill the blister card must be identified on the claim to the department. The unit dose blister card containing the drug must meet the packaging standards set forth in Minnesota Rules, part 6800.2700, that govern the return of unused drugs to the pharmacy for reuse. The pharmacy provider will be required to credit the department for the actual acquisition cost of all unused drugs that are eligible for reuse. Over-the-counter medications must be dispensed in the manufacturer's unopened package. The commissioner may permit the drug clozapine to be dispensed in a quantity that is less than a 30-day supply. Whenever a generically equivalent product is available, payment shall be on the basis of the actual acquisition cost of the generic drug, unless the prescriber specifically indicates "dispense as written - brand necessary" on the prescription as required by section 151.21, subdivision 2.
(d) For purposes of this subdivision, "multisource drugs" means covered outpatient drugs, excluding innovator multisource drugs for which there are two or more drug products, which:
(1) are related as therapeutically equivalent under the Food and Drug Administration's most recent publication of "Approved Drug Products with Therapeutic Equivalence Evaluations";
(2) are pharmaceutically equivalent and bioequivalent as determined by the Food and Drug Administration; and
(3) are sold or marketed in Minnesota.
"Innovator multisource drug" means a multisource drug that was originally marketed under an original new drug application approved by the Food and Drug Administration.
(e) The basis for determining the amount of payment for drugs administered in an outpatient setting shall be the lower of the usual and customary cost submitted by the provider; the average wholesale price minus five percent; or the maximum allowable cost set by the federal government under United States Code, title 42, chapter 7, section 1396r-8(e) and Code of Federal Regulations, title 42, section 447.332, or by the commissioner under paragraph (c).
Sec. 19. Minnesota Statutes 2000, section 256B.0625, subdivision 13a, is amended to read:
Subd. 13a. [DRUG UTILIZATION REVIEW BOARD.] A nine-member drug utilization review board is established. The board is comprised of at least three but no more than four licensed physicians actively engaged in the practice of medicine in Minnesota; 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. The board shall be staffed by an employee of the department who shall serve as an ex officio nonvoting member of the board. The members of the board shall be appointed by the commissioner and shall serve three-year terms. The members shall be selected from lists submitted by professional associations. The commissioner shall appoint the initial members of the board for terms expiring as follows: three members for terms expiring June 30, 1996; three members for terms expiring June 30, 1997; and three members for terms expiring June 30, 1998. Members may be reappointed once. The board shall annually elect a chair from among the members.
The commissioner shall, with the advice of the board:
(1) implement a medical assistance retrospective and prospective drug utilization review program as required by United States Code, title 42, section 1396r-8(g)(3);
(2) develop and implement the predetermined criteria and practice parameters for appropriate prescribing to be used in retrospective and prospective drug utilization review;
(3) develop, select, implement, and assess interventions for physicians, pharmacists, and patients that are educational and not punitive in nature;
(4) establish a grievance and appeals process for physicians and pharmacists under this section;
(5) publish and disseminate educational information to physicians and pharmacists regarding the board and the review program;
(6) adopt and implement procedures designed to ensure the confidentiality of any information collected, stored, retrieved, assessed, or analyzed by the board, staff to the board, or contractors to the review program that identifies individual physicians, pharmacists, or recipients;
(7) establish and implement an ongoing process to (i) receive public comment regarding drug utilization review criteria and standards, and (ii) consider the comments along with other scientific and clinical information in order to revise criteria and standards on a timely basis; and
(8) adopt any rules necessary to carry out this section.
The board may establish advisory committees. The commissioner may contract with appropriate organizations to assist the board in carrying out the board's duties. The commissioner may enter into contracts for services to develop and implement a retrospective and prospective review program.
The board shall report to the commissioner annually on the date the Drug Utilization Review Annual Report is
due to the Health Care Financing Administration. This report is to cover the preceding federal fiscal year. The
commissioner shall make the report available to the public upon request. The report must include information on
the activities of the board and the program; the effectiveness of implemented interventions; administrative costs; and
any fiscal impact resulting from the program. An honorarium of $50 $100 per meeting and
reimbursement for mileage shall be paid to each board member in attendance.
Sec. 20. Minnesota Statutes 2000, section 256B.0625, subdivision 17, is amended to read:
Subd. 17. [TRANSPORTATION COSTS.] (a) Medical assistance covers transportation costs incurred solely for obtaining emergency medical care or transportation costs incurred by nonambulatory persons in obtaining emergency or nonemergency medical care when paid directly to an ambulance company, common carrier, or other recognized providers of transportation services. For the purpose of this subdivision, a person who is incapable of transport by taxicab or bus shall be considered to be nonambulatory.
(b) Medical assistance covers special transportation, as defined in Minnesota Rules, part 9505.0315, subpart 1,
item F, if the provider receives and maintains a current physician's order by the recipient's attending physician
certifying that the recipient has a physical or mental impairment that would prohibit the recipient from safely
accessing and using a bus, taxi, other commercial transportation, or private automobile. Special transportation
includes driver-assisted service to eligible individuals. Driver-assisted service includes passenger pickup at and
return to the individual's residence or place of business, assistance with admittance of the individual to the medical
facility, and assistance in passenger securement or in securing of wheelchairs or stretchers in the vehicle. The
commissioner shall establish maximum medical assistance reimbursement rates for special transportation services
for persons who need a wheelchair lift accessible van or stretcher-equipped vehicle and for those
who do not need a wheelchair lift accessible van or stretcher-equipped vehicle. The average of these
two rates per trip must not exceed $15 for the base rate and $1.20 $1.50 per mile. Special
transportation provided to nonambulatory ambulatory persons who do not need a wheelchair lift
van or stretcher-equipped vehicle, may be reimbursed at a lower rate than special transportation provided to persons
who need a wheelchair lift van or stretcher-equipped vehicle.
Sec. 21. Minnesota Statutes 2000, section 256B.0625, subdivision 17a, is amended to read:
Subd. 17a. [PAYMENT FOR AMBULANCE SERVICES.] Effective for services rendered on or after
July 1, 1999 2001, medical assistance payments for ambulance services shall be increased by
five percent paid at the greater of: (1) the medical assistance reimbursement rate in effect on June 30, 2000;
or (2) the current Medicare reimbursement rate for ambulance services.
Sec. 22. Minnesota Statutes 2000, section 256B.0625, subdivision 18a, is amended to read:
Subd. 18a. [PAYMENT FOR MEALS AND LODGING 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) Medical assistance covers 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 proficiency.
Sec. 23. Minnesota Statutes 2000, section 256B.0625, subdivision 30, is amended to read:
Subd. 30. [OTHER CLINIC SERVICES.] (a) Medical assistance covers rural health clinic services, federally qualified health center services, nonprofit community health clinic services, public health clinic services, and the services of a clinic meeting the criteria established in rule by the commissioner. Rural health clinic services and federally qualified health center services mean services defined in United States Code, title 42, section 1396d(a)(2)(B) and (C). Payment for rural health clinic and federally qualified health center services shall be made according to applicable federal law and regulation.
(b) A federally qualified health center that is beginning initial operation shall submit an estimate of budgeted costs and visits for the initial reporting period in the form and detail required by the commissioner. A federally qualified health center that is already in operation shall submit an initial report using actual costs and visits for the initial reporting period. Within 90 days of the end of its reporting period, a federally qualified health center shall submit, in the form and detail required by the commissioner, a report of its operations, including allowable costs actually incurred for the period and the actual number of visits for services furnished during the period, and other information required by the commissioner. Federally qualified health centers that file Medicare cost reports shall provide the commissioner with a copy of the most recent Medicare cost report filed with the Medicare program intermediary for the reporting year which support the costs claimed on their cost report to the state.
(c) In order to continue cost-based payment under the medical assistance program according to paragraphs (a) and (b), a federally qualified health center or rural health clinic must apply for designation as an essential community provider within six months of final adoption of rules by the department of health according to section 62Q.19, subdivision 7. For those federally qualified health centers and rural health clinics that have applied for essential community provider status within the six-month time prescribed, medical assistance payments will continue to be made according to paragraphs (a) and (b) for the first three years after application. For federally qualified health centers and rural health clinics that either do not apply within the time specified above or who have had essential community provider status for three years, medical assistance payments for health services provided by these entities shall be according to the same rates and conditions applicable to the same service provided by health care providers that are not federally qualified health centers or rural health clinics.
(d) Effective July 1, 1999, the provisions of paragraph (c) requiring a federally qualified health center or a rural health clinic to make application for an essential community provider designation in order to have cost-based payments made according to paragraphs (a) and (b) no longer apply.
(e) Effective January 1, 2000, payments made according to paragraphs (a) and (b) shall be limited to the cost phase-out schedule of the Balanced Budget Act of 1997.
(f) Effective January 1, 2001, each federally qualified health center and rural health clinic may elect to be paid either under the prospective payment system established in United States Code, title 42, section 1396a, paragraph (a) or under an alternative payment methodology consistent with the requirements of United States Code, title 42, section 1392a, paragraph (a) and approved by the health care financing administration. The alternative payment methodology shall be 100 percent of cost as determined according to Medicare cost principles.
Sec. 24. Minnesota Statutes 2000, section 256B.0625, subdivision 34, is amended to read:
Subd. 34. [INDIAN HEALTH SERVICES FACILITIES.] Medical assistance payments and MinnesotaCare payments to facilities of the Indian health service and facilities operated by a tribe or tribal organization under funding authorized by United States Code, title 25, sections 450f to 450n, or title III of the Indian Self-Determination and Education Assistance Act, Public Law Number 93-638, for enrollees who are eligible for federal financial participation, shall be at the option of the facility in accordance with the rate published by the United States Assistant Secretary for Health under the authority of United States Code, title 42, sections 248(a) and 249(b). General assistance medical care payments to facilities of the Indian health services and facilities operated by a tribe or tribal organization for the provision of outpatient medical care services billed after June 30, 1990, must be in accordance with the general assistance medical care rates paid for the same services when provided in a facility other than a facility of the Indian health service or a facility operated by a tribe or tribal organization. MinnesotaCare payments for enrollees who are not eligible for federal financial participation at facilities of the Indian Health Service and facilities operated by a tribe or tribal organization for the provision of outpatient medical services must be in accordance with the medical assistance rates paid for the same services when provided in a facility other than a facility of the Indian Health Service or a facility operated by a tribe or tribal organization.
[EFFECTIVE DATE.] This section is effective the day following final enactment.
Sec. 25. Minnesota Statutes 2000, section 256B.0635, subdivision 1, is amended to read:
Subdivision 1. [INCREASED EMPLOYMENT.] Beginning January 1, 1998 (a) Until June 30,
2002, medical assistance may be paid for persons who received MFIP-S or medical assistance for families and
children in at least three of six months preceding the month in which the person became ineligible for MFIP-S or
medical assistance, if the ineligibility was due to an increase in hours of employment or employment income or due
to the loss of an earned income disregard. In addition, to receive continued assistance under this section, persons
who received medical assistance for families and children but did not receive MFIP-S must have had income less
than or equal to the assistance standard for their family size under the state's AFDC plan in effect as of July 16, 1996,
as required by the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), Public
Law Number 104-193, increased by three percent effective July 1, 2000, at the time medical assistance
eligibility began. A person
who is eligible for extended medical assistance is entitled to six months of assistance without reapplication, unless the assistance unit ceases to include a dependent child. For a person under 21 years of age, medical assistance may not be discontinued within the six-month period of extended eligibility until it has been determined that the person is not otherwise eligible for medical assistance. Medical assistance may be continued for an additional six months if the person meets all requirements for the additional six months, according to title XIX of the Social Security Act, as amended by section 303 of the Family Support Act of 1988, Public Law Number 100-485.
(b) Beginning July 1, 2002, medical assistance for families and children may be paid for persons who were eligible under section 256B.055, subdivision 3a, paragraph (b), in at least three of six months preceding the month in which the person became ineligible under that section if the ineligibility was due to an increase in hours of employment or employment income or due to the loss of an earned income disregard. A person who is eligible for extended medical assistance is entitled to six months of assistance without reapplication, unless the assistance unit ceases to include a dependent child, except medical assistance may not be discontinued for that dependent child under 21 years of age within the six-month period of extended eligibility until it has been determined that the person is not otherwise eligible for medical assistance. Medical assistance may be continued for an additional six months if the person meets all requirements for the additional six months, according to title XIX of the Social Security Act, as amended by section 303 of the Family Support Act of 1988, Public Law Number 100-485.
[EFFECTIVE DATE.] This section is effective July 1, 2001.
Sec. 26. Minnesota Statutes 2000, section 256B.0635, subdivision 2, is amended to read:
Subd. 2. [INCREASED CHILD OR SPOUSAL SUPPORT.] Beginning January 1, 1998 (a) Until
June 30, 2002, medical assistance may be paid for persons who received MFIP-S or medical assistance for
families and children in at least three of the six months preceding the month in which the person became ineligible
for MFIP-S or medical assistance, if the ineligibility was the result of the collection of child or spousal support under
part D of title IV of the Social Security Act. In addition, to receive continued assistance under this section, persons
who received medical assistance for families and children but did not receive MFIP-S must have had income less
than or equal to the assistance standard for their family size under the state's AFDC plan in effect as of July 16, 1996,
as required by the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), Public
Law Number 104-193 increased by three percent effective July 1, 2000, at the time medical assistance
eligibility began. A person who is eligible for extended medical assistance under this subdivision is entitled to four
months of assistance without reapplication, unless the assistance unit ceases to include a dependent child. For
a person under 21 years of age, except medical assistance may not be discontinued for that
dependent child under 21 years of age within the four-month period of extended eligibility until it has been
determined that the person is not otherwise eligible for medical assistance.
(b) Beginning July 1, 2002, medical assistance for families and children may be paid for persons who were eligible under section 256B.055, subdivision 3a, paragraph (b), in at least three of the six months preceding the month in which the person became ineligible under that section if the ineligibility was the result of the collection of child or spousal support under part D of title IV of the Social Security Act. A person who is eligible for extended medical assistance under this subdivision is entitled to four months of assistance without reapplication, unless the assistance unit ceases to include a dependent child, except medical assistance may not be discontinued for that dependent child under 21 years of age within the four-month period of extended eligibility until it has been determined that the person is not otherwise eligible for medical assistance.
[EFFECTIVE DATE.] This section is effective July 1, 2001.
Sec. 27. [256B.0637] [PRESUMPTIVE ELIGIBILITY FOR CERTAIN PERSONS NEEDING TREATMENT FOR BREAST OR CERVICAL CANCER.]
Medical assistance is available during a presumptive eligibility period for persons who meet the criteria in
section 256B.057, subdivision 10. For purposes of this section, the presumptive eligibility period begins on the date
on which an entity designated by the commissioner determines, based on preliminary information, that the person
meets
the criteria in section 256B.057, subdivision 10. The presumptive eligibility period ends on the day on which a determination is made as to the person's eligibility, except that if an application is not submitted by the last day of the month following the month during which the determination based on preliminary information is made, the presumptive eligibility period ends on that last day of the month.
Sec. 28. [256B.195] [HEALTH CARE SAFETY NET PRESERVATION.]
Subdivision 1. [INTERGOVERNMENTAL TRANSFERS AND RELATED PAYMENTS.] (a) This section is contingent on federal approval of the intergovernmental transfers and payments to safety net hospitals authorized under this section.
(b) In addition to the percentage contribution paid by a county under section 256B.19, subdivision 1, the governmental units designated in this subdivision shall be responsible for an additional portion of the nonfederal share of medical assistance costs attributable to them. For purposes of this section, "designated governmental unit" means Hennepin county, Ramsey county, or the University of Minnesota. For purposes of this section, "nonstate, government hospital" means Hennepin County Medical Center, the successor or assignee to St. Paul-Ramsey Medical Center as described in section 383A.91, or Fairview University Medical Center.
(c) Effective July 1, 2001, the governmental units designated in paragraph (a) shall in total transfer $2,833,333 on a monthly basis to the state Medicaid agency. The commissioner shall allocate this assessment between the governmental units based on the proportion of the Medicare upper payment limit for each nonstate, government hospital located within the governmental unit to the total Medicare upper payment limit of all participating hospitals in paragraph (b).
(d) The commissioner shall distribute the proceeds of this intergovernmental transfer, including the federal Medicaid match, as follows:
(1) Proceeds may be no less than the amount of the intergovernmental transfer in paragraph (c) multiplied by 1.75.
(2) The remaining proceeds provide funding for hospital charity care aid under section 144.585. The commissioner of human services shall work with the commissioner of health to assure that hospital charity care aid payments are administered in a manner that generates Medicaid matching funds.
(e) The successor or assignee to St. Paul-Ramsey Medical Center shall transfer on a monthly basis to Ramsey county an amount equal to the county assessment under paragraph (c).
Subd. 2. [DETERMINATION OF INTERGOVERNMENTAL TRANSFER AMOUNTS.] Medicaid rate changes, including those required to obtain federal financial participation under section 62J.692, subdivision 8, enacted prior to the effective date of this legislation, shall precede the determination of intergovernmental transfer amounts determined in this section. Participation in the intergovernmental transfer program shall not result in the offset of any nonstate, government hospital's receipt of Medicaid payment increases.
Subd. 3. [STATE PLAN AMENDMENTS.] The commissioner shall amend the state Medicaid plan as necessary to implement this section.
Subd. 4. [PROPORTIONATE ADJUSTMENTS.] (a) The commissioner shall adjust the intergovernmental transfers under subdivision 1, paragraph (c), and the payments under subdivision 1, paragraph (d), upon the approval of the designated governmental unit named in subdivision 1, paragraph (b), based on the commissioner's determination of Medicare upper payment limits, hospital-specific federal limitations on disproportionate share payments or to maximize additional federal reimbursements.
(b) In the event that: (i) federal approval is not received for the total intergovernmental transfer amount
specified in subdivision 1, paragraph (d), or, (ii) federal rules regarding the establishment of the 150 percent
Medicare upper payment limit, section 1102 of the Social Security Act, United States Code, title 42, section 1302,
enacted on
March 13, 2001, are rescinded or, (iii) the federal 150 percent Medicare upper payment limit is reduced to 100 percent, the amount of the intergovernmental transfers and Medicaid payments to the nonstate, government hospitals named in subdivision 1, paragraph (b), shall be adjusted for each hospital based on the proportion of each hospital's Medicaid inpatient hospital days to the total Medicaid inpatient hospital days provided by all participating hospitals.
[EFFECTIVE DATE.] This section is effective July 1, 2001.
Sec. 29. Minnesota Statutes 2000, section 256B.69, subdivision 4, is amended to read:
Subd. 4. [LIMITATION OF CHOICE.] 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. 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 20; and
(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; and
(8) persons eligible for medical assistance according to section 256B.057, subdivision 10.
Children under age 21 who are in foster placement may enroll in the project on an elective basis. Individuals
excluded under clauses (6) and (7) may choose to enroll on an elective basis. 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. Beginning on or after July 1, 1997, The commissioner
may require those individuals to enroll in the prepaid medical assistance program who otherwise would have been
excluded under clauses (1) and, (3), and (8), and under Minnesota Rules, part 9500.1452,
subpart 2, items H, K, and L. 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.
Sec. 30. Minnesota Statutes 2000, section 256B.69, subdivision 5, is amended to read:
Subd. 5. [PROSPECTIVE PER CAPITA PAYMENT.] The commissioner shall establish the method and amount of payments for services. The commissioner shall annually contract with demonstration providers to provide services consistent with these established methods and amounts for payment. Payment rates established by the commissioner must be within the limits of available appropriations.
If allowed by the commissioner, a demonstration provider may contract with an insurer, health care provider, nonprofit health service plan corporation, or the commissioner, to provide insurance or similar protection against the cost of care provided by the demonstration provider or to provide coverage against the risks incurred by demonstration providers under this section. The recipients enrolled with a demonstration provider are a permissible group under group insurance laws and chapter 62C, the Nonprofit Health Service Plan Corporations Act. Under this type of contract, the insurer or corporation may make benefit payments to a demonstration provider for services rendered or to be rendered to a recipient. Any insurer or nonprofit health service plan corporation licensed to do business in this state is authorized to provide this insurance or similar protection.
Payments to providers participating in the project are exempt from the requirements of sections 256.966 and 256B.03, subdivision 2. The commissioner shall complete development of capitation rates for payments before delivery of services under this section is begun. For payments made during calendar year 1990 and later years, the commissioner shall contract with an independent actuary to establish prepayment rates.
By January 15, 1996, the commissioner shall report to the legislature on the methodology used to allocate to participating counties available administrative reimbursement for advocacy and enrollment costs. The report shall reflect the commissioner's judgment as to the adequacy of the funds made available and of the methodology for equitable distribution of the funds. The commissioner must involve participating counties in the development of the report.
Sec. 31. Minnesota Statutes 2000, section 256B.69, subdivision 5b, is amended to read:
Subd. 5b. [PROSPECTIVE REIMBURSEMENT RATES.] (a) For prepaid medical assistance and general assistance medical care program contract rates set by the commissioner under subdivision 5 and effective on or after January 1, 1998, capitation rates for nonmetropolitan counties shall on a weighted average be no less than 88 percent of the capitation rates for metropolitan counties, excluding Hennepin county. The commissioner shall make a pro rata adjustment in capitation rates paid to counties other than nonmetropolitan counties in order to make this provision budget neutral.
(b) For prepaid medical assistance program contract rates set by the commissioner under subdivision 5 and
effective on or after January 1, 2001 2002, capitation rates for nonmetropolitan counties shall, on
a weighted average, be no less than 89 95 percent of the capitation rates for metropolitan counties,
excluding Hennepin county. The commissioner shall make a pro rata adjustment in capitation rates paid to
Hennepin county in order to make the portion of the increase between 89 and 95 percent budget neutral.
(c) This subdivision shall not affect the nongeographically based risk adjusted rates established under section 62Q.03, subdivision 5a, paragraph (f).
(d) The commissioner shall require prepaid health plans to use all revenue received from the increase in capitation rates for nonmetropolitan counties from 89 to no less than 95 percent of the capitation rate for metropolitan counties, excluding Hennepin county, to increase reimbursement rates, effective January 1, 2002, for providers under contract with the prepaid health plan to serve enrollees from nonmetropolitan counties.
Sec. 32. Minnesota Statutes 2000, section 256B.69, is amended by adding a subdivision to read:
Subd. 6c. [DENTAL SERVICES DEMONSTRATION PROJECT.] The commissioner shall establish
a dental services demonstration project in Crow Wing, Todd, Morrison, Wadena, and Cass counties for provision
of dental services to medical assistance, general assistance medical care, and MinnesotaCare recipients. The
commissioner
may contract on a prospective per capita payment basis for these dental services with an organization licensed under chapter 62C, 62D, or 62N in accordance with section 256B.037 or may establish and administer a fee-for-service system for the reimbursement of dental services.
[EFFECTIVE DATE.] This section is effective January 1, 2002.
Sec. 33. Minnesota Statutes 2000, section 256B.75, is amended to read:
256B.75 [HOSPITAL OUTPATIENT REIMBURSEMENT.]
(a) For outpatient hospital facility fee payments for services rendered on or after October 1, 1992, the commissioner of human services shall pay the lower of (1) submitted charge, or (2) 32 percent above the rate in effect on June 30, 1992, except for those services for which there is a federal maximum allowable payment. Effective for services rendered on or after January 1, 2000, payment rates for nonsurgical outpatient hospital facility fees and emergency room facility fees shall be increased by eight percent over the rates in effect on December 31, 1999, except for those services for which there is a federal maximum allowable payment. Services for which there is a federal maximum allowable payment shall be paid at the lower of (1) submitted charge, or (2) the federal maximum allowable payment. Total aggregate payment for outpatient hospital facility fee services shall not exceed the Medicare upper limit. If it is determined that a provision of this section conflicts with existing or future requirements of the United States government with respect to federal financial participation in medical assistance, the federal requirements prevail. The commissioner may, in the aggregate, prospectively reduce payment rates to avoid reduced federal financial participation resulting from rates that are in excess of the Medicare upper limitations.
(b) Notwithstanding paragraph (a), payment for outpatient, emergency, and ambulatory surgery hospital facility fee services for critical access hospitals designated under section 144.1483, clause (11), shall be paid on a cost-based payment system that is based on the cost-finding methods and allowable costs of the Medicare program.
(c) Effective for services provided on or after July 1, 2002, rates that are based on the Medicare outpatient prospective payment system shall be replaced by a budget neutral prospective payment system that is derived using medical assistance data. The department shall provide a proposal to the 2002 legislature to define and implement this provision.
Sec. 34. Minnesota Statutes 2000, 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 Health Care Finance Administration's common procedural coding system (HCPCS)
codes titled "office and other outpatient services," "preventive medicine new and established patient," "delivery,
antepartum, and postpartum care," "critical care," Caesarean cesarean delivery and pharmacologic
management provided to psychiatric patients, and HCPCS 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; and
(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 October 1, 2001, 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 July 1, 2001, the commissioner may increase
reimbursements to dentists and dental clinics deemed by the commissioner to be critical access dental providers.
Reimbursement to a critical access dental provider may be increased by not more than 50 percent above the
reimbursement rate that
would otherwise be paid to the provider. Payments to health plan companies shall be adjusted to 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.
(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.
[EFFECTIVE DATE.] This section is effective the day following final enactment.
Sec. 35. [256B.78] [MEDICAL ASSISTANCE DEMONSTRATION PROJECT FOR FAMILY PLANNING SERVICES.]
(a) The commissioner of human services shall establish a medical assistance demonstration project to determine whether improved access to coverage of prepregnancy family planning services reduces medical assistance and MFIP costs.
(b) This section is effective upon federal approval of the demonstration project.
Sec. 36. Minnesota Statutes 2000, 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-statewide (MFIP-S), who is having a payment made on the person's behalf under sections 256I.01 to 256I.06, or who resides in group residential housing as defined in chapter 256I and can meet a spenddown using the cost of remedial services received through group residential housing; or
(2)(i) who is a resident of Minnesota; and whose equity in assets is not in excess of $1,000 per assistance unit. Exempt assets, the reduction of excess assets, and the waiver of excess assets must conform to the medical assistance program in chapter 256B, 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; and
(ii) who has countable income not in excess of the assistance standards established in section 256B.056,
subdivision 4 that does not exceed 133 and 1/3 percent of the AFDC income standard in effect under the
July 16, 1996, AFDC state plan, increased by three percent, or whose excess income is spent down according
to section 256B.056, subdivision 5, using a six-month budget period. The method for calculating earned income
disregards and deductions for a person who resides with a dependent child under age 21 shall follow section
256B.056, subdivision 1a. However, if a disregard of $30 and one-third of the remainder has been applied to the
wage earner's income, the disregard shall not be applied again until the wage earner's income has not been
considered in an eligibility determination for general assistance, general assistance medical care, medical assistance,
or MFIP-S for 12 consecutive months. The earned income and work expense deductions for a person who does not
reside with a dependent child under age 21 shall be the same as the method used to determine eligibility for a person
under section 256D.06, subdivision 1, except the disregard of the first $50 of earned income is not allowed;
(3) who would be eligible for medical assistance except that the person resides in a facility that is determined by the commissioner or the federal Health Care Financing Administration to be an institution for mental diseases; or
(4) who is ineligible for medical assistance under chapter 256B or general assistance medical care under any other provision of this section, and is receiving care and rehabilitation services from a nonprofit center established to serve victims of torture. These individuals are eligible for general assistance medical care only for the period during which they are receiving services from the center. During this period of eligibility, individuals eligible under this clause shall not be required to participate in prepaid general assistance medical care.
(b) Beginning January 1, 2000, applicants or recipients who meet all eligibility requirements of MinnesotaCare as defined in sections 256L.01 to 256L.16, and are:
(i) adults with dependent children under 21 whose gross family income is equal to or less than 275 percent of the federal poverty guidelines; or
(ii) adults without children with earned income and whose family gross income is between 75 percent of the federal poverty guidelines and the amount set by section 256L.04, subdivision 7, shall be terminated from general assistance medical care upon enrollment in MinnesotaCare.
(c) For services rendered on or after July 1, 1997, eligibility is limited to one month prior to application if the person is determined eligible in the prior month. A redetermination of eligibility must occur every 12 months. Beginning January 1, 2000, Minnesota health care program applications completed by recipients and applicants who are persons described in paragraph (b), may be returned to the county agency to be forwarded to the department of human services or sent directly to the department of human services for enrollment in MinnesotaCare. If all other eligibility requirements of this subdivision are met, eligibility for general assistance medical care shall be available in any month during which a MinnesotaCare eligibility determination and enrollment are 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 paragraph (e).
(d) 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 an initial application when health care is delivered due to a medical condition or disability, a health care provider may act on the person's behalf to complete the initial application. 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. On the basis of information provided on the completed application, an applicant who meets the following criteria shall be determined eligible beginning in the month of application:
(1) has gross income less than 90 percent of the applicable income standard;
(2) has liquid assets that total within $300 of the asset standard;
(3) does not reside in a long-term care facility; and
(4) meets all other eligibility requirements.
The applicant must provide all required verifications within 30 days' notice of the eligibility determination or eligibility shall be terminated.
(e) 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.
(f) 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.
(g) 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. General assistance medical care is limited to payment of emergency services only for applicants or recipients as described in paragraph (b), whose MinnesotaCare coverage is denied or terminated for nonpayment of premiums as required by sections 256L.06 and 256L.07.
(h) In determining the amount of assets of an individual, 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.
(i) 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 Number 104-193, sections 421 and 422, and subsequently set out in federal rules.
(j)(1) An undocumented noncitizen or a nonimmigrant is ineligible for general assistance medical care other than emergency services. 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.
(2) This paragraph does not apply to a child under age 18, to a Cuban or Haitian entrant as defined in Public Law Number 96-422, section 501(e)(1) or (2)(a), or to a noncitizen who is aged, blind, or disabled as defined in Code of Federal Regulations, title 42, sections 435.520, 435.530, 435.531, 435.540, and 435.541, or effective October 1, 1998, to an individual eligible for general assistance medical care under paragraph (a), clause (4), who cooperates with the Immigration and Naturalization Service to pursue any applicable immigration status, including citizenship, that would qualify the individual for medical assistance with federal financial participation.
(k) For purposes of paragraphs (g) and (j), "emergency services" has the meaning given in Code of Federal Regulations, title 42, section 440.255(b)(1), except that it also means services rendered because of suspected or actual pesticide poisoning.
(l) 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.
Sec. 37. Minnesota Statutes 2000, section 256D.03, subdivision 4, is amended to read:
Subd. 4. [GENERAL ASSISTANCE MEDICAL CARE; SERVICES.] (a) For a person who is eligible under subdivision 3, paragraph (a), clause (3), 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;
(12) chiropractic services as covered under the medical assistance program;
(13) podiatric services;
(14) dental services;
(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; and
(22) telemedicine consultations, to the extent they are covered under section 256B.0625, subdivision 3b.
(b) Except as provided in paragraph (c), for a recipient who is eligible under subdivision 3, paragraph (a), clause (1) or (2), general assistance medical care covers the services listed in paragraph (a) with the exception of special transportation services.
(c) Gender reassignment surgery and related services are not covered services under this subdivision unless the individual began receiving gender reassignment services prior to July 1, 1995.
(d) 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. Payment rates established by the commissioner must be within the limits of available appropriations. Notwithstanding the provisions of subdivision 3, an individual who becomes ineligible for general assistance medical care because of failure to submit income reports or recertification forms in a timely manner, shall remain enrolled in the prepaid health plan and shall remain eligible for general assistance medical care coverage through the last day of the month in which the enrollee became ineligible for general assistance medical care.
(e) There shall be no copayment required of any recipient of benefits for any services provided under this subdivision. 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.
(f) Any county may, from its own resources, provide medical payments for which state payments are not made.
(g) Chemical dependency services that are reimbursed under chapter 254B must not be reimbursed under general assistance medical care.
(h) 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.
(i) 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.
Sec. 38. Minnesota Statutes 2000, section 256J.31, subdivision 12, is amended to read:
Subd. 12. [RIGHT TO DISCONTINUE CASH ASSISTANCE.] A participant who is not in vendor payment
status may discontinue receipt of the cash assistance portion of the MFIP assistance grant and retain eligibility for
child care assistance under section 119B.05 and for medical assistance under sections 256B.055, subdivision 3a,
and 256B.0635. For the months a participant chooses to discontinue the receipt of the cash portion of the MFIP
grant, the assistance unit accrues months of eligibility to be applied toward eligibility for child care under section
119B.05 and for medical assistance under sections 256B.055, subdivision 3a, and 256B.0635.
[EFFECTIVE DATE.] This section is effective July 1, 2002.
Sec. 39. Minnesota Statutes 2000, section 256K.03, subdivision 1, is amended to read:
Subdivision 1. [NOTIFICATION OF PROGRAM.] Except for the provisions in this section, the provisions for the MFIP application process shall be followed. Within two days after receipt of a completed combined application form, the county agency must refer to the provider the applicant who meets the conditions under section 256K.02, and notify the applicant in writing of the program including the following provisions:
(1) notification that, as part of the application process, applicants are required to attend orientation, to be followed immediately by a job search;
(2) the program provider, the date, time, and location of the scheduled program orientation;
(3) the procedures for qualifying for and receiving benefits under the program;
(4) the immediate availability of supportive services, including, but not limited to, child care, transportation,
medical assistance, and other work-related aid; and
(5) the rights, responsibilities, and obligations of participants in the program, including, but not limited to, the grounds for exemptions and deferrals, the consequences for refusing or failing to participate fully, and the appeal process.
[EFFECTIVE DATE.] This section is effective July 1, 2002.
Sec. 40. Minnesota Statutes 2000, section 256K.07, is amended to read:
256K.07 [ELIGIBILITY FOR FOOD STAMPS, MEDICAL ASSISTANCE, AND CHILD CARE.]
The participant shall be treated as an MFIP recipient for food stamps, medical assistance, and child care
eligibility purposes. The participant who leaves the program as a result of increased earnings from employment shall
be eligible for transitional medical assistance and child care without regard to MFIP receipt in three of the
six months preceding ineligibility.
[EFFECTIVE DATE.] This section is effective July 1, 2002.
Sec. 41. Minnesota Statutes 2000, section 256L.06, subdivision 3, is amended to read:
Subd. 3. [ADMINISTRATION AND COMMISSIONER'S DUTIES.] (a) Premiums are dedicated to the commissioner for MinnesotaCare.
(b) The commissioner shall develop and implement procedures to: (1) require enrollees to report changes in income; (2) adjust sliding scale premium payments, based upon changes in enrollee income; and (3) disenroll enrollees from MinnesotaCare for failure to pay required premiums. Failure to pay includes payment with a
dishonored check, a returned automatic bank withdrawal, or a refused credit card or debit card payment. The commissioner may demand a guaranteed form of payment, including a cashier's check or a money order, as the only means to replace a dishonored, returned, or refused payment.
(c) Premiums are calculated on a calendar month basis and may be paid on a monthly, quarterly, or annual basis, with the first payment due upon notice from the commissioner of the premium amount required. The commissioner shall inform applicants and enrollees of these premium payment options. Premium payment is required before enrollment is complete and to maintain eligibility in MinnesotaCare.
(d) Nonpayment of the premium will result in disenrollment from the plan within one calendar month after
the due date effective for the calendar month for which the premium was due. Persons disenrolled for
nonpayment or who voluntarily terminate coverage from the program may not reenroll until four calendar months
have elapsed. Persons disenrolled for nonpayment who pay all past due premiums as well as current premiums due,
including premiums due for the period of disenrollment, within 20 days of disenrollment, shall be reenrolled
retroactively to the first day of disenrollment. Persons disenrolled for nonpayment or who voluntarily terminate
coverage from the program may not reenroll for four calendar months unless the person demonstrates good cause
for nonpayment. Good cause does not exist if a person chooses to pay other family expenses instead of the premium.
The commissioner shall define good cause in rule.
[EFFECTIVE DATE.] This section is effective July 1, 2002.
Sec. 42. Minnesota Statutes 2000, section 256L.12, subdivision 9, is amended to read:
Subd. 9. [RATE SETTING.] Rates will be prospective, per capita, where possible. The commissioner may allow health plans to arrange for inpatient hospital services on a risk or nonrisk basis. The commissioner shall consult with an independent actuary to determine appropriate rates. Rates established by the commissioner must be within the limits of available appropriations.
Sec. 43. Minnesota Statutes 2000, section 256L.12, is amended by adding a subdivision to read:
Subd. 11. [COVERAGE AT INDIAN HEALTH SERVICE FACILITIES.] For American Indian enrollees of MinnesotaCare, MinnesotaCare shall cover health care services provided at Indian Health Service facilities and facilities operated by a tribe or tribal organization under funding authorized by United States Code, title 25, sections 450f to 450n, or title III of the Indian Self-Determination and Education Act, Public Law Number 93-638, if those services would otherwise be covered under section 256L.03. Payments for services provided under this subdivision shall be made on a fee-for-service basis, and may, at the option of the tribe or organization, be made at the rates authorized under sections 256.969, subdivision 16, and 256B.0625, subdivision 34, for those MinnesotaCare enrollees eligible for coverage at medical assistance rates. For purposes of this subdivision, "American Indian" has the meaning given to persons to whom services will be provided for in the Code of Federal Regulations, title 42, section 36.12.
Sec. 44. Minnesota Statutes 2000, section 256L.16, is amended to read:
256L.16 [PAYMENT RATES; SERVICES FOR FAMILIES AND CHILDREN UNDER THE MINNESOTACARE HEALTH CARE REFORM WAIVER.]
Section 256L.11, subdivision 2, shall not apply to services provided to children families with
children who are eligible to receive expanded services according to section 256L.03, subdivision
1a 256L.04, subdivision 1, paragraph (a).
Sec. 45. Laws 1995, chapter 178, article 2, section 36, is amended to read:
Sec. 36. [EMPOWERMENT ZONES; ADMINISTRATIVE SIMPLIFICATION OF WELFARE LAWS.]
(a) The commissioner of human services shall make recommendations to effectuate the changes in federal laws and regulations, state laws and rules, and the state plan to improve the administrative efficiency of the aid to families with dependent children, general assistance, work readiness, family general assistance, medical assistance, general assistance medical care, and food stamp programs. At a minimum, the following administrative standards and procedures must be changed.
The commissioner shall:
(1) require income or eligibility reviews no more frequently than annually for cases in which income is normally invariant, as in aid to families with dependent children cases where the only source of household income is Supplemental Social Security Income;
(2) permit households to report income annually when the source of income is excluded, such as a minor's earnings;
(3) require income or eligibility reviews no more frequently than annually for extended medical assistance
cases;
(4) require income or eligibility reviews no more frequently than annually for a medical assistance
postpartum client, where the client previously had eligibility under a different basis prior to pregnancy or if other
household members have eligibility with the same income/basis that applies to the client;
(5) (4) permit all income or eligibility reviews for foster care medical assistance cases to use the
short application form; and
(6) (5) make dependent care expenses declaratory for medical assistance; and
(7) permit households to only report gifts worth $100 or more per month.
(b) The county's administrative savings resulting from these changes may be allocated to fund any lawful purpose.
(c) The recommendations must be provided in a report to the chairs of the appropriate legislative committees by August 1, 1995. The recommendations must include a list of the administrative standards and procedures that require approval by the federal government before implementation, and also which administrative simplification standards and procedures may be implemented by a county prior to receiving a federal waiver.
(d) The commissioner shall seek the necessary waivers from the federal government as soon as possible to implement the administrative simplification standards and procedures.
Sec. 46. Laws 1999, chapter 245, article 4, section 110, is amended to read:
Sec. 110. [PROGRAMS FOR SENIOR CITIZENS.]
The commissioner of human services shall study the eligibility criteria of and benefits provided to persons age
65 and over through the array of cash assistance and health care programs administered by the department, and the
extent to which these programs can be combined, simplified, or coordinated to reduce administrative costs and
improve access. The commissioner shall also study potential barriers to enrollment for low-income seniors who
would otherwise deplete resources necessary to maintain independent community living. At a minimum, the study
must include an evaluation of asset requirements and enrollment sites. The commissioner shall report study findings
and recommendations to the legislature by June September 30, 2001.
Sec. 47. [NOTICE OF NEW PREMIUM SCHEDULE.]
The commissioner of human services shall provide medical assistance enrollees subject to premiums as employed persons with disabilities with prior notice of the new premium schedule established under the section 14 amendment to section 256B.057, subdivision 9, paragraph (c). This notice must be provided at least two months before the month in which the first premium payment under the new schedule is due.
Sec. 48. [MEDICATION THERAPY MANAGEMENT PILOT PROGRAM.]
Subdivision 1. [ESTABLISHMENT.] The commissioner of human services, in consultation with the advisory committee established under subdivision 2, shall implement, beginning July 1, 2001, a two-year medication therapy management pilot program for medical assistance enrollees. Medication therapy management must be provided by teams of physicians and pharmacists working in collaborative practice, as defined in Minnesota Statutes, section 151.01, subdivision 27, clause (5), to help patients use medications safely and effectively. The commissioner may enroll individual pharmacists who participate in the pilot program as medical assistance providers and shall seek to ensure that participating pharmacists represent all geographic regions of the state.
Subd. 2. [ADVISORY COMMITTEE.] The commissioner shall establish a ten-member medication therapy management advisory committee, to advise the commissioner in the implementation and administration of the program and the development of eligibility criteria for enrollees and providers and requirements for collaborative practice agreements. The committee shall be comprised of: two licensed physicians; two licensed pharmacists; two consumer representatives; three members with expertise in the area of medication therapy management, who may be licensed physicians or licensed pharmacists; and a representative of the commissioner, who shall serve as an ex-officio nonvoting member. In appointing members who are not consumer representatives, the commissioner shall consider recommendations of associations representing pharmacy and medical practitioners. The committee is governed by section 15.059, except that committee members do not receive compensation or reimbursement for expenses.
Subd. 3. [EVALUATION.] The commissioner shall evaluate the cost-effectiveness of the pilot program and its effect on patient outcomes and quality of care, and shall report to the legislature by December 15, 2003. The commissioner may contract with a vendor to conduct the evaluation.
Sec. 49. [REGULATORY SIMPLIFICATION FOR STATE HEALTH CARE PROGRAM PROVIDERS.]
The commissioner of human services, in consultation with providers participating in state health care programs, shall identify nonfinancial barriers to increased provider enrollment and provider retention in state health care programs, and shall implement procedures to address these barriers. Areas to be examined by the commissioner shall include, but are not limited to, regulatory complexity and inconsistencies between state health care programs, provider requirements, provision of technical assistance to providers, responsiveness to provider inquiries and complaints, claims processing turnaround times, and policies for rejecting provider claims. The commissioner shall report to the legislature by February 15, 2002, on any changes to the administration of state health care programs that will be implemented as a result of the study, and present recommendations for any necessary changes in state law.
Sec. 50. [REPEALER.]
(a) Minnesota Statutes 2000, section 256B.037, subdivision 5, is repealed effective January 1, 2002.
(b) Minnesota Statutes 2000, section 256B.0635, subdivision 3, is repealed effective July 1, 2002.
ARTICLE 4
CONTINUING CARE AND HOME CARE
Section 1. Minnesota Statutes 2000, section 245A.13, subdivision 7, is amended to read:
Subd. 7. [RATE RECOMMENDATION.] The commissioner of human services may review rates of a residential
program participating in the medical assistance program which is in receivership and that has needs or deficiencies
documented by the department of health or the department of human services. If the commissioner of human
services determines that a review of the rate established under section 256B.501 sections 256B.5012 and
256B.5013 is needed, the commissioner shall:
(1) review the order or determination that cites the deficiencies or needs; and
(2) determine the need for additional staff, additional annual hours by type of employee, and additional consultants, services, supplies, equipment, repairs, or capital assets necessary to satisfy the needs or deficiencies.
Sec. 2. Minnesota Statutes 2000, section 245A.13, subdivision 8, is amended to read:
Subd. 8. [ADJUSTMENT TO THE RATE.] Upon review of rates under subdivision 7, the commissioner may
adjust the residential program's payment rate. The commissioner shall review the circumstances, together with the
residential program cost report program's most recent income and expense report, to determine
whether or not the deficiencies or needs can be corrected or met by reallocating residential program staff, costs,
revenues, or any other resources including any investments, efficiency incentives, or
allowances. If the commissioner determines that any deficiency cannot be corrected or the need cannot be met
with the payment rate currently being paid, the commissioner shall determine the payment rate adjustment by
dividing the additional annual costs established during the commissioner's review by the residential program's actual
resident days from the most recent desk-audited cost income and expense report or the estimated
resident days in the projected receivership period. The payment rate adjustment must meet the conditions in
Minnesota Rules, parts 9553.0010 to 9553.0080, and remains in effect during the period of the receivership or
until another date set by the commissioner. Upon the subsequent sale, closure, or transfer of the residential
program, the commissioner may recover amounts that were paid as payment rate adjustments under this subdivision.
This recovery shall be determined through a review of actual costs and resident days in the receivership period.
The costs the commissioner finds to be allowable shall be divided by the actual resident days for the receivership
period. This rate shall be compared to the rate paid throughout the receivership period, with the difference,
multiplied by resident days, being the amount to be repaid to the commissioner. Allowable costs shall be determined
by the commissioner as those ordinary, necessary, and related to resident care by prudent and cost-conscious
management. The buyer or transferee shall repay this amount to the commissioner within 60 days after the
commissioner notifies the buyer or transferee of the obligation to repay. This provision does not limit the liability
of the seller to the commissioner pursuant to section 256B.0641.
Sec. 3. Minnesota Statutes 2000, section 252.275, subdivision 4b, is amended to read:
Subd. 4b. [GUARANTEED FLOOR.] Each county with an original allocation for the preceding year that is
equal to or less than the guaranteed floor minimum index shall have a guaranteed floor equal to its original
allocation for the preceding year. Each county with an original allocation for the preceding year that is greater than
the guaranteed floor minimum index shall have a guaranteed floor equal to the lesser of clause (1) or (2):
(1) the county's original allocation for the preceding year; or
(2) 70 percent of the county's reported expenditures eligible for reimbursement during the 12 months ending on June 30 of the preceding calendar year.
For calendar year 1993, the guaranteed floor minimum index shall be $20,000. For each subsequent year, the
index shall be adjusted by the projected change in the average value in the United States Department of Labor Bureau
of Labor Statistics consumer price index (all urban) for that year.
Notwithstanding this subdivision, no county shall be allocated a guaranteed floor of less than $1,000.
When the amount of funds available for allocation is less than the amount available in the previous year, each county's previous year allocation shall be reduced in proportion to the reduction in the statewide funding, to establish each county's guaranteed floor.
Sec. 4. Minnesota Statutes 2000, section 254B.02, subdivision 3, is amended to read:
Subd. 3. [RESERVE ACCOUNT.] The commissioner shall allocate money from the reserve account to counties that, during the current fiscal year, have met or exceeded the base level of expenditures for eligible chemical dependency services from local money. The commissioner shall establish the base level for fiscal year 1988 as the amount of local money used for eligible services in calendar year 1986. In later years, the base level must be increased in the same proportion as state appropriations to implement Laws 1986, chapter 394, sections 8 to 20, are increased. The base level must be decreased if the fund balance from which allocations are made under section 254B.02, subdivision 1, is decreased in later years. The local match rate for the reserve account is the same rate as applied to the initial allocation. Reserve account payments must not be included when calculating the county adjustments made according to subdivision 2. For counties providing medical assistance or general assistance medical care through managed care plans on January 1, 1996, the base year is fiscal year 1995. For counties beginning provision of managed care after January 1, 1996, the base year is the most recent fiscal year before enrollment in managed care begins. For counties providing managed care, the base level will be increased or decreased in proportion to changes in the fund balance from which allocations are made under subdivision 2, but will be additionally increased or decreased in proportion to the change in county adjusted population made in subdivision 1, paragraphs (b) and (c). Effective July 1, 2001, funds deposited in the reserve account in excess of those needed to meet obligations for services provided during the biennium under this section and sections 254B.06 and 254B.09 shall cancel to the general fund.
Sec. 5. Minnesota Statutes 2000, 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.
(c) The calendar year 1998 2002 rate for vendors may not increase more than three
two percent above the rate approved in effect on January 1, 1997 2001. The calendar year
1999 2003 rate for vendors may not increase more than three two percent above
the rate in effect on January 1, 1998 2002. The calendar years 2004 and 2005 rates may not exceed the
rate in effect on January 1, 2003.
(d) 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. 6. Minnesota Statutes 2000, section 254B.04, subdivision 1, is amended to read:
Subdivision 1. [ELIGIBILITY.] (a) Persons eligible for benefits under Code of Federal Regulations, title 25, part 20, persons eligible for medical assistance benefits under sections 256B.055, 256B.056, and 256B.057, subdivisions 1, 2, 5, and 6, or who meet the income standards of section 256B.056, subdivision 4, and persons eligible for general assistance medical care under section 256D.03, subdivision 3, are entitled to chemical dependency fund services. State money appropriated for this paragraph must be placed in a separate account established for this purpose.
Persons with dependent children who are determined to be in need of chemical dependency treatment pursuant to an assessment under section 626.556, subdivision 10, or a case plan under section 260C.201, subdivision 6, or 260C.212, shall be assisted by the local agency to access needed treatment services. Treatment services must be appropriate for the individual or family, which may include long-term care treatment or treatment in a facility that allows the dependent children to stay in the treatment facility. The county shall pay for out-of-home placement costs, if applicable.
(b) A person not entitled to services under paragraph (a), but with family income that is less than the 1997
federal poverty guidelines equivalent of 60 percent of the state median income for a family of like size and
composition, shall be eligible to receive chemical dependency fund services within the limit of funds available
after persons entitled to services under paragraph (a) have been served appropriated for this group for the
fiscal year. If notified by the state agency of limited funds, a county must give preferential treatment to persons
with dependent children who are in need of chemical dependency treatment pursuant to an assessment under section
626.556, subdivision 10, or a case plan under section 260C.201, subdivision 6, or 260C.212. A county may spend
money from its own sources to serve persons under this paragraph. State money appropriated for this paragraph
must be placed in a separate account established for this purpose.
(c) Persons whose income is between the 1997 federal poverty guidelines equivalent of 60 percent and
115 percent of the state median income shall be eligible for chemical dependency services on a sliding fee basis,
within the limit of funds available, after persons entitled to services under paragraph (a) and persons eligible for
services under paragraph (b) have been served appropriated for this group for the fiscal year. Persons
eligible under this paragraph must contribute to the cost of services according to the sliding fee scale established
under subdivision 3. A county may spend money from its own sources to provide services to persons under this
paragraph. State money appropriated for this paragraph must be placed in a separate account established for this
purpose.
Sec. 7. Minnesota Statutes 2000, section 254B.09, is amended by adding a subdivision to read:
Subd. 8. [PAYMENTS TO IMPROVE SERVICES TO AMERICAN INDIANS.] The commissioner may set rates for chemical dependency services according to the American Indian Health Improvement Act, Public Law Number 94-437, for eligible vendors. These rates shall supersede rates set in county purchase of service agreements when payments are made on behalf of clients eligible according to Public Law Number 94-437.
Sec. 8. Minnesota Statutes 2000, section 256.01, is amended by adding a subdivision to read:
Subd. 19. [GRANTS FOR CASE MANAGEMENT SERVICES TO PERSONS WITH HIV OR AIDS.] The commissioner may award grants to eligible vendors for the development, implementation, and evaluation of case management services for individuals infected with the human immunodeficiency virus. HIV/AIDs case management services will be provided to increase access to cost effective health care services, to reduce the risk of HIV transmission, to ensure that basic client needs are met, and to increase client access to needed community supports or services.
Sec. 9. Minnesota Statutes 2000, 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 to assist for individuals with functional limitations and their families in
purchasing and securing supports which the individuals need to live as independently and productively in the
community as possible who wish to purchase and secure their own supports. The commissioner and
local agencies shall jointly develop an implementation plan which must include a way to resolve the issues related
to county liability. The program shall:
(1) make support grants available to individuals or families as an effective alternative to existing programs and
services, such as the developmental disability family support program, the alternative care program, personal
care attendant services, home health aide services, and private duty nursing facility services;
(2) provide consumers more control, flexibility, and responsibility over the needed supports their
services and supports;
(3) promote local program management and decision making; and
(4) encourage the use of informal and typical community supports.
Sec. 10. Minnesota Statutes 2000, 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 or the person's legal representative, 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 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, home environmental modifications, or assistance
purchased by the person or the person's family. Examples of supports include respite care, assistance with daily
living, and adaptive aids 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. 11. Minnesota Statutes 2000, 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 is eligible for and has been approved to receive services
under alternative care services as determined under section 256B.0913 or the person has been approved to
receive a grant under the developmental disability 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 home and community-based services under United States Code, title 42, section 1396h(c); personal care attendant and home health aide services under section 256B.0625; a developmental disability 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) The commissioner may limit the participation of nursing facility residents, residents of intermediate care
facilities for persons with mental retardation, and the recipients of services from federal waiver programs in the
consumer support grant program if the participation of these individuals will result in an increase in the cost to the
state.
(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. 12. Minnesota Statutes 2000, 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 board chooses to participate in the program, 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 5, paragraph (f).
(b) Support grants to a person or a person's family 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 or the person's family to delay or prevent out-of-home placement of the person; and
(4) it must be consistent with the needs identified in the service plan, 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 or the person's family. 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 or the person's family shall
be provided sufficient information to ensure an informed choice of alternatives by the person, the person's legal
representative, if any, or the person's family. 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 or alternative care program.
(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. 13. Minnesota Statutes 2000, 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 specific programs or services, such as the developmental
disability family support program and alternative care program, personal care attendant assistant
services, home
health aide services, or nursing facility private duty nursing services, the amount of funds
transferred by the commissioner between the developmental disability family support program account, the
alternative care 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 expended on those individuals for those programs and services or, in situations where an individual is unable to obtain the support needed from the program of origination due to the unavailability of service providers at the time or the location where the supports are needed, the allocation will be based on the county's best estimate of the nonfederal dollars that would have been expended if the services had been available; 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 alternative care account and 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 shall may use up to five percent of each county's allocation, as adjusted,
for payments to that county for administrative expenses, to be paid as a proportionate addition to reported direct
service expenditures.
(f) Except as provided in this paragraph, the county allocation for each individual or individual's family cannot exceed 80 percent of the total nonfederal dollars expended on the individual by the program of origination except for the developmental disabilities family support grant program which can be approved up to 100 percent of the nonfederal dollars and in situations as described in paragraph (b), clause (3). In situations where exceptional need exists or the individual's need for support increases, up to 100 percent of the nonfederal dollars expended by the consumer's program of origination may be allocated to the county. Allocations that exceed 80 percent of the nonfederal dollars expended on the individual by the program of origination must be approved by the commissioner. The remainder of the amount expended on the individual by the program of origination will be used in the following proportions: half will be made available to the consumer support grant program and participating counties for consumer training, resource development, and other costs, and half will be returned to the state general fund.
(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. 14. Minnesota Statutes 2000, section 256.476, subdivision 8, is amended to read:
Subd. 8. [COMMISSIONER RESPONSIBILITIES.] The commissioner shall:
(1) transfer and allocate funds pursuant to this section;
(2) determine allocations based on projected and actual local agency use;
(3) monitor and oversee overall program spending;
(4) evaluate the effectiveness of the program;
(5) provide training and technical assistance for local agencies and consumers to help identify potential applicants to the program; and
(6) develop guidelines for local agency program administration and consumer information; and.
(7) apply for a federal waiver or take any other action necessary to maximize federal funding for the program
by September 1, 1999.
Sec. 15. Minnesota Statutes 2000, section 256B.0625, subdivision 7, is amended to read:
Subd. 7. [PRIVATE DUTY NURSING.] Medical assistance covers private duty nursing services in a recipient's
home. Recipients who are authorized to receive private duty nursing services in their home may use approved hours
outside of the home during hours when normal life activities take them outside of their home and when, without
the provision of private duty nursing, their health and safety would be jeopardized. To use private duty nursing
services at school, the recipient or responsible party must provide written authorization in the care plan identifying
the chosen provider and the daily amount of services to be used at school. Medical assistance does not cover private
duty nursing services for residents of a hospital, nursing facility, intermediate care facility, or a health care facility
licensed by the commissioner of health, except as authorized in section 256B.64 for ventilator-dependent recipients
in hospitals or unless a resident who is otherwise eligible is on leave from the facility and the facility either pays for
the private duty nursing services or forgoes the facility per diem for the leave days that private duty nursing services
are used. Total hours of service and payment allowed for services outside the home cannot exceed that which is
otherwise allowed in an in-home setting according to section 256B.0627. All private duty nursing services must be
provided according to the limits established under section 256B.0627. Private duty nursing services may not be
reimbursed if the nurse is the spouse of the recipient or the parent or foster care provider of a recipient who
is under age 18, or the recipient's legal guardian.
Sec. 16. Minnesota Statutes 2000, section 256B.0625, subdivision 19a, is amended to read:
Subd. 19a. [PERSONAL CARE ASSISTANT SERVICES.] Medical assistance covers personal care
assistant services in a recipient's home. To qualify for personal care assistant services, recipients
or responsible parties must be able to identify the recipient's needs, direct and evaluate task accomplishment, and
provide for health and safety. Approved hours may be used outside the home when normal life activities take them
outside the home and when, without the provision of personal care, their health and safety would be
jeopardized. To use personal care assistant services at school, the recipient or responsible party must
provide written authorization in the care plan identifying the chosen provider and the daily amount of services to
be used at school. Total hours for services, whether actually performed inside or outside the recipient's home, cannot
exceed that which is otherwise allowed for personal care assistant services in an in-home setting according
to section 256B.0627. Medical assistance does not cover personal care assistant services for residents of
a hospital, nursing facility, intermediate care facility, health care facility licensed by the commissioner of health, or
unless a resident who is otherwise eligible is on leave from the facility and the facility either pays for the personal
care assistant services or forgoes the facility per diem for the leave days that personal care assistant
services are used. All personal care services must be provided according to section 256B.0627. Personal care
assistant services may not be reimbursed if the personal care assistant is the spouse or legal guardian of the
recipient or the parent of a recipient under age 18, or the responsible party or the foster care provider of a recipient
who cannot direct the recipient's own care unless, in the case of a foster care provider, a county or state case manager
visits the recipient as needed, but not less than every six months, to monitor the health and safety of the recipient
and to ensure the goals of the care plan are met. Parents of adult recipients, adult children of the recipient or adult
siblings of the recipient may be reimbursed for personal care assistant services if they are not the
recipient's legal guardian and, if they are granted a waiver under section 256B.0627. Until July
1, 2001, and
Notwithstanding the provisions of section 256B.0627, subdivision 4, paragraph (b), clause (4), the noncorporate legal guardian or conservator of an adult, who is not the responsible party and not the personal care provider organization, may be granted a hardship waiver under section 256B.0627, to be reimbursed to provide personal care assistant services to the recipient, and shall not be considered to have a service provider interest for purposes of participation on the screening team under section 256B.092, subdivision 7.
Sec. 17. Minnesota Statutes 2000, section 256B.0625, subdivision 19c, is amended to read:
Subd. 19c. [PERSONAL CARE.] Medical assistance covers personal care assistant services provided
by an individual who is qualified to provide the services according to subdivision 19a and section 256B.0627, where
the services are prescribed by a physician in accordance with a plan of treatment and are supervised by the recipient
under the fiscal agent option according to section 256B.0627, subdivision 10, or a qualified professional.
"Qualified professional" means a mental health professional as defined in section 245.462, subdivision 18, or
245.4871, subdivision 27; or a registered nurse as defined in sections 148.171 to 148.285. As part of the assessment,
the county public health nurse will consult with assist the recipient or responsible party and
to identify the most appropriate person to provide supervision of the personal care assistant. The qualified
professional shall perform the duties described in Minnesota Rules, part 9505.0335, subpart 4.
Sec. 18. Minnesota Statutes 2000, 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 245.4888, 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 county-contracted vendors shall be based on a monthly rate negotiated by the host county. 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 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, except to reimburse the county for advance funding provided by the county to the vendor.
(f) If the service is provided by a team which includes contracted vendors 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 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, the county must document, in the recipient's file, the need for team case management and a description of the roles of the team members.
(g) 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 sections 245.4886 and 256E.12 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.
(h) Any net increase in revenue to the county as a result of the change in this section must be used to provide expanded mental health services as defined in sections 245.461 to 245.4888, the Comprehensive Adult and Children's Mental Health Acts, excluding inpatient and residential treatment. For adults, increased revenue may also be used for services and consumer supports which are part of adult mental health projects approved under Laws 1997, chapter 203, article 7, section 25. For children, increased revenue may also be used for respite care and nonresidential individualized rehabilitation services as defined in section 245.492, subdivisions 17 and 23. "Increased revenue" has the meaning given in Minnesota Rules, part 9520.0903, subpart 3.
(i) 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.
(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, is responsible for any federal disallowances. The county may share this responsibility with its contracted vendors.
(k) The commissioner shall set aside a portion of the federal funds earned 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) Notwithstanding section 256.025, subdivision 2, payments to counties for case management expenditures under this section shall only be made from federal earnings from services provided under this section. Payments to contracted vendors shall include both the federal earnings and the county share.
(m) Notwithstanding section 256B.041, county payments for the cost of mental health case management services provided by county or state staff shall not be made to the state treasurer. 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 256B.041 consists only of federal earnings from services provided under this section.
(n) Case management services under this subdivision do not include therapy, treatment, legal, or outreach services.
(o) 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 30 180 days of the recipient's residency in that facility and may not exceed more
than two six months in a calendar year.
(p) Payment for case management services under this subdivision shall not duplicate payments made under other program authorities for the same purpose.
(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.
(r) For each calendar year beginning with the calendar year 2001, the annualized amount of state funds for each county determined under paragraph (g) 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.
(s) For counties receiving the minimum allocation of $3,000 or $5,000 described in paragraph (g), the adjustment in paragraph (r) shall be determined so that the county receives the higher of the following amounts:
(1) a continuation of the minimum allocation in paragraph (g); or
(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, in comparison to the prior fiscal year, times the average statewide grant per person per month for counties not receiving the minimum allocation.
(t) The adjustments in paragraphs (r) and (s) shall be calculated separately for children and adults.
Sec. 19. Minnesota Statutes 2000, section 256B.0625, is amended by adding a subdivision to read:
Subd. 43. [TARGETED CASE MANAGEMENT.] For purposes of subdivisions 43a to 43h, the following terms have the meanings given them:
(1) "Home care service recipients" means those individuals receiving the following services under section 256B.0627: skilled nursing visits, home health aide visits, private duty nursing, personal care assistants, or therapies provided through a home health agency.
(2) "Home care targeted case management" means the provision of targeted case management services for the purpose of assisting home care service recipients to gain access to needed services and supports so that they may remain in the community.
(3) "Institutions" means hospitals, consistent with Code of Federal Regulations, title 42, section 440.10; regional treatment center inpatient services, consistent with section 245.474; nursing facilities; and intermediate care facilities for persons with mental retardation.
(4) "Relocation targeted case management" means the provision of targeted case management services for the purpose of assisting recipients to gain access to needed services and supports if they choose to move from an institution to the community. Relocation targeted case management may be provided during the last 180 consecutive days of an eligible recipient's institutional stay.
(5) "Targeted case management" means case management services provided to help recipients gain access to needed medical, social, educational, and other services and supports.
Sec. 20. Minnesota Statutes 2000, section 256B.0625, is amended by adding a subdivision to read:
Subd. 43a. [ELIGIBILITY.] The following persons are eligible for relocation targeted case management or home care targeted case management:
(1) medical assistance eligible persons residing in institutions who choose to move into the community are eligible for relocation targeted case management services; and
(2) medical assistance eligible persons receiving home care services, who are not eligible for any other medical assistance reimbursable case management service, are eligible for home care targeted case management services beginning January 1, 2003.
Sec. 21. Minnesota Statutes 2000, section 256B.0625, is amended by adding a subdivision to read:
Subd. 43b. [RELOCATION TARGETED CASE MANAGEMENT PROVIDER QUALIFICATIONS.] The following qualifications and certification standards must be met by providers of relocation targeted case management:
(a) The commissioner must certify each provider of relocation targeted case management before enrollment. The certification process shall examine the provider's ability to meet the requirements in this subdivision and other federal and state requirements of this service. A certified relocation targeted case management provider may subcontract with another provider to deliver relocation targeted case management services. Subcontracted providers must demonstrate the ability to provide the services outlined in subdivision 43d.
(b) A relocation targeted case management provider is an enrolled medical assistance provider who is determined by the commissioner to have all of the following characteristics:
(1) the legal authority to provide public welfare under sections 393.01, subdivision 7; and 393.07, or a federally recognized Indian tribe;
(2) the demonstrated capacity and experience to provide the components of case management to coordinate and link community resources needed by the eligible population;
(3) the administrative capacity and experience to serve the target population for whom it will provide services and ensure quality of services under state and federal requirements;
(4) the legal authority to provide complete investigative and protective services under section 626.556, subdivision 10, and child welfare and foster care services under section 393.07, subdivisions 1 and 2, or a federally recognized Indian tribe;
(5) a financial management system that provides accurate documentation of services and costs under state and federal requirements; and
(6) the capacity to document and maintain individual case records under state and federal requirements.
A provider of targeted case management under subdivision 20 may be deemed a certified provider of relocation targeted case management.
Sec. 22. Minnesota Statutes 2000, section 256B.0625, is amended by adding a subdivision to read:
Subd. 43c. [HOME CARE TARGETED CASE MANAGEMENT PROVIDER QUALIFICATIONS.] The following qualifications and certification standards must be met by providers of home care targeted case management.
(a) The commissioner must certify each provider of home care targeted case management before enrollment. The certification process shall examine the provider's ability to meet the requirements in this subdivision and other state and federal requirements of this service.
(b) A home care targeted case management provider is an enrolled medical assistance provider who has a minimum of a bachelor's degree or a license in a health or human services field, and 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) the administrative capacity and experience to serve the target population for whom it will provide services and ensure 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 capacity to coordinate with county administrative functions.
Sec. 23. Minnesota Statutes 2000, section 256B.0625, is amended by adding a subdivision to read:
Subd. 43d. [ELIGIBLE SERVICES.] Services eligible for medical assistance reimbursement as targeted case management include:
(1) assessment of the recipient's need for targeted case management services;
(2) development, completion, and regular review of a written individual service plan, which is based upon the assessment of the recipient's needs and choices, and which will ensure access to medical, social, educational, and other related services and supports;
(3) routine contact or communication with the recipient, recipient's family, primary caregiver, legal representative, substitute care provider, service providers, or other relevant persons identified as necessary to the development or implementation of the goals of the individual service plan;
(4) coordinating referrals for, and the provision of, case management services for the recipient with appropriate service providers, consistent with section 1902(a)(23) of the Social Security Act;
(5) coordinating and monitoring the overall service delivery to ensure quality of services, appropriateness, and continued need;
(6) completing and maintaining necessary documentation that supports and verifies the activities in this subdivision;
(7) traveling to conduct a visit with the recipient or other relevant person necessary to develop or implement the goals of the individual service plan; and
(8) coordinating with the institution discharge planner in the 180-day period before the recipient's discharge.
Sec. 24. Minnesota Statutes 2000, section 256B.0625, is amended by adding a subdivision to read:
Subd. 43e. [TIME LINES.] The following time lines must be met for assigning a case manager:
(1) for relocation targeted case management, an eligible recipient must be assigned a case manager who visits the person within 20 working days of requesting a case manager from their county of financial responsibility as determined under chapter 256G. If a county agency does not provide case management services as required, the recipient may, after written notice to the county agency, obtain targeted relocation case management services from a home care targeted case management provider, as defined in subdivision 43c; and
(2) for home care targeted case management, an eligible recipient must be assigned a case manager within 20 working days of requesting a case manager from a home care targeted case management provider, as defined in subdivision 43c.
Sec. 25. Minnesota Statutes 2000, section 256B.0625, is amended by adding a subdivision to read:
Subd. 43f. [EVALUATION.] The commissioner shall evaluate the delivery of targeted case management, including, but not limited to, access to case management services, consumer satisfaction with case management services, and quality of case management services.
Sec. 26. Minnesota Statutes 2000, section 256B.0625, is amended by adding a subdivision to read:
Subd. 43g. [CONTACT DOCUMENTATION.] The case manager must document each face-to-face and telephone contact with the recipient and others involved in the recipient's individual service plan.
Sec. 27. Minnesota Statutes 2000, section 256B.0625, is amended by adding a subdivision to read:
Subd. 43h. [PAYMENT RATES.] The commissioner shall set payment rates for targeted case management under this subdivision. Case managers may bill according to the following criteria:
(1) for relocation targeted case management, case managers may bill for direct case management activities, including face-to-face and telephone contacts, in the 180 days preceding an eligible recipient's discharge from an institution;
(2) for home care targeted case management, case managers may bill for direct case management activities, including face-to-face and telephone contacts; and
(3) billings for targeted case management services under this subdivision shall not duplicate payments made under other program authorities for the same purpose.
Sec. 28. Minnesota Statutes 2000, section 256B.0627, subdivision 1, is amended to read:
Subdivision 1. [DEFINITION.] (a) "Activities of daily living" includes eating, toileting, grooming, dressing, bathing, transferring, mobility, and positioning.
(b) "Assessment" means a review and evaluation of a recipient's need for home care services conducted in person. Assessments for private duty nursing shall be conducted by a registered private duty nurse. Assessments for home health agency services shall be conducted by a home health agency nurse. 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, 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. 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 for medical assistance home care services for mental retardation or related conditions and alternative care services for developmentally disabled home and community-based waivered recipients may be conducted by the county public health nurse to ensure coordination and avoid duplication. 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 party.
(b) (c) "Care plan" means a written description of personal care assistant services developed by
the qualified professional or the recipient's physician with the recipient or responsible party to be used by
the personal care assistant with a copy provided to the recipient or responsible party.
(d) "Complex and regular private duty nursing care" means, effective July 1, 2001:
(1) complex care is private duty nursing provided to recipients who are ventilator dependent or for whom a physician has certified that were it not for private duty nursing the recipient would meet the criteria for inpatient hospital intensive care unit (ICU) level of care; and
(2) regular care is private duty nursing provided to all other recipients.
(e) "Health-related functions" means functions that can be delegated or assigned by a licensed health care professional under state law to be performed by a personal care attendant.
(c) (f) "Home care services" means a health service, determined by the commissioner as
medically necessary, that is ordered by a physician and documented in a service plan that is reviewed by the
physician at least once every 62 60 days for the provision of home health services, or private duty
nursing, or at least once every 365 days for personal care. Home care services are provided to the recipient at the
recipient's residence that is a place other than a hospital or long-term care facility or as specified in section
256B.0625.
(g) "Instrumental activities of daily living" includes meal planning and preparation, managing finances, shopping for food, clothing, and other essential items, performing essential household chores, communication by telephone and other media, and getting around and participating in the community.
(d) (h) "Medically necessary" has the meaning given in Minnesota Rules, parts 9505.0170 to
9505.0475.
(e) (i) "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 Minnesota Rules, part 9505.0335, subpart 3, items A to D;
(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; and
(6) is subject to criminal background checks and procedures specified in section 245A.04.
(f) (j) "Personal care provider organization" means an organization enrolled to provide personal
care assistant services under the medical assistance program that complies with the following: (1) owners
who have a five percent interest or more, and managerial officials are subject to a background study as provided in
section 245A.04. This applies to currently enrolled personal care provider organizations and those agencies seeking
enrollment as a personal care provider organization. An organization will be barred from enrollment if an owner
or managerial official of the organization has been convicted of a crime specified in section 245A.04, or a
comparable crime in another jurisdiction, unless the owner or managerial official meets the reconsideration criteria
specified in section 245A.04; (2) the organization must maintain a surety bond and liability insurance throughout
the duration of
enrollment and provides proof thereof. The insurer must notify the department of human services of the cancellation or lapse of policy; and (3) the organization must maintain documentation of services as specified in Minnesota Rules, part 9505.2175, subpart 7, as well as evidence of compliance with personal care assistant training requirements.
(g) (k) "Responsible party" means an individual residing with a recipient of personal care
assistant services who is capable of providing the supportive care necessary to assist the recipient to live
in the community, is at least 18 years old, and is not a personal care assistant. Responsible parties who are parents
of minors or guardians of minors or incapacitated persons may delegate the responsibility to another adult during
a temporary absence of at least 24 hours but not more than six months. The person delegated as a responsible party
must be able to meet the definition of responsible party, except that the delegated responsible party is required to
reside with the recipient only while serving as the responsible party. Foster care license holders may be designated
the responsible party for residents of the foster care home if case management is provided as required in section
256B.0625, subdivision 19a. For persons who, as of April 1, 1992, are sharing personal care assistant
services in order to obtain the availability of 24-hour coverage, an employee of the personal care provider
organization may be designated as the responsible party if case management is provided as required in section
256B.0625, subdivision 19a.
(h) (l) "Service plan" means a written description of the services needed based on the assessment
developed by the nurse who conducts the assessment together with the recipient or responsible party. The service
plan shall include a description of the covered home care services, frequency and duration of services, and expected
outcomes and goals. The recipient and the provider chosen by the recipient or responsible party must be given a copy
of the completed service plan within 30 calendar days of the request for home care services by the recipient or
responsible party.
(i) (m) "Skilled nurse visits" are provided in a recipient's residence under a plan of care or service
plan that specifies a level of care which the nurse is qualified to provide. These services are:
(1) nursing services according to the written plan of care or service plan and accepted standards of medical and nursing practice in accordance with chapter 148;
(2) services which due to the recipient's medical condition may only be safely and effectively provided by a registered nurse or a licensed practical nurse;
(3) assessments performed only by a registered nurse; and
(4) teaching and training the recipient, the recipient's family, or other caregivers requiring the skills of a registered nurse or licensed practical nurse.
(n) "Telehomecare" means the use of telecommunications technology by a home health care professional to deliver home health care services, within the professional's scope of practice, to a patient located at a site other than the site where the practitioner is located.
Sec. 29. Minnesota Statutes 2000, section 256B.0627, subdivision 2, is amended to read:
Subd. 2. [SERVICES COVERED.] Home care services covered under this section include:
(1) nursing services under section 256B.0625, subdivision 6a;
(2) private duty nursing services under section 256B.0625, subdivision 7;
(3) home health aide services under section 256B.0625, subdivision 6a;
(4) personal care assistant services under section 256B.0625, subdivision 19a;
(5) supervision of personal care assistant services provided by a qualified professional under section 256B.0625, subdivision 19a;
(6) consulting qualified professional of personal care assistant services under the fiscal
agent intermediary option as specified in subdivision 10;
(7) face-to-face assessments by county public health nurses for services under section 256B.0625, subdivision 19a; and
(8) service updates and review of temporary increases for personal care assistant services by the county public health nurse for services under section 256B.0625, subdivision 19a.
Sec. 30. Minnesota Statutes 2000, section 256B.0627, subdivision 4, is amended to read:
Subd. 4. [PERSONAL CARE ASSISTANT SERVICES.] (a) The personal care assistant
services that are eligible for payment are the following: services and supports furnished to an individual,
as needed, to assist in accomplishing activities of daily living; instrumental activities of daily living; health-related
functions through hands-on assistance, supervision, and cuing; and redirection and intervention for behavior
including observation and monitoring.
(b) Payment for services will be made within the limits approved using the prior authorized process established in subdivision 5.
(c) The amount and type of services authorized shall be based on an assessment of the recipient's needs in these areas:
(1) bowel and bladder care;
(2) skin care to maintain the health of the skin;
(3) repetitive maintenance range of motion, muscle strengthening exercises, and other tasks specific to maintaining a recipient's optimal level of function;
(4) respiratory assistance;
(5) transfers and ambulation;
(6) bathing, grooming, and hairwashing necessary for personal hygiene;
(7) turning and positioning;
(8) assistance with furnishing medication that is self-administered;
(9) application and maintenance of prosthetics and orthotics;
(10) cleaning medical equipment;
(11) dressing or undressing;
(12) assistance with eating and meal preparation and necessary grocery shopping;
(13) accompanying a recipient to obtain medical diagnosis or treatment;
(14) assisting, monitoring, or prompting the recipient to complete the services in clauses (1) to (13);
(15) redirection, monitoring, and observation that are medically necessary and an integral part of completing the personal care assistant services described in clauses (1) to (14);
(16) redirection and intervention for behavior, including observation and monitoring;
(17) interventions for seizure disorders, including monitoring and observation if the recipient has had a seizure that requires intervention within the past three months;
(18) tracheostomy suctioning using a clean procedure if the procedure is properly delegated by a registered nurse. Before this procedure can be delegated to a personal care assistant, a registered nurse must determine that the tracheostomy suctioning can be accomplished utilizing a clean rather than a sterile procedure and must ensure that the personal care assistant has been taught the proper procedure; and
(19) incidental household services that are an integral part of a personal care service described in clauses (1) to (18).
For purposes of this subdivision, monitoring and observation means watching for outward visible signs that are likely to occur and for which there is a covered personal care service or an appropriate personal care intervention. For purposes of this subdivision, a clean procedure refers to a procedure that reduces the numbers of microorganisms or prevents or reduces the transmission of microorganisms from one person or place to another. A clean procedure may be used beginning 14 days after insertion.
(b) (d) The personal care assistant services that are not eligible for payment are the
following:
(1) services not ordered by the physician;
(2) assessments by personal care assistant provider organizations or by independently enrolled registered nurses;
(3) services that are not in the service plan;
(4) services provided by the recipient's spouse, legal guardian for an adult or child recipient, or parent of a recipient under age 18;
(5) services provided by a foster care provider of a recipient who cannot direct the recipient's own care, unless monitored by a county or state case manager under section 256B.0625, subdivision 19a;
(6) services provided by the residential or program license holder in a residence for more than four persons;
(7) services that are the responsibility of a residential or program license holder under the terms of a service agreement and administrative rules;
(8) sterile procedures;
(9) injections of fluids into veins, muscles, or skin;
(10) services provided by parents of adult recipients, adult children, or siblings of the recipient, unless these relatives meet one of the following hardship criteria and the commissioner waives this requirement:
(i) the relative resigns from a part-time or full-time job to provide personal care for the recipient;
(ii) the relative goes from a full-time to a part-time job with less compensation to provide personal care for the recipient;
(iii) the relative takes a leave of absence without pay to provide personal care for the recipient;
(iv) the relative incurs substantial expenses by providing personal care for the recipient; or
(v) because of labor conditions, special language needs, or intermittent hours of care needed, the relative is needed in order to provide an adequate number of qualified personal care assistants to meet the medical needs of the recipient;
(11) homemaker services that are not an integral part of a personal care assistant services;
(12) home maintenance, or chore services;
(13) services not specified under paragraph (a); and
(14) services not authorized by the commissioner or the commissioner's designee.
(e) The recipient or responsible party may choose to supervise the personal care assistant or to have a qualified professional, as defined in section 256B.0625, subdivision 19c, provide the supervision. As required under section 256B.0625, subdivision 19c, the county public health nurse, as a part of the assessment, will assist the recipient or responsible party to identify the most appropriate person to provide supervision of the personal care assistant. Health-related delegated tasks performed by the personal care assistant will be under the supervision of a qualified professional or the direction of the recipient's physician. If the recipient has a qualified professional, Minnesota Rules, part 9505.0335, subpart 4, applies.
Sec. 31. Minnesota Statutes 2000, section 256B.0627, subdivision 5, is amended to read:
Subd. 5. [LIMITATION ON PAYMENTS.] Medical assistance payments for home care services shall be limited according to this subdivision.
(a) [LIMITS ON SERVICES WITHOUT PRIOR AUTHORIZATION.] A recipient may receive the following home care services during a calendar year:
(1) up to two face-to-face assessments to determine a recipient's need for personal care assistant services;
(2) one service update done to determine a recipient's need for personal care assistant services; and
(3) up to five nine skilled nurse visits.
(b) [PRIOR AUTHORIZATION; EXCEPTIONS.] All home care services above the limits in paragraph (a) must receive the commissioner's prior authorization, except when:
(1) the home care services were required to treat an emergency medical condition that if not immediately treated could cause a recipient serious physical or mental disability, continuation of severe pain, or death. The provider must request retroactive authorization no later than five working days after giving the initial service. The provider must be able to substantiate the emergency by documentation such as reports, notes, and admission or discharge histories;
(2) the home care services were provided on or after the date on which the recipient's eligibility began, but before the date on which the recipient was notified that the case was opened. Authorization will be considered if the request is submitted by the provider within 20 working days of the date the recipient was notified that the case was opened;
(3) a third-party payor for home care services has denied or adjusted a payment. Authorization requests must be submitted by the provider within 20 working days of the notice of denial or adjustment. A copy of the notice must be included with the request;
(4) the commissioner has determined that a county or state human services agency has made an error; or
(5) the professional nurse determines an immediate need for up to 40 skilled nursing or home health aide visits per calendar year and submits a request for authorization within 20 working days of the initial service date, and medical assistance is determined to be the appropriate payer.
(c) [RETROACTIVE AUTHORIZATION.] A request for retroactive authorization will be evaluated according to the same criteria applied to prior authorization requests.
(d) [ASSESSMENT AND SERVICE PLAN.] Assessments under section 256B.0627, 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. Within 30 days of recipient or responsible party 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. 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 medical 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. 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.
(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 subdivision 1.
(e) [PRIOR AUTHORIZATION.] The commissioner, or the commissioner's designee, shall review the assessment, service update, request for temporary services, service plan, and any additional information that is submitted. The commissioner shall, within 30 days after receiving a complete request, assessment, and service plan, authorize home care services as follows:
(1) [HOME HEALTH SERVICES.] All home health services provided by a licensed nurse or a home
health aide must be prior authorized by the commissioner or the commissioner's designee. Prior authorization must
be based on medical necessity and cost-effectiveness when compared with other care options. When home health
services are used in combination with personal care and private duty nursing, the cost of all home care services shall
be considered for cost-effectiveness. The commissioner shall limit nurse and home health aide visits to no
more than one visit each per day. The commissioner, or the commissioner's designee, may authorize up to two
skilled nurse visits per day.
(2) [PERSONAL CARE ASSISTANT SERVICES.] (i) All personal care assistant services and supervision by a qualified professional, if requested by the recipient, must be prior authorized by the commissioner or the commissioner's designee except for the assessments established in paragraph (a). The amount of personal care assistant services authorized must be based on the recipient's home care rating. A child may not be found to be dependent in an activity of daily living if because of the child's age an adult would either perform the activity for the child or assist the child with the activity and the amount of assistance needed is similar to the assistance appropriate for a typical child of the same age. Based on medical necessity, the commissioner may authorize:
(A) up to two times the average number of direct care hours provided in nursing facilities for the recipient's comparable case mix level; or
(B) up to three times the average number of direct care hours provided in nursing facilities for recipients who have complex medical needs or are dependent in at least seven activities of daily living and need physical assistance with eating or have a neurological diagnosis; or
(C) up to 60 percent of the average reimbursement rate, as of July 1, 1991, for care provided in a regional treatment center for recipients who have Level I behavior, plus any inflation adjustment as provided by the legislature for personal care service; or
(D) up to the amount the commissioner would pay, as of July 1, 1991, plus any inflation adjustment provided for home care services, for care provided in a regional treatment center for recipients referred to the commissioner by a regional treatment center preadmission evaluation team. For purposes of this clause, home care services means all services provided in the home or community that would be included in the payment to a regional treatment center; or
(E) up to the amount medical assistance would reimburse for facility care for recipients referred to the commissioner by a preadmission screening team established under section 256B.0911 or 256B.092; and
(F) a reasonable amount of time for the provision of supervision by a qualified professional of personal care assistant services, if a qualified professional is requested by the recipient or responsible party.
(ii) The number of direct care hours shall be determined according to the annual cost report submitted to the department by nursing facilities. The average number of direct care hours, as established by May 1, 1992, shall be calculated and incorporated into the home care limits on July 1, 1992. These limits shall be calculated to the nearest quarter hour.
(iii) The home care rating shall be determined by the commissioner or the commissioner's designee based on information submitted to the commissioner by the county public health nurse on forms specified by the commissioner. The home care rating shall be a combination of current assessment tools developed under sections 256B.0911 and 256B.501 with an addition for seizure activity that will assess the frequency and severity of seizure activity and with adjustments, additions, and clarifications that are necessary to reflect the needs and conditions of recipients who need home care including children and adults under 65 years of age. The commissioner shall establish these forms and protocols under this section and shall use an advisory group, including representatives of recipients, providers, and counties, for consultation in establishing and revising the forms and protocols.
(iv) A recipient shall qualify as having complex medical needs if the care required is difficult to perform and because of recipient's medical condition requires more time than community-based standards allow or requires more skill than would ordinarily be required and the recipient needs or has one or more of the following:
(A) daily tube feedings;
(B) daily parenteral therapy;
(C) wound or decubiti care;
(D) postural drainage, percussion, nebulizer treatments, suctioning, tracheotomy care, oxygen, mechanical ventilation;
(E) catheterization;
(F) ostomy care;
(G) quadriplegia; or
(H) other comparable medical conditions or treatments the commissioner determines would otherwise require institutional care.
(v) A recipient shall qualify as having Level I behavior if there is reasonable supporting evidence that the recipient exhibits, or that without supervision, observation, or redirection would exhibit, one or more of the following behaviors that cause, or have the potential to cause:
(A) injury to the recipient's own body;
(B) physical injury to other people; or
(C) destruction of property.
(vi) Time authorized for personal care relating to Level I behavior in subclause (v), items (A) to (C), shall be based on the predictability, frequency, and amount of intervention required.
(vii) A recipient shall qualify as having Level II behavior if the recipient exhibits on a daily basis one or more of the following behaviors that interfere with the completion of personal care assistant services under subdivision 4, paragraph (a):
(A) unusual or repetitive habits;
(B) withdrawn behavior; or
(C) offensive behavior.
(viii) A recipient with a home care rating of Level II behavior in subclause (vii), items (A) to (C), shall be rated as comparable to a recipient with complex medical needs under subclause (iv). If a recipient has both complex medical needs and Level II behavior, the home care rating shall be the next complex category up to the maximum rating under subclause (i), item (B).
(3) [PRIVATE DUTY NURSING SERVICES.] All private duty nursing services shall be prior authorized by the commissioner or the commissioner's designee. Prior authorization for private duty nursing services shall be based on medical necessity and cost-effectiveness when compared with alternative care options. The commissioner may authorize medically necessary private duty nursing services in quarter-hour units when:
(i) the recipient requires more individual and continuous care than can be provided during a nurse visit; or
(ii) the cares are outside of the scope of services that can be provided by a home health aide or personal care assistant.
The commissioner may authorize:
(A) up to two times the average amount of direct care hours provided in nursing facilities statewide for case mix classification "K" as established by the annual cost report submitted to the department by nursing facilities in May 1992;
(B) private duty nursing in combination with other home care services up to the total cost allowed under clause (2);
(C) up to 16 hours per day if the recipient requires more nursing than the maximum number of direct care hours
as established in item (A) and the recipient meets the hospital admission criteria established under Minnesota Rules,
parts 9505.0500 9505.0501 to 9505.0540.
The commissioner may authorize up to 16 hours per day of medically necessary private duty nursing services or up to 24 hours per day of medically necessary private duty nursing services until such time as the commissioner is able to make a determination of eligibility for recipients who are cooperatively applying for home care services under
the community alternative care program developed under section 256B.49, or until it is determined by the appropriate regulatory agency that a health benefit plan is or is not required to pay for appropriate medically necessary health care services. Recipients or their representatives must cooperatively assist the commissioner in obtaining this determination. Recipients who are eligible for the community alternative care program may not receive more hours of nursing under this section than would otherwise be authorized under section 256B.49.
Beginning July 1, 2001, private duty nursing services shall be authorized for complex and regular care according to subdivision 1.
(4) [VENTILATOR-DEPENDENT RECIPIENTS.] If the recipient is ventilator-dependent, the monthly medical assistance authorization for home care services shall not exceed what the commissioner would pay for care at the highest cost hospital designated as a long-term hospital under the Medicare program. For purposes of this clause, home care services means all services provided in the home that would be included in the payment for care at the long-term hospital. "Ventilator-dependent" means an individual who receives mechanical ventilation for life support at least six hours per day and is expected to be or has been dependent for at least 30 consecutive days.
(f) [PRIOR AUTHORIZATION; TIME LIMITS.] The commissioner or the commissioner's designee shall determine the time period for which a prior authorization shall be effective. 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. Under no circumstances, other than the exceptions in paragraph (b), 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 paragraph (h), 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.
(g) [APPROVAL OF HOME CARE SERVICES.] The commissioner or the commissioner's designee shall determine the medical necessity of home care services, the level of caregiver according to subdivision 2, and the institutional comparison according to this subdivision, the cost-effectiveness of services, and the amount, scope, and duration of home care services reimbursable by medical assistance, based on the assessment, primary payer coverage determination information as required, the service plan, the recipient's age, the cost of services, the recipient's medical condition, and diagnosis or disability. The commissioner may publish additional criteria for determining medical necessity according to section 256B.04.
(h) [PRIOR AUTHORIZATION REQUESTS; TEMPORARY SERVICES.] The agency nurse, the independently enrolled private duty nurse, or county public health nurse may request a temporary authorization for home care services by telephone. The commissioner may approve a temporary level of home care services based on the assessment, and service or care plan information, and primary payer coverage determination information as required. Authorization for a temporary level of home care services including nurse supervision is limited to the time specified by the commissioner, but shall not exceed 45 days, unless extended because the county public health nurse has not completed the required assessment and service plan, or the commissioner's determination has not been made. The level of services authorized under this provision shall have no bearing on a future prior authorization.
(i) [PRIOR AUTHORIZATION REQUIRED IN FOSTER CARE SETTING.] Home care services provided in an adult or child foster care setting must receive prior authorization by the department according to the limits established in paragraph (a).
The commissioner may not authorize:
(1) home care services that are the responsibility of the foster care provider under the terms of the foster care placement agreement and administrative rules;
(2) personal care assistant services when the foster care license holder is also the personal care provider or personal care assistant unless the recipient can direct the recipient's own care, or case management is provided as required in section 256B.0625, subdivision 19a;
(3) personal care assistant services when the responsible party is an employee of, or under contract with, or has any direct or indirect financial relationship with the personal care provider or personal care assistant, unless case management is provided as required in section 256B.0625, subdivision 19a; or
(4) personal care assistant and private duty nursing services when the number of foster care residents is greater than four unless the county responsible for the recipient's foster placement made the placement prior to April 1, 1992, requests that personal care assistant and private duty nursing services be provided, and case management is provided as required in section 256B.0625, subdivision 19a.
Sec. 32. Minnesota Statutes 2000, section 256B.0627, subdivision 7, is amended to read:
Subd. 7. [NONCOVERED HOME CARE SERVICES.] The following home care services are not eligible for payment under medical assistance:
(1) skilled nurse visits for the sole purpose of supervision of the home health aide;
(2) a skilled nursing visit:
(i) only for the purpose of monitoring medication compliance with an established medication program for a recipient; or
(ii) to administer or assist with medication administration, including injections, prefilling syringes for injections, or oral medication set-up of an adult recipient, when as determined and documented by the registered nurse, the need can be met by an available pharmacy or the recipient is physically and mentally able to self-administer or prefill a medication;
(3) home care services to a recipient who is eligible for covered services including hospice, if elected by the
recipient, under the Medicare program or any other insurance held by the recipient;
(4) services to other members of the recipient's household;
(5) a visit made by a skilled nurse solely to train other home health agency workers;
(6) any home care service included in the daily rate of the community-based residential facility where the recipient is residing;
(7) nursing and rehabilitation therapy services that are reasonably accessible to a recipient outside the recipient's place of residence, excluding the assessment, counseling and education, and personal assistant care;
(8) any home health agency service, excluding personal care assistant services and private duty nursing services, which are performed in a place other than the recipient's residence; and
(9) Medicare evaluation or administrative nursing visits on dual-eligible recipients that do not qualify for Medicare visit billing.
Sec. 33. Minnesota Statutes 2000, section 256B.0627, subdivision 8, is amended to read:
Subd. 8. [SHARED PERSONAL CARE ASSISTANT SERVICES.] (a) Medical assistance payments for shared personal care assistance services shall be limited according to this subdivision.
(b) Recipients of personal care assistant services may share staff and the commissioner shall provide a rate system for shared personal care assistant services. For two persons sharing services, the rate paid to a provider shall not exceed 1-1/2 times the rate paid for serving a single individual, and for three persons sharing services, the rate paid
to a provider shall not exceed twice the rate paid for serving a single individual. These rates apply only to situations in which all recipients were present and received shared services on the date for which the service is billed. No more than three persons may receive shared services from a personal care assistant in a single setting.
(c) Shared service is the provision of personal care assistant services by a personal care assistant to two or three recipients at the same time and in the same setting. For the purposes of this subdivision, "setting" means:
(1) the home or foster care home of one of the individual recipients; or
(2) a child care program in which all recipients served by one personal care assistant are participating, which is licensed under chapter 245A or operated by a local school district or private school; or
(3) outside the home or foster care home of one of the recipients when normal life activities take the recipients outside the home.
The provisions of this subdivision do not apply when a personal care assistant is caring for multiple recipients in more than one setting.
(d) The recipient or the recipient's responsible party, in conjunction with the county public health nurse, shall determine:
(1) whether shared personal care assistant services is an appropriate option based on the individual needs and preferences of the recipient; and
(2) the amount of shared services allocated as part of the overall authorization of personal care assistant services.
The recipient or the responsible party, in conjunction with the supervising qualified professional, if a qualified professional is requested by any one of the recipients or responsible parties, shall arrange the setting and grouping of shared services based on the individual needs and preferences of the recipients. Decisions on the selection of recipients to share services must be based on the ages of the recipients, compatibility, and coordination of their care needs.
(e) The following items must be considered by the recipient or the responsible party and the supervising qualified professional, if a qualified professional has been requested by any one of the recipients or responsible parties, and documented in the recipient's health service record:
(1) the additional qualifications needed by the personal care assistant to provide care to several recipients in the same setting;
(2) the additional training and supervision needed by the personal care assistant to ensure that the needs of the recipient are met appropriately and safely. The provider must provide on-site supervision by a qualified professional within the first 14 days of shared services, and monthly thereafter, if supervision by a qualified provider has been requested by any one of the recipients or responsible parties;
(3) the setting in which the shared services will be provided;
(4) the ongoing monitoring and evaluation of the effectiveness and appropriateness of the service and process used to make changes in service or setting; and
(5) a contingency plan which accounts for absence of the recipient in a shared services setting due to illness or other circumstances and staffing contingencies.
(f) The provider must offer the recipient or the responsible party the option of shared or one-on-one personal care assistant services. The recipient or the responsible party can withdraw from participating in a shared services arrangement at any time.
(g) In addition to documentation requirements under Minnesota Rules, part 9505.2175, a personal care provider must meet documentation requirements for shared personal care assistant services and must document the following in the health service record for each individual recipient sharing services:
(1) permission by the recipient or the recipient's responsible party, if any, for the maximum number of shared services hours per week chosen by the recipient;
(2) permission by the recipient or the recipient's responsible party, if any, for personal care assistant services provided outside the recipient's residence;
(3) permission by the recipient or the recipient's responsible party, if any, for others to receive shared services in the recipient's residence;
(4) revocation by the recipient or the recipient's responsible party, if any, of the shared service authorization, or the shared service to be provided to others in the recipient's residence, or the shared service to be provided outside the recipient's residence;
(5) supervision of the shared personal care assistant services by the qualified professional, if a qualified professional is requested by one of the recipients or responsible parties, including the date, time of day, number of hours spent supervising the provision of shared services, whether the supervision was face-to-face or another method of supervision, changes in the recipient's condition, shared services scheduling issues and recommendations;
(6) documentation by the qualified professional, if a qualified professional is requested by one of the recipients or responsible parties, of telephone calls or other discussions with the personal care assistant regarding services being provided to the recipient who has requested the supervision; and
(7) daily documentation of the shared services provided by each identified personal care assistant including:
(i) the names of each recipient receiving shared services together;
(ii) the setting for the shared services, including the starting and ending times that the recipient received shared services; and
(iii) notes by the personal care assistant regarding changes in the recipient's condition, problems that may arise from the sharing of services, scheduling issues, care issues, and other notes as required by the qualified professional, if a qualified professional is requested by one of the recipients or responsible parties.
(h) Unless otherwise provided in this subdivision, all other statutory and regulatory provisions relating to personal care assistant services apply to shared services.
(i) In the event that supervision by a qualified professional has been requested by one or more recipients, but not by all of the recipients, the supervision duties of the qualified professional shall be limited to only those recipients who have requested the supervision.
Nothing in this subdivision shall be construed to reduce the total number of hours authorized for an individual recipient.
Sec. 34. Minnesota Statutes 2000, section 256B.0627, subdivision 10, is amended to read:
Subd. 10. [FISCAL AGENT INTERMEDIARY OPTION AVAILABLE FOR PERSONAL
CARE ASSISTANT SERVICES.] (a) "Fiscal agent option" is an option that allows the recipient to:
(1) use a fiscal agent instead of a personal care provider organization;
(2) supervise the personal care assistant; and
(3) use a consulting professional.
The commissioner may allow a recipient of personal care assistant services to use a fiscal agent
intermediary to assist the recipient in paying and accounting for medically necessary covered personal care
assistant services authorized in subdivision 4 and within the payment parameters of subdivision 5. Unless otherwise
provided in this subdivision, all other statutory and regulatory provisions relating to personal care assistant
services apply to a recipient using the fiscal agent intermediary option.
(b) The recipient or responsible party shall:
(1) hire, and terminate the personal care assistant and consulting professional, with the fiscal agent
recruit, hire, and terminate a qualified professional, if a qualified professional is requested by the recipient or
responsible party;
(2) recruit the personal care assistant and consulting professional and orient and train the personal care
assistant in areas that do not require professional delegation as determined by the county public health nurse
verify and document the credentials of the qualified professional, if a qualified professional is requested by the
recipient or responsible party;
(3) supervise and evaluate the personal care assistant in areas that do not require professional delegation as
determined in the assessment;
(4) cooperate with a consulting develop a service plan based on physician orders and public health
nurse assessment with the assistance of a qualified professional and implement recommendations pertaining
to the health and safety of the recipient, if a qualified professional is requested by the recipient or responsible
party, that addresses the health and safety of the recipient;
(5) hire a qualified professional to train and supervise the performance of delegated tasks done by (4)
recruit, hire, and terminate the personal care assistant;
(6) monitor services and verify in writing the hours worked by the personal care assistant and the
consulting (5) orient and train the personal care assistant with assistance as needed from the qualified
professional;
(7) develop and revise a care plan with assistance from a consulting (6) supervise and evaluate the
personal care assistant with assistance as needed from the recipient's physician or the qualified professional;
(8) verify and document the credentials of the consulting (7) monitor and verify in writing and report
to the fiscal intermediary the number of hours worked by the personal care assistant and the qualified
professional; and
(9) (8) enter into a written agreement, as specified in paragraph (f).
(c) The duties of the fiscal agent intermediary shall be to:
(1) bill the medical assistance program for personal care assistant and consulting qualified
professional services;
(2) request and secure background checks on personal care assistants and consulting qualified
professionals according to section 245A.04;
(3) pay the personal care assistant and consulting qualified professional based on actual hours
of services provided;
(4) withhold and pay all applicable federal and state taxes;
(5) verify and document keep records of hours worked by the personal care assistant and
consulting qualified professional;
(6) make the arrangements and pay unemployment insurance, taxes, workers' compensation, liability insurance, and other benefits, if any;
(7) enroll in the medical assistance program as a fiscal agent intermediary; and
(8) enter into a written agreement as specified in paragraph (f) before services are provided.
(d) The fiscal agent intermediary:
(1) may not be related to the recipient, consulting qualified professional, or the personal care
assistant;
(2) must ensure arm's length transactions with the recipient and personal care assistant; and
(3) shall be considered a joint employer of the personal care assistant and consulting qualified
professional to the extent specified in this section.
The fiscal agent intermediary or owners of the entity that provides fiscal agent
intermediary services under this subdivision must pass a criminal background check as required in section
256B.0627, subdivision 1, paragraph (e).
(e) If the recipient or responsible party requests a qualified professional, the consulting
qualified professional providing assistance to the recipient shall meet the qualifications specified in section
256B.0625, subdivision 19c. The consulting qualified professional shall assist the recipient in
developing and revising a plan to meet the recipient's assessed needs, and supervise the performance of
delegated tasks, as determined by the public health nurse as assessed by the public health nurse. In
performing this function, the consulting qualified professional must visit the recipient in the
recipient's home at least once annually. The consulting qualified professional must report to
the local county public health nurse concerns relating to the health and safety of the recipient, and any suspected
abuse, neglect, or financial exploitation of the recipient to the appropriate authorities.
(f) The fiscal agent intermediary, recipient or responsible party, personal care assistant, and
consulting qualified professional shall enter into a written agreement before services are started.
The agreement shall include:
(1) the duties of the recipient, qualified professional, personal care assistant, and fiscal agent based on paragraphs (a) to (e);
(2) the salary and benefits for the personal care assistant and those providing professional consultation
the qualified professional;
(3) the administrative fee of the fiscal agent intermediary and services paid for with that fee,
including background check fees;
(4) procedures to respond to billing or payment complaints; and
(5) procedures for hiring and terminating the personal care assistant and those providing professional
consultation the qualified professional.
(g) The rates paid for personal care assistant services, qualified professional assistance
services, and fiscal agency intermediary services under this subdivision shall be the same
rates paid for personal care assistant services and qualified professional services under subdivision 2
respectively. Except for the administrative fee of the fiscal agent intermediary specified in
paragraph (f), the remainder of the rates paid to the fiscal agent intermediary must be used to pay
for the salary and benefits for the personal care assistant or those providing professional consultation the
qualified professional.
(h) As part of the assessment defined in subdivision 1, the following conditions must be met to use or continue
use of a fiscal agent intermediary:
(1) the recipient must be able to direct the recipient's own care, or the responsible party for the recipient must be readily available to direct the care of the personal care assistant;
(2) the recipient or responsible party must be knowledgeable of the health care needs of the recipient and be able to effectively communicate those needs;
(3) a face-to-face assessment must be conducted by the local county public health nurse at least annually, or when
there is a significant change in the recipient's condition or change in the need for personal care assistant services.
The county public health nurse shall determine the services that require professional delegation, if any, and the
amount and frequency of related supervision;
(4) the recipient cannot select the shared services option as specified in subdivision 8; and
(5) parties must be in compliance with the written agreement specified in paragraph (f).
(i) The commissioner shall deny, revoke, or suspend the authorization to use the fiscal agent
intermediary option if:
(1) it has been determined by the consulting qualified professional or local county public health
nurse that the use of this option jeopardizes the recipient's health and safety;
(2) the parties have failed to comply with the written agreement specified in paragraph (f); or
(3) the use of the option has led to abusive or fraudulent billing for personal care assistant services.
The recipient or responsible party may appeal the commissioner's action according to section 256.045. The denial,
revocation, or suspension to use the fiscal agent intermediary option shall not affect the recipient's
authorized level of personal care assistant services as determined in subdivision 5.
Sec. 35. Minnesota Statutes 2000, section 256B.0627, subdivision 11, is amended to read:
Subd. 11. [SHARED PRIVATE DUTY NURSING CARE OPTION.] (a) Medical assistance payments for shared private duty nursing services by a private duty nurse shall be limited according to this subdivision. For the purposes of this section, "private duty nursing agency" means an agency licensed under chapter 144A to provide private duty nursing services.
(b) Recipients of private duty nursing services may share nursing staff and the commissioner shall provide a rate
methodology for shared private duty nursing. For two persons sharing nursing care, the rate paid to a provider shall
not exceed 1.5 times the nonwaivered regular private duty nursing rates paid for serving a single
individual who is not ventilator dependent, by a registered nurse or licensed practical nurse. These rates
apply only to situations in which both recipients are present and receive shared private duty nursing care on the date
for which the service is billed. No more than two persons may receive shared private duty nursing services from a
private duty nurse in a single setting.
(c) Shared private duty nursing care is the provision of nursing services by a private duty nurse to two recipients at the same time and in the same setting. For the purposes of this subdivision, "setting" means:
(1) the home or foster care home of one of the individual recipients; or
(2) a child care program licensed under chapter 245A or operated by a local school district or private school; or
(3) an adult day care service licensed under chapter 245A; or
(4) outside the home or foster care home of one of the recipients when normal life activities take the recipients outside the home.
This subdivision does not apply when a private duty nurse is caring for multiple recipients in more than one setting.
(d) The recipient or the recipient's legal representative, and the recipient's physician, in conjunction with the home health care agency, shall determine:
(1) whether shared private duty nursing care is an appropriate option based on the individual needs and preferences of the recipient; and
(2) the amount of shared private duty nursing services authorized as part of the overall authorization of nursing services.
(e) The recipient or the recipient's legal representative, in conjunction with the private duty nursing agency, shall approve the setting, grouping, and arrangement of shared private duty nursing care based on the individual needs and preferences of the recipients. Decisions on the selection of recipients to share services must be based on the ages of the recipients, compatibility, and coordination of their care needs.
(f) The following items must be considered by the recipient or the recipient's legal representative and the private duty nursing agency, and documented in the recipient's health service record:
(1) the additional training needed by the private duty nurse to provide care to two recipients in the same setting and to ensure that the needs of the recipients are met appropriately and safely;
(2) the setting in which the shared private duty nursing care will be provided;
(3) the ongoing monitoring and evaluation of the effectiveness and appropriateness of the service and process used to make changes in service or setting;
(4) a contingency plan which accounts for absence of the recipient in a shared private duty nursing setting due to illness or other circumstances;
(5) staffing backup contingencies in the event of employee illness or absence; and
(6) arrangements for additional assistance to respond to urgent or emergency care needs of the recipients.
(g) The provider must offer the recipient or responsible party the option of shared or one-on-one private duty nursing services. The recipient or responsible party can withdraw from participating in a shared service arrangement at any time.
(h) The private duty nursing agency must document the following in the health service record for each individual recipient sharing private duty nursing care:
(1) permission by the recipient or the recipient's legal representative for the maximum number of shared nursing care hours per week chosen by the recipient;
(2) permission by the recipient or the recipient's legal representative for shared private duty nursing services provided outside the recipient's residence;
(3) permission by the recipient or the recipient's legal representative for others to receive shared private duty nursing services in the recipient's residence;
(4) revocation by the recipient or the recipient's legal representative of the shared private duty nursing care authorization, or the shared care to be provided to others in the recipient's residence, or the shared private duty nursing services to be provided outside the recipient's residence; and
(5) daily documentation of the shared private duty nursing services provided by each identified private duty nurse, including:
(i) the names of each recipient receiving shared private duty nursing services together;
(ii) the setting for the shared services, including the starting and ending times that the recipient received shared private duty nursing care; and
(iii) notes by the private duty nurse regarding changes in the recipient's condition, problems that may arise from the sharing of private duty nursing services, and scheduling and care issues.
(i) Unless otherwise provided in this subdivision, all other statutory and regulatory provisions relating to private duty nursing services apply to shared private duty nursing services.
Nothing in this subdivision shall be construed to reduce the total number of private duty nursing hours authorized for an individual recipient under subdivision 5.
Sec. 36. Minnesota Statutes 2000, section 256B.0627, is amended by adding a subdivision to read:
Subd. 13. [CONSUMER-DIRECTED HOME CARE DEMONSTRATION PROJECT.] (a) Upon the receipt of federal waiver authority, the commissioner shall implement a consumer-directed home care demonstration project. The consumer-directed home care demonstration project must demonstrate and evaluate the outcomes of a consumer-directed service delivery alternative to improve access, increase consumer control and accountability over available resources, and enable the use of supports that are more individualized and cost-effective for eligible medical assistance recipients receiving certain medical assistance home care services. The consumer-directed home care demonstration project will be administered locally by county agencies, tribal governments, or administrative entities under contract with the state in regions where counties choose not to provide this service.
(b) Grant awards for persons who have been receiving medical assistance covered personal care, home health aide, or private duty nursing services for a period of 12 consecutive months or more prior to enrollment in the consumer-directed home care demonstration project will be established on a case-by-case basis using historical service expenditure data. An average monthly expenditure for each continuing enrollee will be calculated based on historical expenditures made on behalf of the enrollee for personal care, home health aide, or private duty nursing services during the 12 month period directly prior to enrollment in the project. The grant award will equal 90 percent of the average monthly expenditure.
(c) Grant awards for project enrollees who have been receiving medical assistance covered personal care, home health aide, or private duty nursing services for a period of less than 12 consecutive months prior to project enrollment will be calculated on a case-by-case basis using the service authorization in place at the time of enrollment. The total number of units of personal care, home health aide, or private duty nursing services the enrollee has been authorized to receive will be converted to the total cost of the authorized services in a given month using the statewide average service payment rates. To determine an estimated monthly expenditure, the total authorized monthly personal care, home health aide or private duty nursing service costs will be reduced by a percentage rate equivalent to the difference between the statewide average service authorization and the statewide average utilization rate for each of the services by medical assistance eligibles during the most recent fiscal year for which 12 months of data is available. The grant award will equal 90 percent of the estimated monthly expenditure.
(d) The state of Minnesota, county agencies, tribal governments, or administrative entities under contract with the state that participate in the implementation and administration of the consumer-directed home care demonstration project, 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-directed home care demonstration project. Liabilities include but are not limited to: workers' compensation liability, the Federal Insurance Contributions Act (FICA), or the Federal Unemployment Tax Act (FUTA).
Sec. 37. Minnesota Statutes 2000, section 256B.0627, is amended by adding a subdivision to read:
Subd. 14. [TELEHOMECARE; SKILLED NURSE VISITS.] Medical assistance covers skilled nurse visits according to section 256B.0625, subdivision 6a, provided via telehomecare, for services which do not require hands-on care between the home care nurse and recipient. The provision of telehomecare must be made via live, two-way interactive audiovisual technology and may be augmented by utilizing store-and-forward technologies. Store-and-forward technology includes telehomecare services that do not occur in real time via synchronous transmissions, and that do not require a face-to-face encounter with the recipient for all or any part of any such telehomecare visit. Individually identifiable patient data obtained through real-time or store-and-forward technology must be maintained in a confidential manner. If the video is used for research, training, or other purposes unrelated to the care of the patient, the identity of the patient must be concealed. A communication between the home care nurse and recipient that consists solely of a telephone conversation, facsimile, electronic mail, or a consultation between two health care practitioners, is not to be considered a telehomecare visit. Multiple daily skilled nurse visits provided via telehomecare are allowed. Coverage of telehomecare is limited to two visits per day. All skilled nurse visits provided via telehomecare must be prior authorized by the commissioner or the commissioner's designee and will be covered at the same allowable rate as skilled nurse visits provided in-person.
Sec. 38. Minnesota Statutes 2000, section 256B.0627, is amended by adding a subdivision to read:
Subd. 15. [THERAPIES THROUGH HOME HEALTH AGENCIES.] (a) [PHYSICAL THERAPY.] Medical assistance covers physical therapy and related services, including specialized maintenance therapy. Services provided by a physical therapy assistant shall be reimbursed at the same rate as services performed by a physical therapist when the services of the physical therapy assistant are provided under the direction of a physical therapist who is on the premises. Services provided by a physical therapy assistant that are provided under the direction of a physical therapist who is not on the premises shall be reimbursed at 65 percent of the physical therapist rate. Direction of the physical therapy assistant must be provided by the physical therapist as described in Minnesota Rules, part 9505.0390, subpart 1, item B. The physical therapist and physical therapist assistant may not both bill for services provided to a recipient on the same day.
(b) [OCCUPATIONAL THERAPY.] Medical assistance covers occupational therapy and related services, including specialized maintenance therapy. Services provided by an occupational therapy assistant shall be reimbursed at the same rate as services performed by an occupational therapist when the services of the occupational therapy assistant are provided under the direction of the occupational therapist who is on the premises. Services provided by an occupational therapy assistant under the direction of an occupational therapist who is not on the premises shall be reimbursed at 65 percent of the occupational therapist rate. Direction of the occupational therapy assistant must be provided by the occupational therapist as described in Minnesota Rules, part 9505.0390, subpart 1, item B. The occupational therapist and occupational therapist assistant may not both bill for services provided to a recipient on the same day.
Sec. 39. Minnesota Statutes 2000, section 256B.0627, is amended by adding a subdivision to read:
Subd. 16. [HARDSHIP CRITERIA; PRIVATE DUTY NURSING.] (a) Payment is allowed for extraordinary services that require specialized nursing skills and are provided by parents of minor children, spouses, and legal guardians who are providing private duty nursing care under the following conditions:
(1) the provision of these services is not legally required of the parents, spouses, or legal guardians;
(2) the services are necessary to prevent hospitalization of the recipient; and
(3) the recipient is eligible for state plan home care or a home and community-based waiver and one of the following hardship criteria are met:
(i) the parent, spouse, or legal guardian resigns from a part-time or full-time job to provide nursing care for the recipient; or
(ii) the parent, spouse, or legal guardian goes from a full-time to a part-time job with less compensation to provide nursing care for the recipient; or
(iii) the parent, spouse, or legal guardian takes a leave of absence without pay to provide nursing care for the recipient; or
(iv) because of labor conditions, special language needs, or intermittent hours of care needed, the parent, spouse, or legal guardian is needed in order to provide adequate private duty nursing services to meet the medical needs of the recipient.
(b) Private duty nursing may be provided by a parent, spouse, or legal guardian who is a nurse licensed in Minnesota. Private duty nursing services provided by a parent, spouse, or legal guardian cannot be used in lieu of nursing services covered and available under liable third-party payers, including Medicare. The private duty nursing provided by a parent, spouse, or legal guardian must be included in the service plan. Authorized skilled nursing services provided by the parent, spouse, or legal guardian may not exceed 50 percent of the total approved nursing hours, or eight hours per day, whichever is less, up to a maximum of 40 hours per week. Nothing in this subdivision precludes the parent's, spouse's, or legal guardian's obligation of assuming the nonreimbursed family responsibilities of emergency backup caregiver and primary caregiver.
(c) A parent or a spouse may not be paid to provide private duty nursing care if the parent or spouse fails to pass a criminal background check according to section 245A.04, or if it has been determined by the home health agency, the case manager, or the physician that the private duty nursing care provided by the parent, spouse, or legal guardian is unsafe.
Sec. 40. Minnesota Statutes 2000, section 256B.0627, is amended by adding a subdivision to read:
Subd. 17. [QUALITY ASSURANCE PLAN FOR PERSONAL CARE ASSISTANT SERVICES.] The commissioner shall establish a quality assurance plan for personal care assistant services that includes:
(1) performance-based provider agreements;
(2) meaningful consumer input, which may include consumer surveys, that measure the extent to which participants receive the services and supports described in the individual plan and participant satisfaction with such services and supports;
(3) ongoing monitoring of the health and well-being of consumers; and
(4) an ongoing public process for development, implementation, and review of the quality assurance plan.
Sec. 41. Minnesota Statutes 2000, section 256B.0911, is amended by adding a subdivision to read:
Subd. 4a. [PREADMISSION SCREENING OF INDIVIDUALS UNDER 65 YEARS OF AGE.] (a) It is the policy of the state of Minnesota to ensure that individuals with disabilities or chronic illness are served in the most integrated setting appropriate to their needs and have the necessary information to make informed choices about home and community-based service options.
(b) Individuals under 65 years of age who are admitted to a nursing facility from a hospital must be screened prior to admission as outlined in subdivision 4.
(c) Individuals under 65 years of age who are admitted to nursing facilities with only a telephone screening must receive a face-to-face assessment from the long-term care consultation team member of the county in which the facility is located or from the recipient's county case manager within 20 working days of admission.
(d) At the face-to-face assessment, the long-term care consultation team member or county case manager must perform the activities required under subdivision 3.
(e) For individuals under 21 years of age, the screening or assessment which recommends nursing facility admission must be approved by the commissioner before the individual is admitted to the nursing facility.
(f) In the event that an individual under 65 years of age is admitted to a nursing facility on an emergency basis, the county must be notified of the admission on the next working day, and a face-to-face assessment as described in paragraph (c) must be conducted within 20 working days of admission.
(g) At the face-to-face assessment, the long-term care consultation team member or the case manager must present information about home and community-based options so the individual can make informed choices. If the individual chooses home and community-based services, the long-term care consultation team member or case manager must complete a written relocation plan within 20 working days of the visit. The plan shall describe the services needed to move out of the facility and a time line for the move which is designed to ensure a smooth transition to the individual's home and community.
(h) An individual under 65 years of age residing in a nursing facility shall receive a face-to-face assessment at least every 12 months to review the person's service choices and available alternatives unless the individual indicates, in writing, that annual visits are not desired. In this case, the individual must receive a face-to-face assessment at least once every 36 months for the same purposes.
(i) Notwithstanding the provisions of subdivision 6, the commissioner may pay county agencies directly for face-to-face assessments for individuals who are eligible for medical assistance, under 65 years of age, and being considered for placement or residing in a nursing facility.
Sec. 42. Minnesota Statutes 2000, section 256B.0916, subdivision 1, is amended to read:
Subdivision 1. [REDUCTION OF WAITING LIST.] (a) The legislature recognizes that as of January 1, 1999, 3,300 persons with mental retardation or related conditions have been screened and determined eligible for the home and community-based waiver services program for persons with mental retardation or related conditions. Many wait for several years before receiving service.
(b) The waiting list for this program shall be reduced or eliminated by June 30, 2003. In order to reduce the number of eligible persons waiting for identified services provided through the home and community-based waiver for persons with mental retardation or related conditions, during the period from July 1, 1999, to June 30, 2003, funding shall be increased to add 100 additional eligible persons each year beyond the February 1999 medical assistance forecast.
(c) The commissioner shall allocate resources in such a manner as to use all resources budgeted during a biennium for the home and community-based waiver for persons with mental retardation or related conditions according to the priorities listed in subdivision 2, paragraph (b), and then to serve other persons on the waiting list. Resources allocated for a fiscal year to serve persons affected by public and private sector ICF/MR closures, but not expected to be expended for that purpose, must be reallocated within that fiscal year to serve other persons on the waiting list, and the number of waiver diversion slots shall be adjusted accordingly.
(d) For fiscal year 2001, at least one-half of the increase in funding over the previous year provided in the February 1999 medical assistance forecast for the home and community-based waiver for persons with mental retardation and related conditions, including changes made by the 1999 legislature, must be used to serve persons who are not affected by public and private sector ICF/MR closures.
(e) The commissioner of finance shall not reduce the expenditure forecast for a biennium for which appropriations have been made, if at the time of the forecast there is a waiting list for waiver services for persons with mental retardation or related conditions who need services within the next 30 months. Funds that would have resulted from a projected reduction in expenditures must be used by the commissioner of human services to serve persons with developmental disabilities through the home and community-based waiver for persons with mental retardation or related conditions.
Sec. 43. Minnesota Statutes 2000, section 256B.0916, is amended by adding a subdivision to read:
Subd. 6a. [STATEWIDE AVAILABILITY OF CONSUMER-DIRECTED COMMUNITY SUPPORT SERVICES.] (a) The commissioner shall submit to the federal Health Care Financing Administration by August 1, 2001, an amendment to the home and community-based waiver for persons with mental retardation or related conditions to make consumer-directed community support services available in every county of the state by January 1, 2002.
(b) If a county declines to meet the requirements for provision of consumer-directed community supports, the commissioner shall contract with another county, a group of counties, or a private agency to plan for and administer consumer-directed community supports in that county.
(c) The state of Minnesota, county agencies, tribal governments, or administrative entities under contract to participate in the implementation and administration of the home and community-based waiver for persons with mental retardation or a related condition, 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 with funds received through the consumer-directed community support service under this section. Liabilities include but are not limited to: workers' compensation liability, the Federal Insurance Contributions Act (FICA), or the Federal Unemployment Tax Act (FUTA).
Sec. 44. Minnesota Statutes 2000, section 256B.0916, subdivision 7, is amended to read:
Subd. 7. [ANNUAL REPORT BY COMMISSIONER.] Beginning October 1, 1999, and each October 1
November 1, 2001, and each November 1 thereafter, the commissioner shall issue an annual report on
county and state use of available resources for the home and community-based waiver for persons with mental
retardation or related conditions. For each county or county partnership, the report shall include:
(1) the amount of funds allocated but not used;
(2) the county specific allowed reserve amount approved and used;
(3) the number, ages, and living situations of individuals screened and waiting for services;
(4) the urgency of need for services to begin within one, two, or more than two years for each individual;
(5) the services needed;
(6) the number of additional persons served by approval of increased capacity within existing allocations;
(7) results of action by the commissioner to streamline administrative requirements and improve county resource management; and
(8) additional action that would decrease the number of those eligible and waiting for waivered services.
The commissioner shall specify intended outcomes for the program and the degree to which these specified outcomes are attained.
Sec. 45. Minnesota Statutes 2000, section 256B.0916, subdivision 9, is amended to read:
Subd. 9. [LEGAL REPRESENTATIVE PARTICIPATION EXCEPTION.] The commissioner, in cooperation
with representatives of counties, service providers, service recipients, family members, legal representatives and
advocates, shall develop criteria to allow legal representatives to be reimbursed for providing specific support services
to meet the person's needs when a plan which assures health and safety has been agreed upon and carried out by the
legal representative, the person, and the county. Legal representatives providing support under consumer-directed
community support services pursuant to section 256B.092, subdivision 4, the home and community-based
waiver for persons with mental retardation or related conditions or the consumer support grant program
pursuant to section 256B.092, subdivision 7 256.476, shall not be considered to have a direct or
indirect service provider interest under section 256B.092, subdivision 7, if a health and safety plan which meets the
criteria established has been agreed upon and implemented. By October 1, 1999 August 1, 2001,
the commissioner shall submit, for federal approval, amendments to allow legal representatives to provide support
and receive reimbursement under the consumer-directed community support services section of the home
and community-based waiver plan.
Sec. 46. Minnesota Statutes 2000, section 256B.092, subdivision 2a, is amended to read:
Subd. 2a. [MEDICAL ASSISTANCE FOR CASE MANAGEMENT ACTIVITIES UNDER THE STATE PLAN
MEDICAID OPTION.] (a) Upon receipt of federal approval, the commissioner shall make payments to
approved vendors counties, private individuals, and agencies enrolled as providers of case
management services participating in the medical assistance program to reimburse costs for providing case
management service activities to medical assistance eligible persons with mental retardation or a related condition,
in accordance with the state Medicaid plan, the home and community-based waiver for persons with mental
retardation and related conditions plan, and federal requirements and limitations.
(b) The commissioner shall ensure that each eligible person is given a choice of county and private agency case management service providers. Case management service providers are prohibited from providing any other service to the person receiving case management services.
Sec. 47. Minnesota Statutes 2000, section 256B.092, subdivision 5, is amended to read:
Subd. 5. [FEDERAL WAIVERS.] (a) The commissioner shall apply for any federal waivers necessary to secure, to the extent allowed by law, federal financial participation under United States Code, title 42, sections 1396 et seq., as amended, for the provision of services to persons who, in the absence of the services, would need the level of care provided in a regional treatment center or a community intermediate care facility for persons with mental retardation or related conditions. The commissioner may seek amendments to the waivers or apply for additional waivers under United States Code, title 42, sections 1396 et seq., as amended, to contain costs. The commissioner shall ensure that payment for the cost of providing home and community-based alternative services under the federal waiver plan shall not exceed the cost of intermediate care services including day training and habilitation services that would have been provided without the waivered services.
(b) The commissioner, in administering home and community-based waivers for persons with mental retardation and related conditions, shall ensure that day services for eligible persons are not provided by the person's residential service provider, unless the person or the person's legal representative is offered a choice of providers and agrees in writing to provision of day services by the residential service provider. The individual service plan for individuals who choose to have their residential service provider provide their day services must describe how health, safety, and protection needs will be met by frequent and regular contact with persons other than the residential service provider.
Sec. 48. Minnesota Statutes 2000, section 256B.093, subdivision 3, is amended to read:
Subd. 3. [TRAUMATIC BRAIN INJURY PROGRAM DUTIES.] The department shall fund administrative case management under this subdivision using medical assistance administrative funds. The traumatic brain injury program duties include:
(1) recommending to the commissioner in consultation with the medical review agent according to Minnesota Rules, parts 9505.0500 to 9505.0540, the approval or denial of medical assistance funds to pay for out-of-state placements for traumatic brain injury services and in-state traumatic brain injury services provided by designated Medicare long-term care hospitals;
(2) coordinating the traumatic brain injury home and community-based waiver;
(3) approving traumatic brain injury waiver eligibility or care plans or both;
(4) providing ongoing technical assistance and consultation to county and facility case managers to
facilitate care plan development for appropriate, accessible, and cost-effective medical assistance services;
(5) (4) providing technical assistance to promote statewide development of appropriate,
accessible, and cost-effective medical assistance services and related policy;
(6) (5) providing training and outreach to facilitate access to appropriate home and
community-based services to prevent institutionalization;
(7) (6) facilitating appropriate admissions, continued stay review, discharges, and utilization
review for neurobehavioral hospitals and other specialized institutions;
(8) (7) providing technical assistance on the use of prior authorization of home care services and
coordination of these services with other medical assistance services;
(9) (8) developing a system for identification of nursing facility and hospital residents with
traumatic brain injury to assist in long-term planning for medical assistance services. Factors will include, but are
not limited to, number of individuals served, length of stay, services received, and barriers to community placement;
and
(10) (9) providing information, referral, and case consultation to access medical assistance
services for recipients without a county or facility case manager. Direct access to this assistance may be limited due
to the structure of the program.
Sec. 49. Minnesota Statutes 2000, section 256B.095, is amended to read:
256B.095 [THREE-YEAR QUALITY ASSURANCE PILOT PROJECT ESTABLISHED.]
Effective July 1, 1998, an alternative quality assurance licensing system pilot project for programs for
persons with developmental disabilities 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 pilot project or may continue regulation of these programs
under the licensing system operated by the commissioner. The pilot project expires on June 30,
2001 2005.
Sec. 50. Minnesota Statutes 2000, section 256B.0951, subdivision 1, is amended to read:
Subdivision 1. [MEMBERSHIP.] The region 10 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. Initial membership of the commission shall be recruited and approved by the region 10
stakeholders group. Prior to approving the commission's membership, the stakeholders group shall provide to the
commissioner a list of the membership in the stakeholders group, as of February 1, 1997, a brief summary of
meetings held by the group since July 1, 1996, and copies of any materials prepared by the group for public
distribution. 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, 2001
2005.
Sec. 51. Minnesota Statutes 2000, section 256B.0951, subdivision 3, is amended to read:
Subd. 3. [COMMISSION DUTIES.] (a) By October 1, 1997, the commission, in cooperation with the commissioners of human services and health, shall do the following: (1) approve an alternative quality assurance licensing system based on the evaluation of outcomes; (2) approve measurable outcomes in the areas of health and safety, consumer evaluation, education and training, providers, and systems that shall be evaluated during the alternative licensing process; and (3) establish variable licensure periods not to exceed three years based on outcomes achieved. For purposes of this subdivision, "outcome" means the behavior, action, or status of a person that can be observed or measured and can be reliably and validly determined.
(b) By January 15, 1998, the commission shall approve, in cooperation with the commissioner of human services, a training program for members of the quality assurance teams established under section 256B.0952, subdivision 4.
(c) The commission and the commissioner shall establish an ongoing review process for the alternative quality assurance licensing system. The review shall take into account the comprehensive nature of the alternative system, which is designed to evaluate the broad spectrum of licensed and unlicensed entities that provide services to clients, as compared to the current licensing system.
(d) The commission shall contract with an independent entity to conduct a financial review of the alternative
quality assurance pilot project. The review shall take into account the comprehensive nature of the
alternative system, which is designed to evaluate the broad spectrum of licensed and unlicensed entities that provide
services to clients, as compared to the current licensing system. The review shall include an evaluation of possible
budgetary savings within the department of human services as a result of implementation of the alternative quality
assurance pilot project. If a federal waiver is approved under subdivision 7, the financial review shall also
evaluate possible savings within the department of health. This review must be completed by December 15, 2000.
(e) The commission shall submit a report to the legislature by January 15, 2001, on the results of the review
process for the alternative quality assurance pilot project, a summary of the results of the independent
financial review, and a recommendation on whether the pilot project should be extended beyond June 30,
2001.
(f) The commissioner, in consultation with the commission, shall examine the feasibility of expanding the project to other populations or geographic areas and identify barriers to expansion. The commissioner shall report findings and recommendations to the legislature by December 15, 2004.
Sec. 52. Minnesota Statutes 2000, section 256B.0951, subdivision 4, is amended to read:
Subd. 4. [COMMISSION'S AUTHORITY TO RECOMMEND VARIANCES OF LICENSING STANDARDS.] The commission may recommend to the commissioners of human services and health variances from the standards governing licensure of programs for persons with developmental disabilities in order to improve the quality of services by implementing an alternative developmental disabilities licensing system if the commission determines that the alternative licensing system does not adversely affect the health or safety of persons being served by the licensed program nor compromise the qualifications of staff to provide services.
Sec. 53. Minnesota Statutes 2000, section 256B.0951, subdivision 5, is amended to read:
Subd. 5. [VARIANCE OF CERTAIN STANDARDS PROHIBITED.] The safety standards, rights, or procedural
protections under sections 245.825; 245.91 to 245.97; 245A.04, subdivisions 3, 3a, 3b, and 3c; 245A.09, subdivision
2, paragraph (c), clauses (2) and (5); 245A.12; 245A.13; 252.41, subdivision 9; 256B.092, subdivisions 1b, clause
(7), and 10; 626.556; 626.557, and procedures for the monitoring of psychotropic medications shall not be varied
under the alternative licensing system pilot project. The commission may make recommendations to the
commissioners of human services and health or to the legislature regarding alternatives to or modifications of the
rules and procedures referenced in this subdivision.
Sec. 54. Minnesota Statutes 2000, section 256B.0951, subdivision 7, is amended to read:
Subd. 7. [WAIVER OF RULES.] The commissioner of health may exempt residents of intermediate care facilities
for persons with mental retardation (ICFs/MR) who participate in the three-year quality assurance pilot project
established in section 256B.095 from the requirements of Minnesota Rules, chapter 4665, upon approval by the
federal government of a waiver of federal certification requirements for ICFs/MR. The commissioners of health
and human services shall apply for any necessary waivers as soon as practicable and shall submit the concept paper
to the federal government by June 1, 1998.
Sec. 55. Minnesota Statutes 2000, section 256B.0951, is amended by adding a subdivision to read:
Subd. 8. [FEDERAL WAIVER.] The commissioner of human services shall seek federal authority to waive provisions of intermediate care facilities for persons with mental retardation (ICFs/MR) regulations to enable the demonstration and evaluation of the alternative quality assurance system for ICFs/MR under the project. The commissioner of human services shall apply for any necessary waivers as soon as practicable.
Sec. 56. Minnesota Statutes 2000, section 256B.0951, is amended by adding a subdivision to read:
Subd. 9. [EVALUATION.] The commission, in consultation with the commissioner of human services, shall conduct an evaluation of the alternative quality assurance system, and present a report to the commissioner by June 30, 2004.
Sec. 57. Minnesota Statutes 2000, section 256B.0952, subdivision 1, is amended to read:
Subdivision 1. [NOTIFICATION.] By January 15, 1998, each affected county shall notify the commission
and the commissioners of human services and health as to whether it chooses to implement on July 1, 1998, the
alternative licensing system for the pilot project. A county that does not implement the alternative licensing system
on July 1, 1998, may give notice to the commission and the commissioners by January 15, 1999, or January 15, 2000,
that it will implement the alternative licensing system on the following July 1. A county that implements the
alternative licensing system commits to participate until June 30, 2001. For each year of the project, region
10 counties shall give notice to the commission and commissioners of human services and health by March 15 of
intent to join the quality assurance alternative licensing system, effective July 1 of that year. A county choosing to
participate in the alternative licensing system commits to participate until June 30, 2005. Counties participating in
the quality assurance alternative licensing system as of January 1, 2001, shall notify the commission and the
commissioners of human services and health by March 15, 2001, of intent to continue participation. Counties that
elect to continue participation must participate in the alternative licensing system until June 30, 2005.
Sec. 58. Minnesota Statutes 2000, section 256B.0952, subdivision 4, is amended to read:
Subd. 4. [APPOINTMENT OF QUALITY ASSURANCE MANAGER.] (a) A county or group of counties that chooses to participate in the alternative licensing system shall designate a quality assurance manager and shall establish quality assurance teams in accordance with subdivision 5. The manager shall recruit, train, and assign duties to the quality assurance team members. In assigning team members to conduct the quality assurance process at a facility, program, or service, the manager shall take into account the size of the service provider, the number
of services to be reviewed, the skills necessary for team members to complete the process, and other relevant factors. The manager shall ensure that no team member has a financial, personal, or family relationship with the facility, program, or service being reviewed or with any clients of the facility, program, or service.
(b) Quality assurance teams shall report the findings of their quality assurance reviews to the quality assurance manager. The quality assurance manager shall provide the report from the quality assurance team to the county and, upon request, to the commissioners of human services and health, and shall provide a summary of the report to the quality assurance review council.
Sec. 59. Minnesota Statutes 2000, section 256B.49, is amended by adding a subdivision 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 and task forces, and others upon request, with notice of, and an opportunity to comment on, any changes or amendments to the federally approved applications for home and community-based waivers, prior to their submission to the federal health care financing administration.
(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. 60. Minnesota Statutes 2000, section 256B.49, is amended by adding a subdivision to read:
Subd. 12. [INFORMED CHOICE.] Persons who are determined likely to require the level of care provided in a nursing facility or hospital shall be informed of the home and community-based support alternatives to the provision of inpatient hospital services or nursing facility services. Each person must be given the choice of either institutional or home and community-based services, using the provisions described in section 256B.77, subdivision 2, paragraph (p).
Sec. 61. Minnesota Statutes 2000, section 256B.49, is amended by adding a subdivision to read:
Subd. 13. [CASE MANAGEMENT.] (a) Each recipient of a home and community-based waiver shall be provided case management services by qualified vendors as described in the federally approved waiver application. The case management service activities provided will include:
(1) assessing the needs of the individual within 20 working days of a recipient's request;
(2) developing the written individual service plan within ten working days after the assessment is completed;
(3) informing the recipient or the recipient's legal guardian or conservator of service options;
(4) assisting the recipient in the identification of potential service providers;
(5) assisting the recipient to access services;
(6) coordinating, evaluating, and monitoring of the services identified in the service plan;
(7) completing the annual reviews of the service plan; and
(8) informing the recipient or legal representative of the right to have assessments completed and service plans developed within specified time periods, and to appeal county action or inaction under section 256.045, subdivision 3.
(b) The case manager may delegate certain aspects of the case management service activities to another individual provided there is oversight by the case manager. The case manager may not delegate those aspects which require professional judgment including assessments, reassessments, and care plan development.
Sec. 62. Minnesota Statutes 2000, section 256B.49, is amended by adding a subdivision to read:
Subd. 14. [ASSESSMENT AND REASSESSMENT.] (a) Assessments of each recipient's strengths, informal support systems, and need for services shall be completed within 20 working days of the recipient's request. Reassessment of each recipient's strengths, support systems, and need for services shall be conducted at least every 12 months and at other times when there has been a significant change in the recipient's functioning.
(b) Persons with mental retardation or a related condition who apply for services under the nursing facility level waiver programs shall be screened for the appropriate level of care according to section 256B.092.
(c) Recipients who are found eligible for home and community-based services under this section before their 65th birthday may remain eligible for these services after their 65th birthday if they continue to meet all other eligibility factors.
Sec. 63. Minnesota Statutes 2000, section 256B.49, is amended by adding a subdivision to read:
Subd. 15. [INDIVIDUALIZED SERVICE PLAN.] Each recipient of home and community-based waivered services shall be provided a copy of the written service plan which:
(1) is developed and signed by the recipient within ten working days of the completion of the assessment;
(2) meets the assessed needs of the recipient;
(3) reasonably ensures the health and safety of the recipient;
(4) promotes independence;
(5) allows for services to be provided in the most integrated settings; and
(6) provides for an informed choice, as defined in section 256B.77, subdivision 2, paragraph (p), of service and support providers.
Sec. 64. Minnesota Statutes 2000, section 256B.49, is amended by adding a subdivision to read:
Subd. 16. [SERVICES AND SUPPORTS.] (a) Services and supports included in the home and community-based waivers for persons with disabilities shall meet the requirements set out in United States Code, title 42, section 1396n. The services and supports, which are offered as alternatives to institutional care, shall promote consumer choice, community inclusion, self-sufficiency, and self-determination.
(b) Beginning January 1, 2003, the commissioner shall simplify and improve access to home and community-based waivered services, to the extent possible, through the establishment of a common service menu that is available to eligible recipients regardless of age, disability type, or waiver program.
(c) Consumer directed community support services shall be offered as an option to all persons eligible for services under subdivision 11, by January 1, 2002.
(d) Services and supports shall be arranged and provided consistent with individualized written plans of care for eligible waiver recipients.
(e) The state of Minnesota and county agencies that administer home and community-based waivered services for persons with disabilities, shall not be liable for damages, injuries, or liabilities sustained through the purchase of supports by the individual, the individual's family, or the authorized representative with funds received through the consumer-directed community support service under this section. Liabilities include but are not limited to: workers' compensation liability, the Federal Insurance Contributions Act (FICA), or the Federal Unemployment Tax Act (FUTA).
Sec. 65. Minnesota Statutes 2000, section 256B.49, is amended by adding a subdivision to read:
Subd. 17. [COST OF SERVICES AND SUPPORTS.] (a) The commissioner shall ensure that the average per capita expenditures estimated in any fiscal year for home and community-based waiver recipients does not exceed the average per capita expenditures that would have been made to provide institutional services for recipients in the absence of the waiver.
(b) The commissioner shall implement on January 1, 2002, one or more aggregate, need-based methods for allocating to local agencies the home and community-based waivered service resources available to support recipients with disabilities in need of the level of care provided in a nursing facility or a hospital. The commissioner shall allocate resources to single counties and county partnerships in a manner that reflects consideration of:
(1) an incentive-based payment process for achieving outcomes;
(2) the need for a state-level risk pool;
(3) the need for retention of management responsibility at the state agency level; and
(4) a phase-in strategy as appropriate.
(c) Until the allocation methods described in paragraph (b) are implemented, the annual allowable reimbursement level of home and community-based waiver services shall be the greater of:
(1) the statewide average payment amount which the recipient is assigned under the waiver reimbursement system in place on June 30, 2001, modified by the percentage of any provider rate increase appropriated for home and community-based services; or
(2) an amount approved by the commissioner based on the recipient's extraordinary needs that cannot be met within the current allowable reimbursement level. The increased reimbursement level must be necessary to allow the recipient to be discharged from an institution or to prevent imminent placement in an institution. The additional reimbursement may be used to secure environmental modifications; assistive technology and equipment; and increased costs for supervision, training, and support services necessary to address the recipient's extraordinary needs. The commissioner may approve an increased reimbursement level for up to one year of the recipient's relocation from an institution or up to six months of a determination that a current waiver recipient is at imminent risk of being placed in an institution.
(d) Beginning July 1, 2001, medically necessary private duty nursing services will be authorized under this section as complex and regular care according to section 256B.0627.
Sec. 66. Minnesota Statutes 2000, section 256B.49, is amended by adding a subdivision to read:
Subd. 18. [PAYMENTS.] The commissioner shall reimburse approved vendors from the medical assistance account for the costs of providing home and community-based services to eligible recipients using the invoice processing procedures of the Medicaid management information system (MMIS). Recipients will be screened and authorized for services according to the federally approved waiver application and its subsequent amendments.
Sec. 67. Minnesota Statutes 2000, section 256B.49, is amended by adding a subdivision to read:
Subd. 19. [HEALTH AND WELFARE.] The commissioner of human services shall take the necessary safeguards to protect the health and welfare of individuals provided services under the waiver.
Sec. 68. Minnesota Statutes 2000, section 256B.49, is amended by adding a subdivision to read:
Subd. 20. [TRAUMATIC BRAIN INJURY AND RELATED CONDITIONS.] The commissioner shall seek to amend the traumatic brain injury waiver to include, as eligible persons, individuals with an acquired or degenerative disease diagnosis where cognitive impairment is present, such as multiple sclerosis.
Sec. 69. Minnesota Statutes 2000, section 256B.69, subdivision 23, is amended to read:
Subd. 23. [ALTERNATIVE INTEGRATED LONG-TERM CARE 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. Medicare funds and services shall be administered according to
the terms and conditions of the federal waiver 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 primary
diagnoses of mental retardation or a related condition, 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 until July 1,
2001. The commissioner shall not implement any demonstration project under this subdivision for persons with
primary diagnoses of mental retardation or a related condition, 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.
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.
(b) 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.
Sec. 70. Minnesota Statutes 2000, section 256D.35, is amended by adding a subdivision to read:
Subd. 11a. [INSTITUTION.] "Institution" means: a hospital, consistent with Code of Federal Regulations, title 42, section 440.10; regional treatment center inpatient services; a nursing facility; and an intermediate care facility for persons with mental retardation.
Sec. 71. Minnesota Statutes 2000, section 256D.35, is amended by adding a subdivision to read:
Subd. 18a. [SHELTER COSTS.] "Shelter costs" means: rent, manufactured home lot rentals; monthly principal, interest, insurance premiums, and property taxes due for mortgages or contract for deed costs; costs for utilities, including heating, cooling, electricity, water, and sewerage; garbage collection fees; and the basic service fee for one telephone.
Sec. 72. Minnesota Statutes 2000, section 256D.44, subdivision 5, is amended to read:
Subd. 5. [SPECIAL NEEDS.] In addition to the state standards of assistance established in subdivisions 1 to 4, payments are allowed for the following special needs of recipients of Minnesota supplemental aid who are not residents of a nursing home, a regional treatment center, or a group residential housing facility.
(a) The county agency shall pay a monthly allowance for medically prescribed diets payable under the Minnesota family investment program if the cost of those additional dietary needs cannot be met through some other maintenance benefit.
(b) Payment for nonrecurring special needs must be allowed for necessary home repairs or necessary repairs or replacement of household furniture and appliances using the payment standard of the AFDC program in effect on July 16, 1996, for these expenses, as long as other funding sources are not available.
(c) A fee for guardian or conservator service is allowed at a reasonable rate negotiated by the county or approved by the court. This rate shall not exceed five percent of the assistance unit's gross monthly income up to a maximum of $100 per month. If the guardian or conservator is a member of the county agency staff, no fee is allowed.
(d) The county agency shall continue to pay a monthly allowance of $68 for restaurant meals for a person who was receiving a restaurant meal allowance on June 1, 1990, and who eats two or more meals in a restaurant daily. The allowance must continue until the person has not received Minnesota supplemental aid for one full calendar month or until the person's living arrangement changes and the person no longer meets the criteria for the restaurant meal allowance, whichever occurs first.
(e) A fee of ten percent of the recipient's gross income or $25, whichever is less, is allowed for representative payee services provided by an agency that meets the requirements under SSI regulations to charge a fee for representative payee services. This special need is available to all recipients of Minnesota supplemental aid regardless of their living arrangement.
(f) Notwithstanding the language in this subdivision, an amount equal to the maximum allotment authorized by the federal Food Stamp Program for a single individual which is in effect on the first day of January of the previous year will be added to the standards of assistance established in subdivisions 1 to 4 for individuals under the age of 65 who are relocating from an institution and who are shelter needy. An eligible individual who receives this benefit prior to age 65 may continue to receive the benefit after the age of 65.
"Shelter needy" means that the assistance unit incurs monthly shelter costs that exceed 40 percent of the assistance unit's gross income before the application of this special needs standard. "Gross income" for the purposes of this section is the applicant's or recipient's income as defined in section 256D.35, subdivision 10, or the standard specified in subdivision 3, whichever is greater. A recipient of a federal or state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be considered shelter needy for purposes of this paragraph.
Sec. 73. Minnesota Statutes 2000, section 256I.05, subdivision 1e, is amended to read:
Subd. 1e. [SUPPLEMENTARY RATE FOR CERTAIN FACILITIES.] Notwithstanding the provisions of
subdivisions 1a and 1c, beginning July 1, 1999 2001, a county agency shall negotiate a
supplementary rate in addition to the rate specified in subdivision 1, equal to 25 125 percent of the
amount specified in subdivision 1a, including any legislatively authorized inflationary adjustments, for a
group residential housing provider that:
(1) is located in Hennepin county and has had a group residential housing contract with the county since June 1996;
(2) operates in three separate locations a 56-bed 71-bed facility, a and two
40-bed facility, and a 30-bed facility facilities; and
(3) serves a chemically dependent clientele, providing 24 hours per day supervision and limiting a resident's maximum length of stay to 13 months out of a consecutive 24-month period.
Sec. 74. [256I.07] [RESPITE CARE PILOT PROJECT FOR FAMILY ADULT FOSTER CARE PROVIDERS.]
Subdivision 1. [PROGRAM ESTABLISHED.] The state recognizes the importance of developing and maintaining quality family foster care resources. In order to accomplish that goal, the commissioner shall establish a two-year respite care pilot project for family adult foster care providers in three counties. This pilot project is intended to provide support to caregivers of adult foster care residents. The commissioner shall establish a pilot project to accomplish the provisions in subdivisions 2 to 4.
Subd. 2. [ELIGIBILITY.] A family adult foster care home provider as defined under section 144D.01, subdivision 7, who has been licensed for six months is eligible for 30 days of respite care per calendar year. In cases of emergency, a county social services agency may waive the six-month licensing requirement. In order to be eligible to receive respite payment from group residential housing and alternative care, a provider must take time off away from their foster care residents.
Subd. 3. [PAYMENT STRUCTURE.] (a) The payment for respite care for an adult foster care resident eligible for only group residential housing shall be based on the current monthly group residential housing base room and board rate and the current maximum monthly group residential housing difficulty of care rate.
(b) The payment for respite care for an adult foster care resident eligible for alternative care funds shall be based on the resident's alternative care foster care rate.
(c) The payment for respite care for an adult foster care resident eligible for Medicaid home and community-based services waiver funds shall be based on the group residential housing base room and board rate.
(d) The total amount available to pay for respite care for a family adult foster care provider shall be based on the number of residents currently served in the foster care home and the source of funding used to pay for each resident's foster care. Respite care must be paid for on a per diem basis and for a full day.
Subd. 4. [PRIVATE PAY RESIDENTS.] Payment for respite care for private pay foster care residents must be arranged between the provider and the resident or the resident's family.
Sec. 75. Laws 1999, chapter 152, section 1, is amended to read:
Section 1. [TASK FORCE.]
A day training and habilitation task force is established. Task force membership shall consist of representatives of the commissioner of human services, counties, service consumers, and vendors of day training and habilitation as defined in Minnesota Statutes, section 252.41, subdivision 9, including at least one representative from each association representing day training and habilitation vendors. Appointments to the task force shall be made by the commissioner of human services and technical assistance shall be provided by the department of human services.
Sec. 76. Laws 1999, chapter 152, section 4, is amended to read:
Sec. 4. [REPORT.]
The task force shall present a report recommending a new payment rate structure to the legislature by January 15,
2000, and shall make recommendations to the commissioner of human services regarding the implementation
of the pilot project for the individualized payment rate structure, so the pilot project can be implemented by July 1,
2002, as required in section 77. The task force expires on March 15, 2000 December 30, 2003.
Sec. 77. [DAY TRAINING AND HABILITATION PAYMENT STRUCTURE PILOT PROJECT.]
Subdivision 1. [INDIVIDUALIZED PAYMENT RATE STRUCTURE.] Notwithstanding Minnesota Statutes, sections 252.451, subdivision 5; and 252.46; and Minnesota Rules, part 9525.1290, subpart 1, items A and B, the commissioner of human services shall initiate a pilot project and phase-in for the individualized payment rate structure described in this section and section 78. The pilot project shall include actual transfers of funds, not simulated transfers. The pilot project may include all or some of the vendors in up to eight counties, with no more than two counties from the seven-county Minneapolis-St. Paul metropolitan area. Following initiation of the pilot project, the commissioner shall phase in implementation of the individualized payment rate structure to the remaining counties and vendors according to the implementation plan developed by the task force. The pilot and phase-in shall not extend over more than 18 months and shall be completed by December 31, 2003.
Subd. 2. [SUNSET.] The pilot project shall sunset upon implementation of a new statewide rate structure according to the implementation plan developed by the task force described in subdivision 3, in its report to the legislature on December 1, 2001. The rates of vendors participating in the pilot project must be modified to be consistent with the new statewide rate structure, as implemented.
Subd. 3. [TASK FORCE RESPONSIBILITIES.] The day training and habilitation task force established under Laws 1999, chapter 152, section 4, shall evaluate the pilot project authorized under subdivision 1, and by December 1, 2001, shall report to the legislature with an implementation plan, which shall address how and when the pilot project individualized payment rate structure will be implemented statewide, shall ensure that vendors that wish to maintain their current per diem rate may do so within the new payment system, and shall identify criteria that would halt statewide implementation if vendors or clients were adversely affected by the new payment rate structure, and with recommendations for any amendments that should be made before statewide implementation. These recommendations shall be made in a report to the chairs of the house health and human services policy and finance committees and the senate health and family security committee and finance division.
Subd. 4. [RATE SETTING.] (a) The rate structure under this section is intended to allow a county to authorize an individual rate for each client in the vendor's program based on the needs and expected outcomes of the individual client. Rates shall be based on an authorized package of services for each individual over a typical time frame. Rates may be established across multiple sites run by a single vendor.
(b) With county concurrence, a vendor shall establish up to four levels of service, A through D, based on the intensity of services provided to an individual client of day training and habilitation services. Service level A shall be the highest intensity of services, marked primarily, but not exclusively, by a one-to-one client-to-staff ratio. Service level D shall be the lowest intensity of services. The county shall document the vendor's description of the type and amount of services associated with each service level.
(c) For each vendor, a county board shall establish a dollar value for one hour of service at each of the service levels defined in paragraph (b). In establishing these values for existing vendors transitioning from the payment rate structure under Minnesota Statutes, section 252.46, subdivision 1, the county board shall follow the formula and guidelines developed by the day training and habilitation task force under paragraph (e).
(d) A vendor may elect to maintain a single transportation rate or may elect to establish up to five types of transportation services: public transportation, public special transportation, nonambulatory transportation, out-of-service area transportation, and ambulatory transportation. For vendors that elect to establish multiple transportation services, the county board shall establish a dollar value for a round trip on each type of transportation service offered through the vendor. With vendor concurrence, the county may also establish a uniform one-way trip value for some or all of the transportation service types.
(e) The county board shall ensure that the vendor translates the vendor's existing program and transportation rates to the rates and values in the pilot project by using the conversion calculations for services and transportation approved by the day training and habilitation task force established under Laws 1999, chapter 152, and included in the task force's recommendations to the legislature. The conversion calculation may be amended by the task force with the approval of the commissioner and any amendments shall become effective upon notification to the pilot project counties from the commissioner. The calculation shall take the total reimbursement dollars available to the vendor and divide by the units of service expected at each service level and of each transportation type. In determining the total reimbursement dollars available to a vendor, the vendor shall multiply the vendor's current per diem rate for both services and transportation, including any new rate increases, by the vendor's actual utilization for the year prior to implementation of the pilot project. Vendors shall be allowed to allocate available reimbursement dollars between service and transportation before the vendor's service level and transportation values are calculated. After translating its existing service and transportation rates to the service level and transportation values under the pilot, the vendor shall project its expected reimbursement income using the expected service and transportation packages for its existing clients, based on current service authorizations. If the projected reimbursement income is less than the vendor would have received under the payment structure of Minnesota Statutes, section 252.46, the vendor and the county, with the approval of the commissioner, shall adjust the vendor's service level and transportation values to eliminate the shortfall. The commissioner shall report all adjustments to the day training and habilitation task force for consideration of possible modifications to the pilot project individualized payment rate structure.
Subd. 5. [INDIVIDUAL RATE AUTHORIZATION.] (a) As part of its annual authorization of services for each client under Minnesota Statutes, section 252.44, paragraph (a), clause (1), and Minnesota Rules, part 9525.0016, subpart 12, the county shall authorize and document a service package and a transportation package as follows:
(1) the service package shall include the amount and type of services at each applicable service level to be provided to the client over a package period. An individual client may receive services at multiple service levels over the course of the package period. The service package rate shall be the sum of the amount of services at each level over the package period, multiplied by the dollar value for each service level;
(2) the transportation package shall include the amount and type of transportation services to be provided to the client over the package period. The transportation package rate shall be the sum of the amount of transportation services, multiplied by the dollar value associated with the type of transportation service authorized for the client;
(3) the package period shall be established by the county, and may be one week, two weeks, or one month; and
(4) the individual rate authorization may be reviewed and modified by the county at any time and must be reviewed and reauthorized by the county at least annually.
(b) For vendors with rates established under this section, a service day under Minnesota Statutes, sections 245B.06 and 252.44, includes any day in which a client receives any reimbursable service from a vendor or attends employment arranged by the vendor.
Subd. 6. [BILLING FOR SERVICES.] The vendor shall bill for, and shall be reimbursed for, the service package rate and transportation package rate for the package period as authorized by the county for each client in the vendor's program. The length of the package period shall not affect the timing or frequency of vendors' submissions of claims for payment under the Medicaid Management Information System II (MMIS) or its successors.
Subd. 7. [NOTIFICATION OF CHANGE IN CLIENT NEEDS.] The vendor shall notify an individual client's case manager if the vendor has knowledge of a material change in the client's needs that may indicate a need for a change in service authorization. Factors that would require such notice include, but are not limited to, significant changes in medical status, residential placement, attendance patterns, behavioral needs, or skill functioning. The vendor shall notify the case manager as soon as possible but no later than 30 calendar days after becoming aware of the change in needs. The service authorization for the client shall not change until the county authorizes a new service and transportation package for the client in accordance with the provisions in Minnesota Statutes, section 256B.092.
Sec. 78. [COUNTY BOARD RESPONSIBILITIES.]
For each vendor with rates established under section 77, the county board shall document the vendor's description of the type and amount of services associated with each service level, the vendor's service level values, the vendor's transportation values, and the package period that will be used to determine the rate for each individual client. The county shall establish a package period of one week, two weeks, or one month.
Sec. 79. [STUDY OF DAY TRAINING AND HABILITATION VENDOR RATES.]
The commissioner shall identify the vendors with the lowest rates or underfunded programs in the state and make recommendations to reconcile the discrepancies prior to the implementation of the individualized payment rate structure described in sections 77 and 78.
Sec. 80. [FEDERAL APPROVAL.]
The commissioner shall seek any amendments to the state Medicaid plan and any waivers necessary to permit implementation of section 77 within the timelines specified.
Sec. 81. [SEMI-INDEPENDENT LIVING SERVICES (SILS) STUDY.]
The commissioner of human services, in consultation with county representatives and other interested persons, shall develop recommendations revising the funding methodology for SILS as defined in Minnesota Statutes, section 252.275, subdivisions 3, 4, 4b, and 4c, and report by January 15, 2002, to the chair of the house of representatives health and human services finance committee and the chairs of the senate health, human services, and corrections budget division.
Sec. 82. [WAIVER REQUEST REGARDING SPOUSAL INCOME.]
By September 1, 2001, the commissioner of human services shall seek federal approval to allow recipients of home and community-based waivers authorized under Minnesota Statutes, section 256B.49, to choose either a waiver of deeming of spousal income or the spousal impoverishment protections authorized under United States Code, title 42, section 1396r-5, with the addition of the group residential housing rate set according to Minnesota Statutes, section 256I.03, subdivision 5, to the personal needs allowance authorized by Minnesota Statutes, section 256B.0575.
Sec. 83. [PROGRAM OPTIONS FOR CERTAIN PERSONS WITH DEVELOPMENTAL DISABILITIES.]
(a) The commissioner of human services shall ensure that services continue to be available to persons with developmental disabilities who were covered by social services supplemental grants prior to July 1, 2001. Services shall be provided in priority order as follows:
(1) to the extent possible, the commissioner shall establish for these persons targeted slots under the home and community-based waivered services program for persons with mental retardation or related conditions;
(2) persons accommodated under clause (1) shall, if eligible, receive room and board services through group residential housing under Minnesota Statutes, chapter 256I; and
(3) any remaining persons shall continue to receive services through community social services supplemental grants to the affected counties.
(b) This section applies only to individuals receiving services under social services supplemental grants as of June 30, 2001.
Sec. 84. [FEDERAL APPROVAL.]
The commissioner of human services, by September 1, 2001, shall request any federal approval and plan amendments necessary to implement the choice of case manager provision in section 256B.092, subdivision 2a, paragraph (b).
Sec. 85. [FEDERAL WAIVER REQUESTS.]
The commissioner of human services shall submit to the federal Health Care Financing Administration by September 1, 2001, a request for a home and community-based services waiver for day services, including: community inclusion, supported employment, and day training and habilitation services defined in Minnesota Statutes, section 252.41, subdivision 3, clause (1), for persons eligible for the waiver under Minnesota Statutes, section 256B.092.
Sec. 86. [REPEALER.]
(a) Minnesota Statutes 2000, sections 256B.0951, subdivision 6; and 256E.06, subdivision 2b, are repealed.
(b) Minnesota Statutes 2000, sections 145.9245; 256.476, subdivision 7; 256B.0912; 256B.0915, subdivisions 3a, 3b, and 3c; and 256B.49, subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 9, and 10, are repealed.
(c) Laws 1995, chapter 178, article 2, section 48, subdivision 6, is repealed.
(d) Minnesota Rules, parts 9505.2455; 9505.2458; 9505.2460; 9505.2465; 9505.2470; 9505.2473; 9505.2475; 9505.2480; 9505.2485; 9505.2486; 9505.2490; 9505.2495; 9505.2496; 9505.2500; 9505.3010; 9505.3015; 9505.3020; 9505.3025; 9505.3030; 9505.3035; 9505.3040; 9505.3065; 9505.3085; 9505.3135; 9505.3500; 9505.3510; 9505.3520; 9505.3530; 9505.3535; 9505.3540; 9505.3545; 9505.3550; 9505.3560; 9505.3570; 9505.3575; 9505.3580; 9505.3585; 9505.3600; 9505.3610; 9505.3620; 9505.3622; 9505.3624; 9505.3626; 9505.3630; 9505.3635; 9505.3640; 9505.3645; 9505.3650; 9505.3660; and 9505.3670, are repealed.
ARTICLE 5
CONSUMER INFORMATION AND ASSISTANCE
AND COMMUNITY-BASED CARE
Section 1. [144A.35] [EXPANSION OF BED DISTRIBUTION STUDY AND CREATION OF CRITICAL ACCESS SITES.]
Subdivision 1. [OLDER ADULT SERVICES DISTRIBUTION STUDY.] The commissioner of health, in coordination with the commissioner of human services, shall monitor and analyze the distribution of older adult services, including, but not limited to, nursing home beds, senior housing, housing with services units, and home and community-based services in the different geographic areas of the state. The study shall include an analysis of the impact of amendments to the nursing home moratorium law which would allow for transfers of nursing home beds within the state. The commissioner of health shall submit to the legislature, beginning January 15, 2002, and each January 15 thereafter, an assessment of the distribution of long-term health care services by geographic area, with particular attention to service deficits or problems, the designation of critical access service sites, and corrective action plans.
Subd. 2. [CRITICAL ACCESS SERVICE SITE.] "Critical access service site" shall include nursing homes, senior housing, housing with services, and home and community-based services that are certified by the state as necessary providers of health care services to a specific geographic area. For purposes of this requirement, a "necessary provider of health care services" is a provider that is:
(1) located more than 20 miles, defined as official mileage as reported by the Minnesota department of transportation, from the next nearest long-term health care provider;
(2) the sole long-term health care provider in the county; or
(3) a long-term health care provider located in a medically underserved area or health professional shortage area.
Subd. 3. [IDENTIFICATION OF CRITICAL ACCESS SERVICE SITES.] Based on the results of the analysis completed in subdivision 1, the commissioners of health and human services shall identify and designate long-term health care providers as critical access service sites.
Subd. 4. [CRITICAL ACCESS SERVICE SITES.] The commissioner of health, in consultation with the commissioner of human services, shall:
(1) develop and implement specific waivers to regulations governing health care personnel scope of duties, physical plant requirements, and location of community-based services, to address critical access service site older adult service needs;
(2) identify payment barriers to the continued operation of older adult services in critical access service sites, and provide recommendations on changes to reimbursement rates to facilitate the continued operation of these services.
Sec. 2. Minnesota Statutes 2000, section 256.973, is amended by adding a subdivision to read:
Subd. 6. [GRANTS FOR HOME-SHARING PROGRAMS.] Grants awarded for home-sharing programs under this section shall be awarded through a request for proposals process every two years according to criteria developed by the commissioner. In awarding grants, the commissioner shall not give priority to an applicant solely because the applicant has previously received a grant under this section. Nothing under this subdivision shall prohibit the commissioner from evaluating the performance of a home-sharing program receiving a grant under this section and allocating funds based on the evaluation.
Sec. 3. Minnesota Statutes 2000, section 256.975, is amended by adding a subdivision 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; and
(8) link callers with quality profiles for nursing facilities and other providers developed by the commissioner of health.
(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.
Sec. 4. [256.9754] [COMMUNITY SERVICES DEVELOPMENT GRANTS PROGRAM.]
Subdivision 1. [DEFINITIONS.] For purposes of this section, the following terms have the meanings given.
(a) "Community" means a town, township, city, or targeted neighborhood within a city, or a consortium of towns, townships, cities, or targeted neighborhoods within cities.
(b) "Older adult services" means any services available under the elderly waiver program or alternative care grant programs; nursing facility services; transportation services; respite services; and other community-based services identified as necessary either to maintain lifestyle choices for older Minnesotans, or to promote independence.
(c) "Older adult" refers to individuals 65 years of age and older.
Subd. 2. [CREATION.] The community services development grants program is created under the administration of the commissioner of human services.
Subd. 3. [PROVISION OF GRANTS.] The commissioner shall make grants available to communities, providers of older adult services identified in subdivision 1, or to a consortium of providers of older adult services, to establish older adult services. Grants may be provided for capital and other costs including, but not limited to, start-up and training costs, equipment, and supplies related to older adult services or other residential or service alternatives to nursing facility care. Grants may also be made to renovate current buildings, provide transportation services, fund programs that would allow older adults or disabled individuals to stay in their own homes by sharing a home, fund programs that coordinate and manage formal and informal services to older adults in their homes to enable them to live as independently as possible in their own homes as an alternative to nursing home care, or expand state-funded programs in the area.
Subd. 4. [ELIGIBILITY.] Grants may be awarded only to communities and providers or to a consortium of providers that have a local match of 50 percent of the costs for the project in the form of donations, local tax dollars, in-kind donations, fundraising, or other local matches.
Subd. 5. [GRANT PREFERENCE.] The commissioner of human services may award grants to the extent grant funds are available and to the extent applications are approved by the commissioner. Denial of approval of an application in one year does not preclude submission of an application in a subsequent year. The maximum grant amount is limited to $750,000.
Sec. 5. Minnesota Statutes 2000, section 256B.0911, subdivision 1, is amended to read:
Subdivision 1. [PURPOSE AND GOAL.] (a) The purpose of the preadmission screening
program long-term care consultation services is to assist persons with long-term or chronic care
needs in making long-term care decisions and selecting options that meet their needs and reflect their preferences.
The availability of, and access to, information and other types of assistance is also intended to prevent or delay
certified nursing facility placements by assessing applicants and residents and offering cost-effective alternatives
appropriate for the person's needs and to provide transition assistance after admission. Further, the
goal of the program these services is to contain costs associated with unnecessary certified nursing
facility admissions. The commissioners of human services and health shall seek to maximize use of available federal
and state funds and establish the broadest program possible within the funding available.
(b) These services must be coordinated with services provided under sections 256.975, subdivision 7, and 256.9772, and with services provided by other public and private agencies in the community to offer a variety of cost-effective alternatives to persons with disabilities and elderly persons. The county agency providing long-term care consultation services shall encourage the use of volunteers from families, religious organizations, social clubs, and similar civic and service organizations to provide community-based services.
Sec. 6. Minnesota Statutes 2000, section 256B.0911, is amended by adding a subdivision to read:
Subd. 1a. [DEFINITIONS.] For purposes of this section, the following definitions apply:
(a) "Long-term care consultation services" means:
(1) providing information and education to the general public regarding availability of the services authorized under this section;
(2) an intake process that provides access to the services described in this section;
(3) assessment of the health, psychological, and social needs of referred individuals;
(4) assistance in identifying services needed to maintain an individual in the least restrictive environment;
(5) providing recommendations on cost-effective community services that are available to the individual;
(6) development of an individual's community support plan;
(7) providing information regarding eligibility for Minnesota health care programs;
(8) preadmission screening to determine the need for a nursing facility level of care;
(9) preliminary determination of Minnesota health care programs eligibility for individuals who need a nursing facility level of care, with appropriate referrals for final determination;
(10) providing recommendations for nursing facility placement when there are no cost-effective community services available; and
(11) assistance to transition people back to community settings after facility admission.
(b) "Minnesota health care programs" means the medical assistance program under chapter 256B, the alternative care program under section 256B.0913, and the prescription drug program under section 256.955.
Sec. 7. Minnesota Statutes 2000, section 256B.0911, subdivision 3, is amended to read:
Subd. 3. [PERSONS RESPONSIBLE FOR CONDUCTING THE PREADMISSION SCREENING
LONG-TERM CARE CONSULTATION TEAM.] (a) A local screening long-term care
consultation team shall be established by the county board of commissioners. Each local screening
consultation team shall consist of screeners who are a at least one social worker and
a at least one public health nurse from their respective county agencies. The board may
designate public health or social services as the lead agency for long-term care consultation services. If a county
does not have a public health nurse available, it may request approval from the commissioner to assign a county
registered nurse with at least one year experience in home care to participate on the team. The screening team
members must confer regarding the most appropriate care for each individual screened. Two or more counties
may collaborate to establish a joint local screening consultation team or teams.
(b) In assessing a person's needs, screeners shall have a physician available for consultation and shall consider
the assessment of the individual's attending physician, if any. The individual's physician shall be included if the
physician chooses to participate. Other personnel may be included on the team as deemed appropriate by the county
agencies. The team is responsible for providing long-term care consultation services to all persons located
in the county who request the services, regardless of eligibility for Minnesota health care programs.
Sec. 8. Minnesota Statutes 2000, section 256B.0911, is amended by adding a subdivision to read:
Subd. 3a. [ASSESSMENT AND SUPPORT PLANNING.] (a) Persons requesting assessment, services planning, or other assistance intended to support community-based living 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 (g).
(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 of human services.
(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) The team must give the person receiving assessment or support planning, or the person's legal representative, materials supplied by the commissioner of human services containing the following information:
(1) the purpose of preadmission screening and assessment;
(2) information about Minnesota health care programs;
(3) the person's freedom to accept or reject the recommendations of the team;
(4) the person's right to confidentiality under the Minnesota Government Data Practices Act, chapter 13; and
(5) 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.
Sec. 9. Minnesota Statutes 2000, section 256B.0911, is amended by adding a subdivision 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 mental retardation who request or are referred for such 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.
(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. 10. Minnesota Statutes 2000, section 256B.0911, is amended by adding a subdivision to read:
Subd. 4a. [PREADMISSION SCREENING ACTIVITIES RELATED TO NURSING FACILITY ADMISSIONS.] (a) All applicants to Medicaid certified nursing facilities, including certified boarding care facilities, must be screened prior to admission regardless of income, assets, or funding sources for nursing facility care, except as described in subdivision 4b. The purpose of the screening is to determine the need for nursing facility level of care as described in paragraph (d) and to complete activities required under federal law related to mental illness and mental retardation as outlined in paragraph (b).
(b) A person who has a diagnosis or possible diagnosis of mental illness, mental retardation, or a related condition must receive a preadmission screening before admission regardless of the exemptions outlined in subdivision 4b, paragraph (b), to identify the need for further evaluation and specialized services, unless the admission prior to screening is authorized by the local mental health authority or the local developmental disabilities case manager, or unless authorized by the county agency according to Public Law Number 101-508.
The following criteria apply to the preadmission screening:
(1) the county must use forms and criteria developed by the commissioner of human services to identify persons who require referral for further evaluation and determination of the need for specialized services; and
(2) the evaluation and determination of the need for specialized services must be done by:
(i) a qualified independent mental health professional, for persons with a primary or secondary diagnosis of a serious mental illness; or
(ii) a qualified mental retardation professional, for persons with a primary or secondary diagnosis of mental retardation or related conditions. For purposes of this requirement, a qualified mental retardation professional must meet the standards for a qualified mental retardation professional under Code of Federal Regulations, title 42, section 483.430.
(c) The local county mental health authority or the state mental retardation authority under Public Laws Numbers 100-203 and 101-508 may prohibit admission to a nursing facility if the individual does not meet the nursing facility level of care criteria or needs specialized services as defined in Public Laws Numbers 100-203 and 101-508. For purposes of this section, "specialized services" for a person with mental retardation or a related condition means active treatment as that term is defined under Code of Federal Regulations, title 42, section 483.440, paragraph (a), clause (1).
(d) The determination of the need for nursing facility level of care must be made according to criteria developed by the commissioner of human services. In assessing a person's needs, consultation team members shall have a physician available for consultation and shall consider the assessment of the individual's attending physician, if any. The individual's physician must be included if the physician chooses to participate. Other personnel may be included on the team as deemed appropriate by the county.
Sec. 11. Minnesota Statutes 2000, section 256B.0911, is amended by adding a subdivision 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; and
(2) a person transferring from one certified nursing facility in Minnesota to another certified nursing facility in Minnesota.
(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;
(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 Act; and
(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.
(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.
Sec. 12. Minnesota Statutes 2000, section 256B.0911, is amended by adding a subdivision 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.
(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.
(d) The county screening or intake activity must include processes to identify persons who may require transition assistance as described in subdivision 3b.
Sec. 13. Minnesota Statutes 2000, section 256B.0911, subdivision 5, is amended to read:
Subd. 5. [SIMPLIFICATION OF FORMS ADMINISTRATIVE ACTIVITY.] The commissioner
shall minimize the number of forms required in the preadmission screening process provision of
long-term care consultation services and shall limit the screening document to items necessary for care
community support plan approval, reimbursement, program planning, evaluation, and policy development.
Sec. 14. Minnesota Statutes 2000, section 256B.0911, subdivision 6, is amended to read:
Subd. 6. [PAYMENT FOR PREADMISSION SCREENING LONG-TERM CARE
CONSULTATION SERVICES.] (a) The total screening 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 screenings 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 for screening determined under
paragraph (a) for each nursing facility according to section 256B.431, subdivision 2b, paragraph (g),
256B.434, or 256B.435.
(c) Payments for screening activities long-term care consultation services are available to the
county or counties to cover staff salaries and expenses to provide the screening function services
described in subdivision 1a. The lead agency county shall employ, or contract with other
agencies to employ, within the limits of available funding, sufficient personnel to conduct the preadmission
screening activity 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 local agency county
shall be accountable for meeting local objectives as approved by the commissioner in the CSSA biennial plan.
(d) Notwithstanding section 256B.0641, overpayments attributable to payment of the screening costs under the medical assistance program may not be recovered from a facility.
(e) The commissioner of human services shall amend the Minnesota medical assistance plan to include
reimbursement for the local screening consultation teams.
(f) 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. 15. Minnesota Statutes 2000, 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 local county agency 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 PASARR OBRA evaluation as required under the federal Omnibus
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 mental retardation or related condition is
approved by the state mental retardation 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.
(c) The commissioner shall make a request to the health care financing administration for a waiver
allowing screening 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 paragraphs (b) and (c) subdivision 4a, paragraph (c).
(c) The local county mental health authority or the state mental retardation authority under Public Law
Numbers 100-203 and 101-508 may prohibit admission to a nursing facility, if the individual does not meet the
nursing facility level of care criteria or needs specialized services as defined in Public Law Numbers 100-203 and
101-508. For purposes of this section, "specialized services" for a person with mental retardation or a related
condition means "active treatment" as that term is defined in Code of Federal Regulations, title 42, section
483.440(a)(1).
(e) Appeals from the screening team's recommendation or the county agency's final decision shall be made
according to section 256.045, subdivision 3.
Sec. 16. Minnesota Statutes 2000, section 256B.0913, subdivision 1, is amended to read:
Subdivision 1. [PURPOSE AND GOALS.] The purpose of the alternative care program is to provide funding for
or access to home and community-based services for frail elderly persons, in order to limit nursing
facility placements. The program is designed to support frail elderly persons in their desire to remain in the
community as independently and as long as possible and to support informal caregivers in their efforts to provide
care for frail elderly people. Further, the goals of the program are:
(1) to contain medical assistance expenditures by providing funding care in the community at
a cost the same or less than nursing facility costs; and
(2) to maintain the moratorium on new construction of nursing home beds.
Sec. 17. Minnesota Statutes 2000, section 256B.0913, subdivision 2, is amended to read:
Subd. 2. [ELIGIBILITY FOR SERVICES.] Alternative care services are available to all frail older
Minnesotans. This includes:
(1) persons who are receiving medical assistance and served under the medical assistance program or the
Medicaid waiver program;
(2) persons age 65 or older who are not eligible for medical assistance without a spenddown
or waiver obligation but who would be eligible for medical assistance within 180 days of admission to a nursing
facility and served under subject to subdivisions 4 to 13; and
(3) persons who are paying for their services out-of-pocket.
Sec. 18. Minnesota Statutes 2000, 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 screened by the county screening team or, if previously screened and served under the
alternative care program, assessed by the local county social worker or public health nurse 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 financially eligible for medical assistance within 180 days of admission to a
nursing facility;
(4) the person meets the asset transfer requirements of is not ineligible for the medical assistance
program due to an asset transfer penalty;
(5) the screening team would recommend nursing facility admission or continued stay for the person if
alternative care services were not available;
(6) the person needs services that are not available at that time in the county funded
through other county, state, or federal funding sources; and
(7) (6) the monthly cost of the alternative care services funded by the program for this person
does not exceed 75 percent of the statewide average monthly medical assistance payment for nursing facility care
at the individual's case mix classification weighted average monthly nursing facility rate of the case mix
resident class to which the individual alternative care client would be assigned under Minnesota Rules,
parts 9549.0050 to 9549.0059, less the recipient's maintenance needs allowance as described in section
256B.0915, subdivision 1d, paragraph (a), until the first day of the state fiscal year in which the resident assessment
system, under section 256B.437, for nursing home rate determination is implemented. Effective on the first day of
the state fiscal year in which a resident assessment system, under section 256B.437, for nursing home rate
determination is implemented and the first day of each subsequent state fiscal year, the monthly cost of alternative
care services for this person shall not exceed the alternative care monthly cap for the case mix resident class to which
the alternative care client would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, which was in
effect on the last day of the previous state fiscal year, and 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. 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 medical supplies and equipment
or adaptations environmental modifications are or will be purchased for an alternative care services
recipient, the costs may be prorated on a monthly basis throughout the year in which they are purchased
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 calculated described in this paragraph.
(b) Individuals who meet the criteria in paragraph (a) and who have been approved for alternative care funding
are called 180-day eligible clients.
(c) The statewide average payment for nursing facility care is the statewide average monthly nursing facility
rate in effect on July 1 of the fiscal year in which the cost is incurred, less the statewide average monthly income of
nursing facility residents who are age 65 or older and who are medical assistance recipients in the month of March
of the previous fiscal year. This monthly limit does not prohibit the 180-day eligible client from paying for additional
services needed or desired.
(d) In determining the total costs of alternative care services for one month, the costs of all services funded
by the alternative care program, including supplies and equipment, must be included.
(e) 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, unless authorized by
the commissioner or waiver obligation. A person whose initial application for medical
assistance 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, the county must bill 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 services reimbursable under the federally approved elderly waiver
program plan. Notwithstanding this provision, upon federal approval, alternative care funds may not
be used to pay for any service the cost of which is payable by medical assistance or which is used by a recipient to
meet a medical assistance income spenddown or waiver obligation.
(f) (c) Alternative care funding is not available for a person who resides in a licensed nursing
home or, certified boarding care home, hospital, or intermediate care facility, except for
case management services which are being provided in support of the discharge planning process to a
nursing home resident or certified boarding care home resident who is ineligible for case management funded by
medical assistance.
Sec. 19. Minnesota Statutes 2000, section 256B.0913, subdivision 5, is amended to read:
Subd. 5. [SERVICES COVERED UNDER ALTERNATIVE CARE.] (a) Alternative care funding may be used for payment of costs of:
(1) adult foster care;
(2) adult day care;
(3) home health aide;
(4) homemaker services;
(5) personal care;
(6) case management;
(7) respite care;
(8) assisted living;
(9) residential care services;
(10) care-related supplies and equipment;
(11) meals delivered to the home;
(12) transportation;
(13) skilled nursing;
(14) chore services;
(15) companion services;
(16) nutrition services;
(17) training for direct informal caregivers;
(18) telemedicine devices to monitor recipients in their own homes as an alternative to hospital care, nursing home
care, or home visits; and
(19) other services including which includes discretionary funds and direct cash payments to
clients, approved by the county agency following approval by the commissioner, subject to the
provisions of paragraph (m) (j). Total annual payments for "other services" for
all clients within a county may not exceed either ten percent of that county's annual alternative care program base
allocation or $5,000, whichever is greater. In no case shall this amount exceed the county's total annual alternative
care program base allocation; and
(20) environmental modifications.
(b) The county agency must ensure that the funds are not used only to supplement and not
to supplant services available through other public assistance or services programs.
(c) Unless specified in statute, the service definitions and standards for alternative care services shall be
the same as the service definitions and standards defined specified in the federally
approved elderly waiver plan. Except for the county agencies' approval of direct cash payments to
clients as described in paragraph (j) or 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 county 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 non-Medicaid certified vendor
if the cost for the item is less than that of a Medicaid vendor.
(d) The adult foster care rate shall be considered a difficulty of care payment and shall not include room and
board. The adult foster care daily rate shall be negotiated between the county agency and the foster care
provider. The rate established under this section shall not exceed 75 percent of the state average monthly nursing
home payment for the case mix classification to which the individual receiving foster care is assigned, and it must
allow for other alternative care services to be authorized by the case manager. The alternative care payment
for the foster care service in combination with the payment for other alternative care services, including case
management, must not exceed the limit specified in subdivision 4, paragraph (a), clause (6).
(e) Personal care services may be provided by a personal care provider organization. must meet the
service standards defined in the federally approved elderly waiver plan, except that a county agency may
contract with a client's relative of the client who meets the relative hardship waiver requirement
as defined in section 256B.0627, subdivision 4, paragraph (b), clause (10), to provide personal care services,
but must ensure nursing if the county agency ensures supervision of this service by a registered
nurse or mental health practitioner. Covered personal care services defined in section 256B.0627,
subdivision 4, must meet applicable standards in Minnesota Rules, part 9505.0335.
(f) A county may use alternative care funds to purchase medical supplies and equipment without prior approval
from the commissioner when: (1) there is no other funding source; (2) the supplies and equipment are specified in
the individual's care plan as medically necessary to enable the individual to remain in the community according to
the criteria in Minnesota Rules, part 9505.0210, item A; and (3) the supplies and equipment represent an effective
and appropriate use of alternative care funds. A county may use alternative care funds to purchase supplies and
equipment from a non-Medicaid certified vendor if the cost for the items is less than that of a Medicaid vendor. A
county 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.
(g) For purposes of this section, residential care services are services which are provided to individuals
living in residential care homes. Residential care homes are currently licensed as board and lodging establishments
and are registered with the department of health as providing special services under section 157.17 and are not
subject to registration under chapter 144D. Residential care services are defined as "supportive services" and
"health-related services." "Supportive services" means the provision of up to 24-hour supervision and oversight.
Supportive services includes: (1) transportation, when provided by the residential care center home
only; (2) socialization, when socialization is part of the plan of care, has specific goals and outcomes established,
and is not diversional or recreational in nature; (3) assisting clients in setting up meetings and appointments; (4)
assisting clients in setting up medical and social services; (5) providing assistance with personal laundry, such as
carrying the client's laundry to the laundry room. Assistance with personal laundry does not include any laundry,
such as bed linen, that is included in the room and board rate. "Health-related services" are limited
to minimal assistance with dressing, grooming, and bathing and providing reminders to residents to take medications
that are self-administered or providing storage for medications, if requested. Individuals receiving residential care
services cannot receive homemaking services funded under this section.
(h) (g) For the purposes of this section, "assisted living" refers to supportive services provided
by a single vendor to clients who reside in the same apartment building of three or more units which are not subject
to registration under chapter 144D and are licensed by the department of health as a class A home care provider
or a class E home care provider. Assisted living services are defined as up to 24-hour supervision, and
oversight, supportive services as defined in clause (1), individualized home care aide tasks as defined in clause (2),
and individualized home management tasks as defined in clause (3) provided to residents of a residential center
living in their units or
apartments with a full kitchen and bathroom. A full kitchen includes a stove, oven, refrigerator, food preparation counter space, and a kitchen utensil storage compartment. Assisted living services must be provided by the management of the residential center or by providers under contract with the management or with the county.
(1) Supportive services include:
(i) socialization, when socialization is part of the plan of care, has specific goals and outcomes established, and is not diversional or recreational in nature;
(ii) assisting clients in setting up meetings and appointments; and
(iii) providing transportation, when provided by the residential center only.
Individuals receiving assisted living services will not receive both assisted living services and homemaking
services. Individualized means services are chosen and designed specifically for each resident's needs, rather than
provided or offered to all residents regardless of their illnesses, disabilities, or physical conditions.
(2) Home care aide tasks means:
(i) preparing modified diets, such as diabetic or low sodium diets;
(ii) reminding residents to take regularly scheduled medications or to perform exercises;
(iii) household chores in the presence of technically sophisticated medical equipment or episodes of acute illness or infectious disease;
(iv) household chores when the resident's care requires the prevention of exposure to infectious disease or containment of infectious disease; and
(v) assisting with dressing, oral hygiene, hair care, grooming, and bathing, if the resident is ambulatory, and if the resident has no serious acute illness or infectious disease. Oral hygiene means care of teeth, gums, and oral prosthetic devices.
(3) Home management tasks means:
(i) housekeeping;
(ii) laundry;
(iii) preparation of regular snacks and meals; and
(iv) shopping.
Individuals receiving assisted living services shall not receive both assisted living services and homemaking services. Individualized means services are chosen and designed specifically for each resident's needs, rather than provided or offered to all residents regardless of their illnesses, disabilities, or physical conditions. Assisted living services as defined in this section shall not be authorized in boarding and lodging establishments licensed according to sections 157.011 and 157.15 to 157.22.
(i) (h) For establishments registered under chapter 144D, assisted living services under this
section means either the services described and licensed in paragraph (g) and delivered by a
class E home care provider licensed by the department of health or the services described under section
144A.4605 and delivered by an assisted living home care provider or a class A home care provider licensed by
the commissioner of health.
(j) For the purposes of this section, reimbursement (i) Payment for assisted living services and
residential care services shall be a monthly rate negotiated and authorized by the county agency based on an
individualized service plan for each resident and may not cover direct rent or food costs. The rate
(1) The individualized monthly negotiated payment for assisted living services as described in paragraph (g)
or (h), and residential care services as described in paragraph (f), 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 medical assistance nursing facility
payment rate of the case mix resident class to which the 180-day alternative care eligible client
would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, unless the less the
maintenance needs allowance as described in subdivision 1d, paragraph (a), until the first day of the state fiscal year
in which a resident assessment system, under section 256B.437, of nursing home rate determination is implemented.
Effective on the first day of the state fiscal year in which a resident assessment system, under section 256B.437, of
nursing home rate determination is implemented and the first day 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 the last day 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.
(2) The individualized monthly negotiated payment for assisted living services are provided by a
home care described under section 144A.4605 and delivered by a provider licensed by the department
of health as a class A home care provider or an assisted living home care provider and are provided
in a building that is registered as a housing with services establishment under chapter 144D and that provides
24-hour supervision in combination with the payment for other alternative care services, including case
management, must not exceed the limit specified in subdivision 4, paragraph (a), clause (6).
(k) For purposes of this section, companion services are defined as nonmedical care, supervision and oversight,
provided to a functionally impaired adult. Companions may assist the individual with such tasks as meal
preparation, laundry and shopping, but do not perform these activities as discrete services. The provision of
companion services does not entail hands-on medical care. Providers may also perform light housekeeping tasks
which are incidental to the care and supervision of the recipient. This service must be approved by the case manager
as part of the care plan. Companion services must be provided by individuals or organizations who are under
contract with the local agency to provide the service. Any person related to the waiver recipient by blood, marriage
or adoption cannot be reimbursed under this service. Persons providing companion services will be monitored by
the case manager.
(l) For purposes of this section, training for direct informal caregivers is defined as a classroom or home course
of instruction which may include: transfer and lifting skills, nutrition, personal and physical cares, home safety in
a home environment, stress reduction and management, behavioral management, long-term care decision making,
care coordination and family dynamics. The training is provided to an informal unpaid caregiver of a 180-day
eligible client which enables the caregiver to deliver care in a home setting with high levels of quality. The training
must be approved by the case manager as part of the individual care plan. Individuals, agencies, and educational
facilities which provide caregiver training and education will be monitored by the case manager.
(m) (j) A county agency may make payment from their alternative care program allocation for
"other services" provided to an alternative care program recipient if those services prevent,
shorten, or delay institutionalization. These services may which include use of "discretionary
funds" for services that are not otherwise defined in this section and direct cash payments to the
recipient client for the purpose of purchasing the recipient's services. The following
provisions apply to payments under this paragraph:
(1) a cash payment to a client under this provision cannot exceed 80 percent of the monthly payment limit for that
client as specified in subdivision 4, paragraph (a), clause (7) (6);
(2) a county may not approve any cash payment for a client who meets either of the following:
(i) has been assessed as having a dependency in orientation, unless the client has an authorized
representative under section 256.476, subdivision 2, paragraph (g), or for a client who. An "authorized
representative" means an individual who is at least 18 years of age and is designated by the person or the person's
legal representative to act on the person's behalf. This individual may be a family member, guardian, representative
payee, or other individual designated by the person or the person's legal representative, if any, to assist in purchasing
and arranging for supports; or
(ii) is concurrently receiving adult foster care, residential care, or assisted living services;
(3) any service approved under this section must be a service which meets the purpose and goals of the
program as listed in subdivision 1;
(4) cash payments must also meet the criteria of and are governed by the procedures and liability protection
established in section 256.476, subdivision 4, paragraphs (b) through (h), and recipients of cash grants must meet
the requirements in section 256.476, subdivision 10; and cash payments to a person or a person's family will
be provided through a monthly payment and be in the form of cash, voucher, or direct county payment to vendor.
Fees or premiums assessed to the person for eligibility for health and human services are not reimbursable through
this service option. Services and goods purchased through cash payments must be identified in the person's
individualized care plan and must meet all of the following criteria:
(i) they must be over and above the normal cost of caring for the person if the person did not have functional limitations;
(ii) they must be directly attributable to the person's functional limitations;
(iii) they must have the potential to be effective at meeting the goals of the program;
(iv) they must be consistent with the needs identified in the individualized service plan. The service plan shall specify the needs of the person and family, the form and amount of payment, the items and services to be reimbursed, and the arrangements for management of the individual grant; and
(v) the person, the person's family, or the legal representative shall be provided sufficient information to ensure an informed choice of alternatives. The local agency shall document this information in the person's care plan, including the type and level of expenditures to be reimbursed;
(4) the county, lead agency under contract, or tribal government under contract to administer the alternative care program 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 representative with funds received through the cash payments under this section. Liabilities include, but are not limited to, workers' compensation, the Federal Insurance Contributions Act (FICA), or the Federal Unemployment Tax Act (FUTA);
(5) persons receiving grants under this section shall have the following responsibilities:
(i) spend the grant money in a manner consistent with their individualized service plan with the local agency;
(ii) notify the local agency of any necessary changes in the grant-expenditures;
(iii) arrange and pay for supports; and
(iv) inform the local agency of areas where they have experienced difficulty securing or maintaining supports; and
(5) (6) the county shall report client outcomes, services, and costs under this paragraph in a
manner prescribed by the commissioner.
(k) Upon implementation of direct cash payments to clients under this section, any person determined eligible for the alternative care program who chooses a cash payment approved by the county agency shall receive the cash payment under this section and not under section 256.476 unless the person was receiving a consumer support grant under section 256.476 before implementation of direct cash payments under this section.
Sec. 20. Minnesota Statutes 2000, section 256B.0913, subdivision 6, is amended to read:
Subd. 6. [ALTERNATIVE CARE PROGRAM ADMINISTRATION.] The alternative care program is administered by the county agency. This agency is the lead agency responsible for the local administration of the alternative care program as described in this section. However, it may contract with the public health nursing service to be the lead agency. The commissioner may contract with federally recognized Indian tribes with a reservation in Minnesota to serve as the lead agency responsible for the local administration of the alternative care program as described in the contract.
Sec. 21. Minnesota Statutes 2000, section 256B.0913, subdivision 7, is amended to read:
Subd. 7. [CASE MANAGEMENT.] Providers of case management services for persons receiving services funded
by the alternative care program must meet the qualification requirements and standards specified in section
256B.0915, subdivision 1b. The case manager must ensure the health and safety of the individual client and
not approve alternative care funding for a client in any setting in which the case manager cannot reasonably
ensure the client's health and safety. The case manager is responsible for the cost-effectiveness of the alternative
care individual care plan and must not approve any care plan in which the cost of services funded by alternative
care and client contributions exceeds the limit specified in section 256B.0915, subdivision 3, paragraph (b).
The county may allow a case manager employed by the county to delegate certain aspects of the case management
activity to another individual employed by the county 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.
Sec. 22. Minnesota Statutes 2000, 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 180-day eligible 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 county
shall be held harmless for damages or injuries sustained through the use of volunteers under this subdivision
including workers' compensation liability. The lead agency shall provide documentation to the commissioner
verifying that the individual's alternative care is not available at that time through any other public assistance or
service program. The lead agency 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.
The case manager must give the individual a ten-day written notice of any decrease in or termination of alternative
care services.
(b) If the county administering alternative care services is different than the county of financial responsibility, the care plan may be implemented without the approval of the county of financial responsibility.
Sec. 23. Minnesota Statutes 2000, section 256B.0913, subdivision 9, is amended to read:
Subd. 9. [CONTRACTING PROVISIONS FOR PROVIDERS.] The lead agency shall document to the
commissioner that the agency made reasonable efforts to inform potential providers of the anticipated need for
services under the alternative care program or waiver programs under sections 256B.0915 and 256B.49, including
a minimum of 14 days' written advance notice of the opportunity to be selected as a service provider and an annual
public meeting with providers to explain and review the criteria for selection. The lead agency shall also document
to the commissioner that the agency allowed potential providers an opportunity to be selected to contract with the county agency. Funds reimbursed to counties under this subdivision 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 county:
(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 county administrative costs;
(6) evaluation of services previously delivered by the provider; and
(7) contract or agreement conditions, including billing requirements, cancellation, and indemnification.
The county must evaluate its own agency services under the criteria established for other providers. The
county shall provide a written statement of the reasons for not selecting providers.
Sec. 24. Minnesota Statutes 2000, section 256B.0913, subdivision 10, is amended to read:
Subd. 10. [ALLOCATION FORMULA.] (a) The alternative care appropriation for fiscal years 1992 and beyond
shall cover only 180-day alternative care eligible clients. Prior to July 1 of each year, the
commissioner shall allocate to county agencies the state funds available for alternative care for persons eligible under
subdivision 2.
(b) Prior to July 1 of each year, the commissioner shall allocate to county agencies the state funds available
for alternative care for persons eligible under subdivision 2. The allocation for fiscal year 1992 shall be calculated
using a base that is adjusted to exclude the medical assistance share of alternative care expenditures. The adjusted
base is calculated by multiplying each county's allocation for fiscal year 1991 by the percentage of county alternative
care expenditures for 180-day eligible clients. The percentage is determined based on expenditures for services
rendered in fiscal year 1989 or calendar year 1989, whichever is greater. The adjusted base for each county
is the county's 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 county, 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 county alternative care program expenditures for 180-day eligible clients as
defined in paragraph (b) are 95 percent or more of its the county's 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 county alternative care program expenditures for 180-day eligible clients as
defined in paragraph (b) are less than 95 percent of its the county's 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) For fiscal year 1992 only, a county may receive an increased allocation if annualized service costs for the
month of May 1991 for 180-day eligible clients are greater than the allocation otherwise determined. A county may
apply for this increase by reporting projected expenditures for May to the commissioner by June 1, 1991. The
amount of the allocation may exceed the amount calculated in paragraph (b). The projected expenditures for May must be based on actual 180-day eligible client caseload and the individual cost of clients' care plans. If a county does not report its expenditures for May, the amount in paragraph (c) or (d) shall be used.
(f) Calculations for paragraphs (c) and (d) are to be made as follows: for each county, the determination of
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 by June 1 of that year. Calculations for paragraphs (c) and (d) must also
include the funds transferred to the consumer support grant program for clients who have transferred to that program
from April 1 through March 31 in the base year.
(g) For the biennium ending June 30, 2001, the allocation of state funds to county agencies shall be calculated
as described in paragraphs (c) and (d). If the annual legislative appropriation for the alternative care program
is inadequate to fund the combined county allocations for fiscal year 2000 or 2001 a biennium, the
commissioner shall distribute to each county the entire annual appropriation as that county's percentage of the
computed base as calculated in paragraph (f) paragraphs (c) and (d).
Sec. 25. Minnesota Statutes 2000, 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 counties with the greatest need. Targeted funds are not intended to be distributed equitably among all counties, 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 county 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 counties 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) counties 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) counties 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) counties that propose projects to divert community residents from nursing home placement or convert nursing home residents to community living; and
(4) counties that can otherwise justify program growth by demonstrating the existence of waiting lists, demographically justified needs, or other unmet needs.
(d) Counties 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 request applications by June 1 each year, for county agencies to apply for
targeted funds by November 1 of each year. The counties selected for targeted funds shall be notified of the
amount of their additional funding by August 1 of each year. Targeted funds allocated to a county agency
in one year shall be treated as part of the county's base allocation for that year in determining allocations for
subsequent years. No reallocations between counties shall be made.
(f) The allocation for each year after fiscal year 1992 shall be determined using the previous fiscal year's
allocation, including any targeted funds, as the base and then applying the criteria under subdivision 10, paragraphs
(c), (d), and (f), to the current year's expenditures.
Sec. 26. Minnesota Statutes 2000, section 256B.0913, subdivision 12, is amended to read:
Subd. 12. [CLIENT PREMIUMS.] (a) A premium is required for all 180-day alternative care
eligible clients to help pay for the cost of participating in the program. The amount of the premium 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 greater than the
medical assistance income standard recipient's maintenance needs allowance as defined in section
256B.0915, subdivision 1d, paragraph (a), but less than 150 percent of the federal poverty guideline
effective on July 1 of the state fiscal year in which the premium 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 greater than 150 percent of the federal poverty guideline effective on July 1 of the state fiscal year in which the premium is being computed, and total assets are less than $10,000, the fee is 25 percent of the cost of alternative care services or the difference between 150 percent of the federal poverty guideline effective on July 1 of the state fiscal year in which the premium is being computed and the client's income less recurring and predictable medical expenses, whichever is less; and
(3) when the alternative care client's total assets are greater than $10,000, the fee is 25 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 except case management shall be included in the estimated costs for the purpose of determining 25 percent of the costs.
The monthly premium shall be calculated based on the cost of the first full month of alternative care services and shall continue unaltered until the next reassessment is completed or at the end of 12 months, whichever comes first. Premiums are due and payable each month alternative care services are received unless the actual cost of the services is less than the premium.
(b) The fee shall be waived by the commissioner when:
(1) a person who is residing in a nursing facility is receiving case management only;
(2) a person is applying for medical assistance;
(3) a married couple is requesting an asset assessment under the spousal impoverishment provisions;
(4) a person is a medical assistance recipient, but has been approved for alternative care-funded assisted living
services;
(5) a person is found eligible for alternative care, but is not yet receiving alternative care services; or
(6) (5) a person's fee under paragraph (a) is less than $25.
(c) The county agency must record in the state's receivable system the client's assessed premium amount or
the reason the premium has been waived. The commissioner will bill and collect the premium from the client
and forward the amounts collected to the commissioner in the manner and at the times prescribed by the
commissioner. 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 county with the client's social security number at the
time of application. If a client fails or refuses to pay the premium due, The county shall supply the
commissioner with the client's social security number and other information the commissioner requires to collect
the premium from the client. The commissioner shall collect unpaid premiums using the Revenue Recapture Act
in chapter 270A and other methods available to the commissioner. The commissioner may require counties to
inform clients of the collection procedures that may be used by the state if a premium is not paid.
(d) The commissioner shall begin to adopt emergency or permanent rules governing client premiums within 30 days after July 1, 1991, including criteria for determining when services to a client must be terminated due to failure to pay a premium.
Sec. 27. Minnesota Statutes 2000, section 256B.0913, subdivision 13, is amended to read:
Subd. 13. [COUNTY BIENNIAL PLAN.] The county biennial plan for the preadmission screening
program long-term care consultation under section 256B.0911, the alternative care program under
this section, and waivers for the elderly under section 256B.0915, and waivers for the disabled
under section 256B.49, shall be incorporated into the biennial Community Social Services Act plan and shall
meet the regulations and timelines of that plan. This county biennial plan shall include:
(1) information on the administration of the preadmission screening program;
(2) information on the administration of the home and community-based services waivers for the elderly under
section 256B.0915, and for the disabled under section 256B.49; and
(3) information on the administration of the alternative care program.
Sec. 28. Minnesota Statutes 2000, section 256B.0913, subdivision 14, is amended to read:
Subd. 14. [REIMBURSEMENT PAYMENT AND RATE ADJUSTMENTS.] (a)
Reimbursement Payment for expenditures for the provided alternative care services
as approved by the client's case manager shall be through the invoice processing procedures of the department's
Medicaid Management Information System (MMIS). To receive reimbursement payment, the
county or vendor must submit invoices within 12 months following the date of service. The county agency and its
vendors under contract shall not be reimbursed for services which exceed the county allocation.
(b) If a county collects less than 50 percent of the client premiums due under subdivision 12, the commissioner
may withhold up to three percent of the county's final alternative care program allocation determined under
subdivisions 10 and 11.
(c) The county shall negotiate individual rates with vendors and may be reimbursed authorize
service payment for actual costs up to the greater of the county's current approved rate or 60 percent
of the maximum rate in fiscal year 1994 and 65 percent of the maximum rate in fiscal year 1995 for each alternative
care service. 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.
(d) (c) On July 1, 1993, the commissioner shall increase the maximum rate for home
delivered meals to $4.50 per meal. 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 (j), 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) Counties may negotiate individual service rates with vendors for actual costs up to the statewide maximum service rate limit.
Sec. 29. Minnesota Statutes 2000, section 256B.0915, subdivision 1d, is amended to read:
Subd. 1d. [POSTELIGIBILITY TREATMENT OF INCOME AND RESOURCES FOR ELDERLY WAIVER.]
(a) 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.
(b) The commissioner of human services shall secure approval of additional elderly waiver slots sufficient to
serve persons who will qualify under the revised income standard described in paragraph (a) before implementing
section 256B.0913, subdivision 16.
(c) In implementing this subdivision, the commissioner shall consider allowing persons who would otherwise
be eligible for the alternative care program but would qualify for the elderly waiver with a spenddown to remain on
the alternative care program.
Sec. 30. Minnesota Statutes 2000, section 256B.0915, subdivision 3, is amended to read:
Subd. 3. [LIMITS OF CASES, RATES, REIMBURSEMENT PAYMENTS, AND
FORECASTING.] (a) The number of medical assistance waiver recipients that a county 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.
(b) The monthly limit for the cost of waivered services to an individual elderly waiver client shall be the
statewide average payment weighted average monthly nursing facility rate of the case mix resident
class to which the elderly waiver client would be assigned under the medical assistance case mix
reimbursement system. 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 cost-of-living percentage increase or any legislatively adopted statewide
percent rate increase for nursing facilities.
(c) If extended medical supplies and equipment or adaptations environmental
modifications are or will be purchased for an elderly waiver services recipient client, the costs
may be prorated on a monthly basis throughout the year in which they are purchased for up to 12
consecutive months beginning with the month of purchase. If the monthly cost of a recipient's other
waivered services exceeds the monthly limit established in this paragraph (b), the annual cost of
the all waivered services shall be determined. In this event, the annual cost of all waivered
services shall not exceed 12 times the monthly limit calculated in this paragraph. The statewide average payment
rate is
calculated by determining the statewide average monthly nursing home rate, effective July 1 of the fiscal year in which the cost is incurred, less the statewide average monthly income of nursing home residents who are age 65 or older, and who are medical assistance recipients in the month of March of the previous state fiscal year. The annual cost divided by 12 of elderly or disabled waivered services of waivered services as described in paragraph (b).
(d) For a person who is a nursing facility resident at the time of requesting a determination of eligibility
for elderly or disabled waivered services shall be the greater of the monthly payment for: (i),
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; or (ii) the
statewide average payment of the case mix resident class to which the resident would be assigned under the medical
assistance case mix reimbursement system, provided that until 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, 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 256B.437 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 limit under
this clause 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. 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 modifications; and
(2) cost of skilled nursing, home health aide, and personal care services reimbursable by medical assistance.
(c) (e) 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.
(d) For both the elderly waiver and the nursing facility disabled waiver, a county may purchase extended
supplies and equipment without prior approval from the commissioner when there is no other funding source and
the supplies and equipment are specified in the individual's care plan as medically necessary to enable the individual
to remain in the community according to the criteria in Minnesota Rules, part 9505.0210, items A and B.
(f) A county 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.
(e) (g) The adult foster care daily rate for the elderly and disabled waivers
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 county agency and the foster care provider. The rate established
under this section shall not exceed the state average monthly nursing home payment for the case mix classification
to which the individual receiving foster care is assigned; the rate must allow for other waiver and medical assistance
home care services to be authorized by the case manager. 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 paragraph (b).
(f) The assisted living and residential care service rates for elderly and community alternatives for disabled
individuals (CADI) waivers shall be made to the vendor as a monthly rate negotiated with the county agency based
on an individualized service plan for each resident. The rate shall not exceed the nonfederal share of the greater of
either the statewide or any of the geographic groups' weighted average monthly medical assistance nursing facility
payment rate of the case mix resident class to which the elderly or disabled client would be assigned under Minnesota
Rules, parts 9549.0050 to 9549.0059, unless the services are provided by a home care provider licensed by the
department of health and are provided in a building that is registered as a housing with services establishment under
chapter 144D and that provides 24-hour supervision. For alternative care assisted living projects established under
Laws 1988, chapter 689, article 2, section 256, monthly rates may not exceed 65 percent of the greater of either the
statewide or any of the geographic groups' weighted average monthly medical assistance nursing facility payment rate for the case mix resident class to which the elderly or disabled client would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059. The rate may not cover direct rent or food costs.
(h) Payment for assisted living service shall be a monthly rate negotiated and authorized by the county agency based on an individualized service plan for each resident and may not cover direct rent or food costs.
(1) The individualized monthly negotiated payment for assisted living services as described in section 256B.0913, subdivision 5, paragraph (g) or (h), and residential care services as described in section 256B.0913, subdivision 5, paragraph (f), 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.
(2) The individualized monthly negotiated payment for assisted living services described in section 144A.4605 and delivered by a provider licensed by the department of health as a class A home care provider or an assisted living home care provider and provided in a building that is registered as a housing with services establishment under chapter 144D 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 paragraph (b).
(g) (i) The county shall negotiate individual service rates with vendors and may be
reimbursed authorize payment for actual costs up to the greater of the county's current approved
rate or 60 percent of the maximum rate in fiscal year 1994 and 65 percent of the maximum rate in fiscal year
1995 for each service within each program. Persons or agencies must be employed by or under a contract
with the county 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.
(h) On July 1, 1993, the commissioner shall increase the maximum rate for home-delivered meals to $4.50
per meal.
(i) (j) 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.
(k) 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 county-specific service rate limits.
(1) Effective July 1, 2001, for service rate limits, except those described or defined in paragraphs (g) and (h), 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) Counties may negotiate individual service rates with vendors for actual costs up to the statewide maximum service rate limit.
(j) (l) Beginning July 1, 1991, the state shall reimburse counties according to the payment
schedule in section 256.025 for the county share of costs incurred under this subdivision on or after January 1, 1991,
for individuals who are receiving medical assistance.
(k) For the community alternatives for disabled individuals waiver, and nursing facility disabled waivers,
county may use waiver funds for the cost of minor adaptations to a client's residence or vehicle without prior approval
from the commissioner if there is no other source of funding and the adaptation:
(1) is necessary to avoid institutionalization;
(2) has no utility apart from the needs of the client; and
(3) meets the criteria in Minnesota Rules, part 9505.0210, items A and B.
For purposes of this subdivision, "residence" means the client's own home, the client's family residence, or a
family foster home. For purposes of this subdivision, "vehicle" means the client's vehicle, the client's family vehicle,
or the client's family foster home vehicle.
(l) The commissioner shall establish a maximum rate unit for baths provided by an adult day care provider
that are not included in the provider's contractual daily or hourly rate. This maximum rate must equal the home
health aide extended rate and shall be paid for baths provided to clients served under the elderly and disabled
waivers.
Sec. 31. Minnesota Statutes 2000, section 256B.0915, subdivision 5, is amended to read:
Subd. 5. [REASSESSMENTS FOR WAIVER CLIENTS.] A reassessment of a client served under the elderly
or disabled 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.
Sec. 32. Minnesota Statutes 2000, section 256B.0917, subdivision 7, is amended to read:
Subd. 7. [CONTRACT.] (a) The commissioner of human services shall execute a contract with Living at Home/Block Nurse Program, Inc. (LAH/BN, Inc.). The contract shall require LAH/BN, Inc. to:
(1) develop criteria for and award grants to establish community-based organizations that will implement living-at-home/block nurse programs throughout the state;
(2) award grants to enable current living-at-home/block nurse programs to continue to implement the
combined living-at-home/block nurse program model;
(3) serve as a state technical assistance center to assist and coordinate the living-at-home/block nurse programs established; and
(4) manage contracts with individual living-at-home/block nurse programs.
(b) The contract shall be effective July 1, 1997, and section 16B.17 shall not apply.
Sec. 33. [256B.0918] [DEVELOPMENT AND PURPOSE OF MEDICAL ASSISTANCE PILOT PROJECT ON SENIOR SERVICES.]
Subdivision 1. [DEVELOPMENT AND PURPOSE.] The commissioner of human services shall develop a medical assistance pilot project on senior services to determine how converting the delivery of housing, supportive services, and health care for seniors into a flexible voucher program will impact public expenditures for older adult service care and provide an alternative way to purchase services based on consumer choice.
Subd. 2. [FEDERAL WAIVER AUTHORITY.] The commissioner shall apply for any necessary federal waivers or approvals to implement this pilot project. The commissioner shall submit the waiver request no later than April 15, 2002.
Subd. 3. [REPORT.] The commissioner shall report to the legislature by January 15, 2003, on approval of waivers requested. Upon federal approval, the commissioner shall seek legislative authorization to implement the pilot project. Once the pilot project is implemented, participating communities and the commissioner of human services shall collaborate to prepare and issue an annual report each December 1 to the appropriate committee chairs in the senate and house on: (1) the use of state resources, including other funds leveraged for this initiative; (2) the status of individuals being served in the pilot project; and (3) the cost-effectiveness of the pilot project. The commissioner shall provide data that may be needed to evaluate the pilot project to communities that request the data.
Subd. 4. [SUNSET.] This section sunsets June 30, 2008.
Sec. 34. [SERVICE ACCESS STUDY.]
By February 15, 2002, the commissioner of human services shall submit to the legislature recommendations for creating coordinated service access at the county agency level for both publicly subsidized and nonsubsidized long-term care services and housing options. The report must:
(1) include a plan to coordinate public funding streams to allow low-income, privately paying consumers to purchase services through a sliding fee scale; and
(2) evaluate the feasibility of statewide implementation, based upon an evaluation of public cost, consumer preferences and satisfaction, and other relevant factors.
Sec. 35. [RESPITE CARE.]
The Minnesota board on aging shall report to the legislature by February 1, 2002, on the provision of in-home and out-of-home respite care services on a sliding scale basis under the federal Older Americans Act.
Sec. 36. [REPEALER.]
Minnesota Statutes 2000, sections 256B.0911, subdivisions 2, 2a, 4, 8, and 9; and 256B.0913, subdivisions 3, 15a, 15b, 15c, and 16; Minnesota Rules, parts 9505.2390; 9505.2395; 9505.2396; 9505.2400; 9505.2405; 9505.2410; 9505.2413; 9505.2415; 9505.2420; 9505.2425; 9505.2426; 9505.2430; 9505.2435; 9505.2440; 9505.2445; 9505.2450; 9505.2455; 9505.2458; 9505.2460; 9505.2465; 9505.2470; 9505.2473; 9505.2475; 9505.2480; 9505.2485; 9505.2486; 9505.2490; 9505.2495; 9505.2496; and 9505.2500, are repealed.
ARTICLE 6
LONG-TERM CARE REFORM AND REIMBURSEMENT
Section 1. [144.0724] [RESIDENT REIMBURSEMENT CLASSIFICATION.]
Subdivision 1. [RESIDENT REIMBURSEMENT CLASSIFICATIONS.] The commissioner of health shall establish resident reimbursement classifications based upon the assessments of residents of nursing homes and boarding care homes conducted under this section and according to section 256B.437. The reimbursement classifications established under this section shall be implemented after June 30, 2002, but no later than January 1, 2003.
Subd. 2. [DEFINITIONS.] For purposes of this section, the following terms have the meanings given.
(a) [ASSESSMENT REFERENCE DATE.] "Assessment reference date" means the last day of the minimum data set observation period. The date sets the designated endpoint of the common observation period, and all minimum data set items refer back in time from that point.
(b) [CASE MIX INDEX.] "Case mix index" means the weighting factors assigned to the RUG-III classifications.
(c) [INDEX MAXIMIZATION.] "Index maximization" means classifying a resident who could be assigned to more than one category, to the category with the highest case mix index.
(d) [MINIMUM DATA SET.] "Minimum data set" means the assessment instrument specified by the Health Care Financing Administration and designated by the Minnesota department of health.
(e) [REPRESENTATIVE.] "Representative" means a person who is the resident's guardian or conservator, the person authorized to pay the nursing home expenses of the resident, a representative of the nursing home ombudsman's office whose assistance has been requested, or any other individual designated by the resident.
(f) [RESOURCE UTILIZATION GROUPS OR RUG.] "Resource utilization groups" or "RUG" means the system for grouping a nursing facility's residents according to their clinical and functional status identified in data supplied by the facility's minimum data set.
Subd. 3. [RESIDENT REIMBURSEMENT CLASSIFICATIONS.] (a) Resident reimbursement classifications shall be based on the minimum data set, version 2.0 assessment instrument, or its successor version mandated by the Health Care Financing Administration that nursing facilities are required to complete for all residents. The commissioner of health shall establish resident classes according to the 34 group, resource utilization groups, version III or RUG-III model. Resident classes must be established based on the individual items on the minimum data set and must be completed according to the facility manual for case mix classification issued by the Minnesota department of health. The facility manual for case mix classification shall be drafted by the Minnesota department of health and presented to the chairs of health and human services legislative committees by December 31, 2001.
(b) Each resident must be classified based on the information from the minimum data set according to general domains in clauses (1) to (7):
(1) extensive services where a resident requires intravenous feeding or medications, suctioning, tracheostomy care, or is on a ventilator or respirator;
(2) rehabilitation where a resident requires physical, occupational, or speech therapy;
(3) special care where a resident has cerebral palsy; quadriplegia; multiple sclerosis; pressure ulcers; fever with vomiting, weight loss, or dehydration; tube feeding and aphasia; or is receiving radiation therapy;
(4) clinically complex status where a resident has burns, coma, septicemia, pneumonia, internal bleeding, chemotherapy, wounds, kidney failure, urinary tract infections, oxygen, or transfusions;
(5) impaired cognition where a resident has poor cognitive performance;
(6) behavior problems where a resident exhibits wandering, has hallucinations, or is physically or verbally abusive toward others, unless the resident's other condition would place the resident in other categories; and
(7) reduced physical functioning where a resident has no special clinical conditions.
(c) The commissioner of health shall establish resident classification according to a 34 group model based on the information on the minimum data set and within the general domains listed in paragraph (b), clauses (1) to (7). Detailed descriptions of each resource utilization group shall be defined in the facility manual for case mix classification issued by the Minnesota department of health. The 34 groups are described as follows:
(1) SE3: requires four or five extensive services;
(2) SE2: requires two or three extensive services;
(3) SE1: requires one extensive service;
(4) RAD: requires rehabilitation services and is dependent in activity of daily living (ADL) at a count of 17 or 18;
(5) RAC: requires rehabilitation services and ADL count is 14 to 16;
(6) RAB: requires rehabilitation services and ADL count is ten to 13;
(7) RAA: requires rehabilitation services and ADL count is four to nine;
(8) SSC: requires special care and ADL count is 17 or 18;
(9) SSB: requires special care and ADL count is 15 or 16;
(10) SSA: requires special care and ADL count is seven to 14;
(11) CC2: clinically complex with depression and ADL count is 17 or 18;
(12) CC1: clinically complex with no depression and ADL count is 17 or 18;
(13) CB2: clinically complex with depression and ADL count is 12 to 16;
(14) CB1: clinically complex with no depression and ADL count is 12 to 16;
(15) CA2: clinically complex with depression and ADL count is four to 11;
(16) CA1: clinically complex with no depression and ADL count is four to 11;
(17) IB2: impaired cognition with nursing rehabilitation and ADL count is six to ten;
(18) IB1: impaired cognition with no nursing rehabilitation and ADL count is six to ten;
(19) IA2: impaired cognition with nursing rehabilitation and ADL count is four or five;
(20) IA1: impaired cognition with no nursing rehabilitation and ADL count is four or five;
(21) BB2: behavior problems with nursing rehabilitation and ADL count is six to ten;
(22) BB1: behavior problems with no nursing rehabilitation and ADL count is six to ten;
(23) BA2: behavior problems with nursing rehabilitation and ADL count is four to five;
(24) BA1: behavior problems with no nursing rehabilitation and ADL count is four to five;
(25) PE2: reduced physical functioning with nursing rehabilitation and ADL count is 16 to 18;
(26) PE1: reduced physical functioning with no nursing rehabilitation and ADL count is 16 to 18;
(27) PD2: reduced physical functioning with nursing rehabilitation and ADL count is 11 to 15;
(28) PD1: reduced physical functioning with no nursing rehabilitation and ADL count is 11 to 15;
(29) PC2: reduced physical functioning with nursing rehabilitation and ADL count is nine or ten;
(30) PC1: reduced physical functioning with no nursing rehabilitation and ADL count is nine or ten;
(31) PB2: reduced physical functioning with nursing rehabilitation and ADL count is six to eight;
(32) PB1: reduced physical functioning with no nursing rehabilitation and ADL count is six to eight;
(33) PA2: reduced physical functioning with nursing rehabilitation and ADL count is four or five; and
(34) PA1: reduced physical functioning with no nursing rehabilitation and ADL count is four or five.
Subd. 4. [RESIDENT ASSESSMENT SCHEDULE.] (a) A facility must conduct and electronically submit to the commissioner of health case mix assessments that conform with the assessment schedule defined by the Code of Federal Regulations, title 42, section 483.20, and published by the United States Department of Health and Human Services, Health Care Financing Administration, in the Long Term Care Assessment Instrument User's Manual, version 2.0, October 1995, and subsequent clarifications made in the Long-Term Care Assessment Instrument Questions and Answers, version 2.0, August 1996. The commissioner of health may substitute successor manuals or question and answer documents published by the United States Department of Health and Human Services, Health Care Financing Administration, to replace or supplement the current version of the manual or document.
(b) The assessments used to determine a case mix classification for reimbursement include the following:
(1) a new admission assessment must be completed by day 14 following admission;
(2) an annual assessment must be completed within 366 days of the last comprehensive assessment;
(3) a significant change assessment must be completed within 14 days of the identification of a significant change; and
(4) the second quarterly assessment following either a new admission assessment, an annual assessment, or a significant change assessment. Each quarterly assessment must be completed within 92 days of the previous assessment.
Subd. 5. [SHORT STAYS.] (a) A facility must submit to the commissioner of health an initial admission assessment for all residents who stay in the facility less than 14 days.
(b) Notwithstanding the admission assessment requirements of paragraph (a), a facility may elect to accept a default rate with a case mix index of 1.0 for all facility residents who stay less than 14 days in lieu of submitting an initial assessment. Facilities may make this election to be effective on the day of implementation of the revised case mix system.
(c) After implementation of the revised case mix system, nursing facilities must elect one of the options described in paragraphs (a) and (b) on the annual report to the commissioner of human services filed for each report year ending September 30. The election shall be effective on the following July 1.
(d) For residents who are admitted or readmitted and leave the facility on a frequent basis and for whom readmission is expected, the resident may be discharged on an extended leave status. This status does not require reassessment each time the resident returns to the facility unless a significant change in the resident's status has occurred since the last assessment. The case mix classification for these residents is determined by the facility election made in paragraphs (a) and (b).
Subd. 6. [PENALTIES FOR LATE OR NONSUBMISSION.] A facility that fails to complete or
submit an assessment for a RUG-III classification within seven days of the time requirements in subdivisions 4 and
5 is subject to a reduced rate for that resident. The reduced rate shall be the lowest rate for that facility. The reduced
rate is
effective on the day of admission for new admission assessments or on the day that the assessment was due for all other assessments and continues in effect until the first day of the month following the date of submission of the resident's assessment.
Subd. 7. [NOTICE OF RESIDENT REIMBURSEMENT CLASSIFICATION.] (a) A facility must elect between the options in clauses (1) and (2) to provide notice to a resident of the resident's case mix classification.
(1) The commissioner of health shall provide to a nursing facility a notice for each resident of the reimbursement classification established under subdivision 1. The notice must inform the resident of the classification that was assigned, the opportunity to review the documentation supporting the classification, the opportunity to obtain clarification from the commissioner, and the opportunity to request a reconsideration of the classification. The commissioner must send notice of resident classification by first class mail. A nursing facility is responsible for the distribution of the notice to each resident, to the person responsible for the payment of the resident's nursing home expenses, or to another person designated by the resident. This notice must be distributed within three working days after the facility's receipt of the notice from the commissioner of health.
(2) A facility may choose to provide a classification notice, as prescribed by the commissioner of health, to a resident upon receipt of the confirmation of the case mix classification calculated by a facility or a corrected case mix classification as indicated on the final validation report from the commissioner. A nursing facility is responsible for the distribution of the notice to each resident, to the person responsible for the payment of the resident's nursing home expenses, or to another person designated by the resident. This notice must be distributed within three working days after the facility's receipt of the validation report from the commissioner. If a facility elects this option, the commissioner of health shall provide the facility with a list of residents and their case mix classifications as determined by the commissioner. A nursing facility may make this election to be effective on the day of implementation of the revised case mix system.
(3) After implementation of the revised case mix system, a nursing facility shall elect a notice of resident reimbursement classification procedure as described in clause (1) or (2) on the annual report to the commissioner of human services filed for each report year ending September 30. The election will be effective the following July 1.
(b) If a facility submits a correction to an assessment conducted under subdivision 3 that results in a change in case mix classification, the facility shall give written notice to the resident or the resident's representative about the item that was corrected and the reason for the correction. The notice of corrected assessment may be provided at the same time that the resident or resident's representative is provided the resident's corrected notice of classification.
Subd. 8. [REQUEST FOR RECONSIDERATION OF RESIDENT CLASSIFICATIONS.] (a) The resident, or resident's representative, or the nursing facility or boarding care home may request that the commissioner of health reconsider the assigned reimbursement classification. The request for reconsideration must be submitted in writing to the commissioner within 30 days of the day the resident or the resident's representative receives the resident classification notice. The request for reconsideration must include the name of the resident, the name and address of the facility in which the resident resides, the reasons for the reconsideration, the requested classification changes, and documentation supporting the requested classification. The documentation accompanying the reconsideration request is limited to documentation which establishes that the needs of the resident at the time of the assessment justify a classification which is different than the classification established by the commissioner of health.
(b) Upon request, the nursing facility must give the resident or the resident's representative a copy of the
assessment form and the other documentation that was given to the commissioner of health to support the assessment
findings. The nursing facility shall also provide access to and a copy of other information from the resident's record
that has been requested by or on behalf of the resident to support a resident's reconsideration request. A copy of any
requested material must be provided within three working days of receipt of a written request for the information.
If a facility fails to provide the material within this time, it is subject to the issuance of a correction order and penalty
assessment under sections 144.653 and 144A.10. Notwithstanding those sections, any correction order issued under
this subdivision must require that the nursing facility immediately compl