Part 1


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(2) adequate to meet the needs of the child and family;

 

(3) culturally appropriate;

 

(4) available and accessible;

 

(5) consistent and timely; and

 

(6) realistic under the circumstances.

 

In the alternative, the court may determine that provision of services or further services for the purpose of rehabilitation is futile and therefore unreasonable under the circumstances or that reasonable efforts are not required as provided in paragraph (a).

 

(i) This section does not prevent out-of-home placement for treatment of a child with a mental disability when the child's diagnostic assessment or individual treatment plan indicates that appropriate and necessary treatment cannot be effectively provided outside of a residential or inpatient treatment program.

 

(j) If continuation of reasonable efforts to prevent placement or reunify the child with the parent or guardian from whom the child was removed is determined by the court to be inconsistent with the permanent plan for the child or upon the court making one of the prima facie determinations under paragraph (a), reasonable efforts must be made to place the child in a timely manner in a safe and permanent home and to complete whatever steps are necessary to legally finalize the permanent placement of the child.

 

(k) Reasonable efforts to place a child for adoption or in another permanent placement may be made concurrently with reasonable efforts to prevent placement or to reunify the child with the parent or guardian from whom the child was removed. When the responsible social services agency decides to concurrently make reasonable efforts for both reunification and permanent placement away from the parent under paragraph (a), the agency shall disclose its decision and both plans for concurrent reasonable efforts to all parties and the court. When the agency discloses its decision to proceed on both plans for reunification and permanent placement away from the parent, the court's review of the agency's reasonable efforts shall include the agency's efforts under both plans.

 

Sec. 62. Minnesota Statutes 2006, section 260.755, subdivision 12, is amended to read:

 

Subd. 12. Indian tribe. "Indian tribe" means an Indian tribe, band, nation, or other organized group or community of Indians recognized as eligible for the services provided to Indians by the secretary because of their status as Indians, including any band Native group under the Alaska Native Claims Settlement Act, United States Code, title 43, section 1602, and exercising tribal governmental powers.

 

Sec. 63. Minnesota Statutes 2006, section 260.755, subdivision 20, is amended to read:

 

Subd. 20. Tribal court. "Tribal court" means a court with federally recognized jurisdiction over child custody proceedings and which is either a court of Indian offenses, or a court established and operated under the code or custom of an Indian tribe, or the any other administrative body of a tribe which is vested with authority over child custody proceedings. Except as provided in section 260.771, subdivision 5, nothing in this chapter shall be construed as conferring jurisdiction on an Indian tribe.

 

Sec. 64. Minnesota Statutes 2006, section 260.761, subdivision 7, is amended to read:

 

Subd. 7. Identification of extended family members. Any agency considering placement of an Indian child shall make reasonable active efforts to identify and locate extended family members.


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Sec. 65. Minnesota Statutes 2006, section 260.765, subdivision 5, is amended to read:

 

Subd. 5. Identification of extended family members. Any agency considering placement of an Indian child shall make reasonable active efforts to identify and locate extended family members.

 

Sec. 66. Minnesota Statutes 2006, section 260.771, subdivision 1, is amended to read:

 

Subdivision 1. Indian tribe jurisdiction. An Indian tribe with a tribal court has exclusive jurisdiction over a child placement proceeding involving an Indian child who resides or is domiciled within the reservation of such the tribe at the commencement of the proceedings, except where jurisdiction is otherwise vested in the state by existing federal law. When an Indian child is in the legal custody of a person or agency pursuant to an order of a ward of the tribal court, the Indian tribe retains exclusive jurisdiction, notwithstanding the residence or domicile of the child.

 

Sec. 67. Minnesota Statutes 2006, section 260.771, subdivision 2, is amended to read:

 

Subd. 2. Court determination of tribal affiliation of child. In any child placement proceeding, the court shall establish whether an Indian child is involved and the identity of the Indian child's tribe. This chapter and the federal Indian Child Welfare Act are applicable without exception in any child custody proceeding, as defined in the federal act, involving an Indian child. This chapter applies to child custody proceedings involving an Indian child whether the child is in the physical or legal custody of an Indian parent, Indian custodian, Indian extended family member, or other person at the commencement of the proceedings. A court shall not determine the applicability of this chapter or the federal Indian Child Welfare Act to a child custody proceeding based upon whether an Indian child is part of an existing Indian family or based upon the level of contact a child has with the child's Indian tribe, reservation, society, or off-reservation community.

 

Sec. 68. [260.852] PLACEMENT PROCEDURES.

 

Subdivision 1. Home study. The state must have procedures for the orderly and timely interstate placement of children that are implemented in accordance with an interstate compact and that, within 60 days after the state receives from another state a request to conduct a study of a home environment for purposes of assessing the safety and suitability of placing a child in the home, the state shall, directly or by contract, conduct and complete a home study and return to the other state a report on the results of the study, which shall address the extent to which placement in the home would meet the needs of the child; except in the case of a home study begun before October 1, 2008, if the state fails to comply with conducting and completing the home study within the 60-day period and this is as a result of circumstances beyond the control of the state, the state has 75 days to comply if the state documents the circumstances involved and certifies that completing the home study is in the best interests of the child.

 

This subdivision does not require the completion within the applicable period of the parts of the home study involving the education and training of the prospective foster or adoptive parents.

 

Subd. 2. Effect of received report. The state shall treat any report described in subdivision 1 that is received from another state, an Indian tribe, or a private agency under contract with another state or Indian tribe as meeting any requirements imposed by the state for the completion of a home study before placing a child in the home, unless, within 14 days after receipt of the report, the state determines, based on grounds that are specific to the content of the report, that making a decision in reliance on the report would be contrary to the welfare of the child.

 

Subd. 3. Resources. The state shall make effective use of cross-jurisdictional resources, including through contract for the purchase of services, and shall eliminate legal barriers to facilitate timely adoptive or permanent placements for waiting children. The state shall not impose any restriction on the use of private agencies for the purpose of conducting a home study to meet the 60-day requirement.


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Subd. 4. Incentive eligibility. Minnesota is an incentive-eligible state and must:

 

(1) have an approved plan as required by the United States Secretary of Health and Human Services;

 

(2) be in compliance with the data requirements of the United States Department of Health and Human Services; and

 

(3) have data that verify that a home study is completed within 30 days.

 

Subd. 5. Data requirements. The state shall provide to the United States Secretary of Health and Human Services a written report, covering the preceding fiscal year, that specifies:

 

(1) the total number of interstate home studies requested by the state with respect to children in foster care under the responsibility of the state, and with respect to each study, the identity of the other state involved;

 

(2) the total number of timely interstate home studies completed by the state with respect to children in foster care under the responsibility of other states and, with respect to each study, the identity of the other state involved; and

 

(3) other information the United States Secretary of Health and Human Services requires in order to determine whether Minnesota is a home study incentive-eligible state.

 

Subd. 6. Definitions. (a) The definitions in this subdivision apply to this section.

 

(b) "Home study" means an evaluation of a home environment conducted in accordance with applicable requirements of the state in which the home is located, to determine whether a proposed placement of a child would meet the individual needs of the child, including the child's safety; permanency; health; well-being; and mental, emotional, and physical development.

 

(c) "Interstate home study" means a home study conducted by a state at the request of another state to facilitate an adoptive or foster placement in the state of a child in foster care under the responsibility of the state.

 

(d) "Timely interstate home study" means an interstate home study completed by a state if the state provides to the state that requested the study, within 30 days after receipt of the request, a report on the results of the study, except that there is no requirement for completion within the 30-day period of the parts of the home study involving the education and training of the prospective foster or adoptive parents.

 

Subd. 7. Background study requirements for adoption and foster care. (a) Background study requirements for an adoption home study must be completed consistent with section 259.41, subdivisions 1, 2, and 3.

 

(b) Background study requirements for a foster care license must be completed consistent with section 245C.08.

 

Subd. 8. Home visits. If a child has been placed in foster care outside the state in which the home of the parents of the child is located, periodically, but at least every six months, a caseworker on the staff of the agency of the state in which the home of the parents of the child is located or the state in which the child has been placed, or a private agency under contract with either state, must visit the child in the home or institution and submit a report on each visit to the agency of the state in which the home of the parents of the child is located.


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Sec. 69. Minnesota Statutes 2006, section 260B.157, subdivision 1, is amended to read:

 

Subdivision 1. Investigation. Upon request of the court the local social services agency or probation officer shall investigate the personal and family history and environment of any minor coming within the jurisdiction of the court under section 260B.101 and shall report its findings to the court. The court may order any minor coming within its jurisdiction to be examined by a duly qualified physician, psychiatrist, or psychologist appointed by the court.

 

The court shall have order a chemical use assessment conducted when a child is (1) found to be delinquent for violating a provision of chapter 152, or for committing a felony-level violation of a provision of chapter 609 if the probation officer determines that alcohol or drug use was a contributing factor in the commission of the offense, or (2) alleged to be delinquent for violating a provision of chapter 152, if the child is being held in custody under a detention order. The assessor's qualifications and the assessment criteria shall comply with Minnesota Rules, parts 9530.6600 to 9530.6655. If funds under chapter 254B are to be used to pay for the recommended treatment, the assessment and placement must comply with all provisions of Minnesota Rules, parts 9530.6600 to 9530.6655 and 9530.7000 to 9530.7030. The commissioner of human services shall reimburse the court for the cost of the chemical use assessment, up to a maximum of $100.

 

The court shall have order a children's mental health screening conducted when a child is found to be delinquent. The screening shall be conducted with a screening instrument approved by the commissioner of human services and shall be conducted by a mental health practitioner as defined in section 245.4871, subdivision 26, or a probation officer who is trained in the use of the screening instrument. If the screening indicates a need for assessment, the local social services agency, in consultation with the child's family, shall have a diagnostic assessment conducted, including a functional assessment, as defined in section 245.4871.

 

With the consent of the commissioner of corrections and agreement of the county to pay the costs thereof, the court may, by order, place a minor coming within its jurisdiction in an institution maintained by the commissioner for the detention, diagnosis, custody and treatment of persons adjudicated to be delinquent, in order that the condition of the minor be given due consideration in the disposition of the case. Any funds received under the provisions of this subdivision shall not cancel until the end of the fiscal year immediately following the fiscal year in which the funds were received. The funds are available for use by the commissioner of corrections during that period and are hereby appropriated annually to the commissioner of corrections as reimbursement of the costs of providing these services to the juvenile courts.

 

Sec. 70. Minnesota Statutes 2006, section 260C.152, subdivision 5, is amended to read:

 

Subd. 5. Notice to foster parents and preadoptive parents and relatives. The foster parents, if any, of a child and any preadoptive parent or relative providing care for the child must be provided notice of and an opportunity a right to be heard in any review or hearing to be held with respect to the child. Any other relative may also request, and must be granted, a notice and the opportunity to be heard under this section. This subdivision does not require that a foster parent, preadoptive parent, or relative providing care for the child be made a party to a review or hearing solely on the basis of the notice and opportunity right to be heard.

 

Sec. 71. Minnesota Statutes 2006, section 260C.163, subdivision 1, is amended to read:

 

Subdivision 1. General. (a) Except for hearings arising under section 260C.425, hearings on any matter shall be without a jury and may be conducted in an informal manner. In all adjudicatory proceedings involving a child alleged to be in need of protection or services, the court shall admit only evidence that would be admissible in a civil trial. To be proved at trial, allegations of a petition alleging a child to be in need of protection or services must be proved by clear and convincing evidence.


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(b) Except for proceedings involving a child alleged to be in need of protection or services and petitions for the termination of parental rights, hearings may be continued or adjourned from time to time. In proceedings involving a child alleged to be in need of protection or services and petitions for the termination of parental rights, hearings may not be continued or adjourned for more than one week unless the court makes specific findings that the continuance or adjournment is in the best interests of the child. If a hearing is held on a petition involving physical or sexual abuse of a child who is alleged to be in need of protection or services or neglected and in foster care, the court shall file the decision with the court administrator as soon as possible but no later than 15 days after the matter is submitted to the court. When a continuance or adjournment is ordered in any proceeding, the court may make any interim orders as it deems in the best interests of the minor in accordance with the provisions of sections 260C.001 to 260C.421.

 

(c) Except as otherwise provided in this paragraph, the court shall exclude the general public from hearings under this chapter and shall admit only those persons who, in the discretion of the court, have a direct interest in the case or in the work of the court.

 

(d) Adoption hearings shall be conducted in accordance with the provisions of laws relating to adoptions.

 

(e) In any permanency hearing, including the transition of a child from foster care to independent living, the court shall ensure that any consult with the child is in an age-appropriate manner.

 

Sec. 72. Minnesota Statutes 2006, section 260C.201, subdivision 11, is amended to read:

 

Subd. 11. Review of court-ordered placements; permanent placement determination. (a) This subdivision and subdivision 11a do not apply in cases where the child is in placement due solely to the child's developmental disability or emotional disturbance, where legal custody has not been transferred to the responsible social services agency, and where the court finds compelling reasons under section 260C.007, subdivision 8, to continue the child in foster care past the time periods specified in this subdivision. Foster care placements of children due solely to their disability are governed by section 260C.141, subdivision 2a. In all other cases where the child is in foster care or in the care of a noncustodial parent under subdivision 1, the court shall commence proceedings to determine the permanent status of a child not later than 12 months after the child is placed in foster care or in the care of a noncustodial parent. At the admit-deny hearing commencing such proceedings, the court shall determine whether there is a prima facie basis for finding that the agency made reasonable efforts, or in the case of an Indian child active efforts, required under section 260.012 and proceed according to the rules of juvenile court.

 

For purposes of this subdivision, the date of the child's placement in foster care is the earlier of the first court-ordered placement or 60 days after the date on which the child has been voluntarily placed in foster care by the child's parent or guardian. For purposes of this subdivision, time spent by a child under the protective supervision of the responsible social services agency in the home of a noncustodial parent pursuant to an order under subdivision 1 counts towards the requirement of a permanency hearing under this subdivision or subdivision 11a. Time spent on a trial home visit does not count counts towards the requirement of a permanency hearing under this subdivision or and a permanency review for a child under eight years of age under subdivision 11a.

 

For purposes of this subdivision, 12 months is calculated as follows:

 

(1) during the pendency of a petition alleging that a child is in need of protection or services, all time periods when a child is placed in foster care or in the home of a noncustodial parent are cumulated;

 

(2) if a child has been placed in foster care within the previous five years under one or more previous petitions, the lengths of all prior time periods when the child was placed in foster care within the previous five years are cumulated. If a child under this clause has been in foster care for 12 months or more, the court, if it is in the best interests of the child and for compelling reasons, may extend the total time the child may continue out of the home under the current petition up to an additional six months before making a permanency determination.


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(b) Unless the responsible social services agency recommends return of the child to the custodial parent or parents, not later than 30 days prior to the admit-deny hearing required under paragraph (a) and the rules of juvenile court, the responsible social services agency shall file pleadings in juvenile court to establish the basis for the juvenile court to order permanent placement of the child, including a termination of parental rights petition, according to paragraph (d). Notice of the hearing and copies of the pleadings must be provided pursuant to section 260C.152.

 

(c) The permanency proceedings shall be conducted in a timely fashion including that any trial required under section 260C.163 shall be commenced within 60 days of the admit-deny hearing required under paragraph (a). At the conclusion of the permanency proceedings, the court shall:

 

(1) order the child returned to the care of the parent or guardian from whom the child was removed; or

 

(2) order a permanent placement or termination of parental rights if permanent placement or termination of parental rights is in the child's best interests. The "best interests of the child" means all relevant factors to be considered and evaluated. Transfer of permanent legal and physical custody, termination of parental rights, or guardianship and legal custody to the commissioner through a consent to adopt are preferred permanency options for a child who cannot return home.

 

(d) If the child is not returned to the home, the court must order one of the following dispositions:

 

(1) permanent legal and physical custody to a relative in the best interests of the child according to the following conditions:

 

(i) an order for transfer of permanent legal and physical custody to a relative shall only be made after the court has reviewed the suitability of the prospective legal and physical custodian;

 

(ii) in transferring permanent legal and physical custody to a relative, the juvenile court shall follow the standards applicable under this chapter and chapter 260, and the procedures set out in the juvenile court rules;

 

(iii) an order establishing permanent legal and physical custody under this subdivision must be filed with the family court;

 

(iv) a transfer of legal and physical custody includes responsibility for the protection, education, care, and control of the child and decision making on behalf of the child;

 

(v) the social services agency may bring a petition or motion naming a fit and willing relative as a proposed permanent legal and physical custodian. The commissioner of human services shall annually prepare for counties information that must be given to proposed custodians about their legal rights and obligations as custodians together with information on financial and medical benefits for which the child is eligible; and

 

(vi) the juvenile court may maintain jurisdiction over the responsible social services agency, the parents or guardian of the child, the child, and the permanent legal and physical custodian for purposes of ensuring appropriate services are delivered to the child and permanent legal custodian or for the purpose of ensuring conditions ordered by the court related to the care and custody of the child are met;

 

(2) termination of parental rights when the requirements of sections 260C.301 to 260C.328 are met or according to the following conditions:

 

(i) order the social services agency to file a petition for termination of parental rights in which case all the requirements of sections 260C.301 to 260C.328 remain applicable; and


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(ii) an adoption completed subsequent to a determination under this subdivision may include an agreement for communication or contact under section 259.58;

 

(3) long-term foster care according to the following conditions:

 

(i) the court may order a child into long-term foster care only if it approves the responsible social service agency's compelling reasons that neither an award of permanent legal and physical custody to a relative, nor termination of parental rights is in the child's best interests;

 

(ii) further, the court may only order long-term foster care for the child under this section if it finds the following:

 

(A) the child has reached age 12 and the responsible social services agency has made reasonable efforts to locate and place the child with an adoptive family or with a fit and willing relative who will agree to a transfer of permanent legal and physical custody of the child, but such efforts have not proven successful; or

 

(B) the child is a sibling of a child described in subitem (A) and the siblings have a significant positive relationship and are ordered into the same long-term foster care home; and

 

(iii) at least annually, the responsible social services agency reconsiders its provision of services to the child and the child's placement in long-term foster care to ensure that:

 

(A) long-term foster care continues to be the most appropriate legal arrangement for meeting the child's need for permanency and stability, including whether there is another permanent placement option under this chapter that would better serve the child's needs and best interests;

 

(B) whenever possible, there is an identified long-term foster care family that is committed to being the foster family for the child as long as the child is a minor or under the jurisdiction of the court;

 

(C) the child is receiving appropriate services or assistance to maintain or build connections with the child's family and community;

 

(D) the child's physical and mental health needs are being appropriately provided for; and

 

(E) the child's educational needs are being met;

 

(4) foster care for a specified period of time according to the following conditions:

 

(i) foster care for a specified period of time may be ordered only if:

 

(A) the sole basis for an adjudication that the child is in need of protection or services is the child's behavior;

 

(B) the court finds that foster care for a specified period of time is in the best interests of the child; and

 

(C) the court approves the responsible social services agency's compelling reasons that neither an award of permanent legal and physical custody to a relative, nor termination of parental rights is in the child's best interests;

 

(ii) the order does not specify that the child continue in foster care for any period exceeding one year; or

 

(5) guardianship and legal custody to the commissioner of human services under the following procedures and conditions:


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(i) there is an identified prospective adoptive home agreed to by the responsible social services agency having legal custody of the child pursuant to court order under this section that has agreed to adopt the child and the court accepts the parent's voluntary consent to adopt under section 259.24, except that such consent executed by a parent under this item, following proper notice that consent given under this provision is irrevocable upon acceptance by the court, shall be irrevocable unless fraud is established and an order issues permitting revocation as stated in item (vii);

 

(ii) if the court accepts a consent to adopt in lieu of ordering one of the other enumerated permanency dispositions, the court must review the matter at least every 90 days. The review will address the reasonable efforts of the agency to achieve a finalized adoption;

 

(iii) a consent to adopt under this clause vests all legal authority regarding the child, including guardianship and legal custody of the child, with the commissioner of human services as if the child were a state ward after termination of parental rights;

 

(iv) the court must forward a copy of the consent to adopt, together with a certified copy of the order transferring guardianship and legal custody to the commissioner, to the commissioner;

 

(v) if an adoption is not finalized by the identified prospective adoptive parent within 12 months of the execution of the consent to adopt under this clause, the commissioner of human services or the commissioner's delegate shall pursue adoptive placement in another home unless the commissioner certifies that the failure to finalize is not due to either an action or a failure to act by the prospective adoptive parent;

 

(vi) notwithstanding item (v), the commissioner of human services or the commissioner's designee must pursue adoptive placement in another home as soon as the commissioner or commissioner's designee determines that finalization of the adoption with the identified prospective adoptive parent is not possible, that the identified prospective adoptive parent is not willing to adopt the child, that the identified prospective adoptive parent is not cooperative in completing the steps necessary to finalize the adoption, or upon the commissioner's determination to withhold consent to the adoption.

 

(vii) unless otherwise required by the Indian Child Welfare Act, United States Code, title 25, section 1913, a consent to adopt executed under this section, following proper notice that consent given under this provision is irrevocable upon acceptance by the court, shall be irrevocable upon acceptance by the court except upon order permitting revocation issued by the same court after written findings that consent was obtained by fraud.

 

(e) In ordering a permanent placement of a child, the court must be governed by the best interests of the child, including a review of the relationship between the child and relatives and the child and other important persons with whom the child has resided or had significant contact. When the court has determined that permanent placement of the child away from the parent is necessary, the court shall consider permanent alternative homes that are available both inside and outside the state.

 

(f) Once a permanent placement determination has been made and permanent placement has been established, further court reviews are necessary if:

 

(1) the placement is long-term foster care or foster care for a specified period of time;

 

(2) the court orders further hearings because it has retained jurisdiction of a transfer of permanent legal and physical custody matter;

 

(3) an adoption has not yet been finalized; or


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(4) there is a disruption of the permanent or long-term placement.

 

(g) Court reviews of an order for long-term foster care, whether under this section or section 260C.317, subdivision 3, paragraph (d), must be conducted at least yearly and must review the child's out-of-home placement plan and the reasonable efforts of the agency to finalize the permanent plan for the child including the agency's efforts to:

 

(1) ensure that long-term foster care continues to be the most appropriate legal arrangement for meeting the child's need for permanency and stability or, if not, to identify and attempt to finalize another permanent placement option under this chapter that would better serve the child's needs and best interests;

 

(2) identify a specific long-term foster home for the child, if one has not already been identified;

 

(3) support continued placement of the child in the identified home, if one has been identified;

 

(4) ensure appropriate services are provided to address the physical health, mental health, and educational needs of the child during the period of long-term foster care and also ensure appropriate services or assistance to maintain relationships with appropriate family members and the child's community; and

 

(5) plan for the child's independence upon the child's leaving long-term foster care living as required under section 260C.212, subdivision 1.

 

(h) In the event it is necessary for a child that has been ordered into foster care for a specified period of time to be in foster care longer than one year after the permanency hearing held under this section, not later than 12 months after the time the child was ordered into foster care for a specified period of time, the matter must be returned to court for a review of the appropriateness of continuing the child in foster care and of the responsible social services agency's reasonable efforts to finalize a permanent plan for the child; if it is in the child's best interests to continue the order for foster care for a specified period of time past a total of 12 months, the court shall set objectives for the child's continuation in foster care, specify any further amount of time the child may be in foster care, and review the plan for the safe return of the child to the parent.

 

(i) An order permanently placing a child out of the home of the parent or guardian must include the following detailed findings:

 

(1) how the child's best interests are served by the order;

 

(2) the nature and extent of the responsible social service agency's reasonable efforts, or, in the case of an Indian child, active efforts to reunify the child with the parent or guardian where reasonable efforts are required;

 

(3) the parent's or parents' efforts and ability to use services to correct the conditions which led to the out-of-home placement; and

 

(4) that the conditions which led to the out-of-home placement have not been corrected so that the child can safely return home.

 

(j) An order for permanent legal and physical custody of a child may be modified under sections 518.18 and 518.185. The social services agency is a party to the proceeding and must receive notice. A parent may only seek modification of an order for long-term foster care upon motion and a showing by the parent of a substantial change in the parent's circumstances such that the parent could provide appropriate care for the child and that removal of the child from the child's permanent placement and the return to the parent's care would be in the best interest of the child. The responsible social services agency may ask the court to vacate an order for long-term foster care upon a


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prima facie showing that there is a factual basis for the court to order another permanency option under this chapter and that such an option is in the child's best interests. Upon a hearing where the court determines that there is a factual basis for vacating the order for long-term foster care and that another permanent order regarding the placement of the child is in the child's best interests, the court may vacate the order for long-term foster care and enter a different order for permanent placement that is in the child's best interests. The court shall not require further reasonable efforts to reunify the child with the parent or guardian as a basis for vacating the order for long-term foster care and ordering a different permanent placement in the child's best interests. The county attorney must file pleadings and give notice as required under the rules of juvenile court in order to modify an order for long-term foster care under this paragraph.

 

(k) The court shall issue an order required under this section within 15 days of the close of the proceedings. The court may extend issuing the order an additional 15 days when necessary in the interests of justice and the best interests of the child.

 

(l) This paragraph applies to proceedings required under this subdivision when the child is on a trial home visit:

 

(1) if the child is on a trial home visit 12 months after the child was placed in foster care or in the care of a noncustodial parent as calculated in this subdivision, the responsible social services agency may file a report with the court regarding the child's and parent's progress on the trial home visit and its reasonable efforts to finalize the child's safe and permanent return to the care of the parent in lieu of filing the pleadings required under paragraph (b). The court shall make findings regarding reasonableness of the responsible social services efforts to finalize the child's return home as the permanent order in the best interests of the child. The court may continue the trial home visit to a total time not to exceed six months as provided in subdivision 1. If the court finds the responsible social services agency has not made reasonable efforts to finalize the child's return home as the permanent order in the best interests of the child, the court may order other or additional efforts to support the child remaining in the care of the parent; and

 

(2) if a trial home visit ordered or continued at proceedings under this subdivision terminates, the court shall re-commence proceedings under this subdivision to determine the permanent status of the child not later than 30 days after the child is returned to foster care.

 

Sec. 73. Minnesota Statutes 2006, section 260C.212, subdivision 1, is amended to read:

 

Subdivision 1. Out-of-home placement; plan. (a) An out-of-home placement plan shall be prepared within 30 days after any child is placed in a residential facility by court order or by the voluntary release of the child by the parent or parents.

 

For purposes of this section, a residential facility means any group home, family foster home or other publicly supported out-of-home residential facility, including any out-of-home residential facility under contract with the state, county or other political subdivision, or any agency thereof, to provide those services or foster care as defined in section 260C.007, subdivision 18.

 

(b) An out-of-home placement plan means a written document which is prepared by the responsible social services agency jointly with the parent or parents or guardian of the child and in consultation with the child's guardian ad litem, the child's tribe, if the child is an Indian child, the child's foster parent or representative of the residential facility, and, where appropriate, the child. For a child in placement due solely or in part to the child's emotional disturbance, preparation of the out-of-home placement plan shall additionally include the child's mental health treatment provider. As appropriate, the plan shall be:

 

(1) submitted to the court for approval under section 260C.178, subdivision 7;


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(2) ordered by the court, either as presented or modified after hearing, under section 260C.178, subdivision 7, or 260C.201, subdivision 6; and

 

(3) signed by the parent or parents or guardian of the child, the child's guardian ad litem, a representative of the child's tribe, the responsible social services agency, and, if possible, the child.

 

(c) The out-of-home placement plan shall be explained to all persons involved in its implementation, including the child who has signed the plan, and shall set forth:

 

(1) a description of the residential facility including how the out-of-home placement plan is designed to achieve a safe placement for the child in the least restrictive, most family-like, setting available which is in close proximity to the home of the parent or parents or guardian of the child when the case plan goal is reunification, and how the placement is consistent with the best interests and special needs of the child according to the factors under subdivision 2, paragraph (b);

 

(2) the specific reasons for the placement of the child in a residential facility, and when reunification is the plan, a description of the problems or conditions in the home of the parent or parents which necessitated removal of the child from home and the changes the parent or parents must make in order for the child to safely return home;

 

(3) a description of the services offered and provided to prevent removal of the child from the home and to reunify the family including:

 

(i) the specific actions to be taken by the parent or parents of the child to eliminate or correct the problems or conditions identified in clause (2), and the time period during which the actions are to be taken; and

 

(ii) the reasonable efforts, or in the case of an Indian child, active efforts to be made to achieve a safe and stable home for the child including social and other supportive services to be provided or offered to the parent or parents or guardian of the child, the child, and the residential facility during the period the child is in the residential facility;

 

(4) a description of any services or resources that were requested by the child or the child's parent, guardian, foster parent, or custodian since the date of the child's placement in the residential facility, and whether those services or resources were provided and if not, the basis for the denial of the services or resources;

 

(5) the visitation plan for the parent or parents or guardian, other relatives as defined in section 260C.007, subdivision 27, and siblings of the child if the siblings are not placed together in the residential facility, and whether visitation is consistent with the best interest of the child, during the period the child is in the residential facility;

 

(6) documentation of steps to finalize the adoption or legal guardianship of the child if the court has issued an order terminating the rights of both parents of the child or of the only known, living parent of the child, and. At a minimum, the documentation must include child-specific recruitment efforts such as relative search and the use of state, regional, and national adoption exchanges to facilitate orderly and timely placements in and outside of the state. A copy of this documentation shall be provided to the court in the review required under section 260C.317, subdivision 3, paragraph (b);

 

(7) to the extent available and accessible, the health and educational records of the child including the most recent information available regarding:

 

(i) the names and addresses of the child's health and educational providers;

 

(ii) the child's grade level performance;


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(iii) the child's school record;

 

(iv) assurances that the child's placement in foster care takes into account proximity to the school in which the child is enrolled at the time of placement;

 

(v) a record of the child's immunizations;

 

(vi) the child's known medical problems, including any known communicable diseases, as defined in section 144.4172, subdivision 2;

 

(vii) the child's medications; and

 

(viii) any other relevant health and education information;

 

(8) an independent living plan for a child age 16 or older who is in placement as a result of a permanency disposition. The plan should include, but not be limited to, the following objectives:

 

(i) educational, vocational, or employment planning;

 

(ii) health care planning and medical coverage;

 

(iii) transportation including, where appropriate, assisting the child in obtaining a driver's license;

 

(iv) money management;

 

(v) planning for housing;

 

(vi) social and recreational skills; and

 

(vii) establishing and maintaining connections with the child's family and community; and

 

(9) for a child in placement due solely or in part to the child's emotional disturbance, diagnostic and assessment information, specific services relating to meeting the mental health care needs of the child, and treatment outcomes.

 

(d) The parent or parents or guardian and the child each shall have the right to legal counsel in the preparation of the case plan and shall be informed of the right at the time of placement of the child. The child shall also have the right to a guardian ad litem. If unable to employ counsel from their own resources, the court shall appoint counsel upon the request of the parent or parents or the child or the child's legal guardian. The parent or parents may also receive assistance from any person or social services agency in preparation of the case plan.

 

After the plan has been agreed upon by the parties involved or approved or ordered by the court, the foster parents shall be fully informed of the provisions of the case plan and shall be provided a copy of the plan.

 

Upon discharge from foster care, the parent, adoptive parent, or permanent legal and physical custodian, as appropriate, and the child, if appropriate, must be provided with a current copy of the child's health and education record.


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Sec. 74. Minnesota Statutes 2006, section 260C.212, subdivision 4, is amended to read:

 

Subd. 4. Responsible social service agency's duties for children in placement. (a) When a child is in placement, the responsible social services agency shall make diligent efforts to identify, locate, and, where appropriate, offer services to both parents of the child.

 

(1) The responsible social services agency shall assess whether a noncustodial or nonadjudicated parent is willing and capable of providing for the day-to-day care of the child temporarily or permanently. An assessment under this clause may include, but is not limited to, obtaining information under section 260C.209. If after assessment, the responsible social services agency determines that a noncustodial or nonadjudicated parent is willing and capable of providing day-to-day care of the child, the responsible social services agency may seek authority from the custodial parent or the court to have that parent assume day-to-day care of the child. If a parent is not an adjudicated parent, the responsible social services agency shall require the nonadjudicated parent to cooperate with paternity establishment procedures as part of the case plan.

 

(2) If, after assessment, the responsible social services agency determines that the child cannot be in the day-to-day care of either parent, the agency shall:

 

(i) prepare an out-of-home placement plan addressing the conditions that each parent must meet before the child can be in that parent's day-to-day care; and

 

(ii) provide a parent who is the subject of a background study under section 260C.209 15 days' notice that it intends to use the study to recommend against putting the child with that parent, as well as the notice provided in section 260C.209, subdivision 4, and the court shall afford the parent an opportunity to be heard concerning the study.

 

The results of a background study of a noncustodial parent shall not be used by the agency to determine that the parent is incapable of providing day-to-day care of the child unless the agency reasonably believes that placement of the child into the home of that parent would endanger the child's health, safety, or welfare.

 

(3) If, after the provision of services following an out-of-home placement plan under this section, the child cannot return to the care of the parent from whom the child was removed or who had legal custody at the time the child was placed in foster care, the agency may petition on behalf of a noncustodial parent to establish legal custody with that parent under section 260C.201, subdivision 11. If paternity has not already been established, it may be established in the same proceeding in the manner provided for under chapter 257.

 

(4) The responsible social services agency may be relieved of the requirement to locate and offer services to both parents by the juvenile court upon a finding of good cause after the filing of a petition under section 260C.141.

 

(b) The responsible social services agency shall give notice to the parent or parents or guardian of each child in a residential facility, other than a child in placement due solely to that child's developmental disability or emotional disturbance, of the following information:

 

(1) that residential care of the child may result in termination of parental rights or an order permanently placing the child out of the custody of the parent, but only after notice and a hearing as required under chapter 260C and the juvenile court rules;

 

(2) time limits on the length of placement and of reunification services, including the date on which the child is expected to be returned to and safely maintained in the home of the parent or parents or placed for adoption or otherwise permanently removed from the care of the parent by court order;


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(3) the nature of the services available to the parent;

 

(4) the consequences to the parent and the child if the parent fails or is unable to use services to correct the circumstances that led to the child's placement;

 

(5) the first consideration for placement with relatives;

 

(6) the benefit to the child in getting the child out of residential care as soon as possible, preferably by returning the child home, but if that is not possible, through a permanent legal placement of the child away from the parent;

 

(7) when safe for the child, the benefits to the child and the parent of maintaining visitation with the child as soon as possible in the course of the case and, in any event, according to the visitation plan under this section; and

 

(8) the financial responsibilities and obligations, if any, of the parent or parents for the support of the child during the period the child is in the residential facility.

 

(c) The responsible social services agency shall inform a parent considering voluntary placement of a child who is not developmentally disabled or emotionally disturbed of the following information:

 

(1) the parent and the child each has a right to separate legal counsel before signing a voluntary placement agreement, but not to counsel appointed at public expense;

 

(2) the parent is not required to agree to the voluntary placement, and a parent who enters a voluntary placement agreement may at any time request that the agency return the child. If the parent so requests, the child must be returned within 24 hours of the receipt of the request;

 

(3) evidence gathered during the time the child is voluntarily placed may be used at a later time as the basis for a petition alleging that the child is in need of protection or services or as the basis for a petition seeking termination of parental rights or other permanent placement of the child away from the parent;

 

(4) if the responsible social services agency files a petition alleging that the child is in need of protection or services or a petition seeking the termination of parental rights or other permanent placement of the child away from the parent, the parent would have the right to appointment of separate legal counsel and the child would have a right to the appointment of counsel and a guardian ad litem as provided by law, and that counsel will be appointed at public expense if they are unable to afford counsel; and

 

(5) the timelines and procedures for review of voluntary placements under subdivision 3, and the effect the time spent in voluntary placement on the scheduling of a permanent placement determination hearing under section 260C.201, subdivision 11.

 

(d) When an agency accepts a child for placement, the agency shall determine whether the child has had a physical examination by or under the direction of a licensed physician within the 12 months immediately preceding the date when the child came into the agency's care. If there is documentation that the child has had an examination within the last 12 months, the agency is responsible for seeing that the child has another physical examination within one year of the documented examination and annually in subsequent years. If the agency determines that the child has not had a physical examination within the 12 months immediately preceding placement, the agency shall ensure that the child has an examination within 30 days of coming into the agency's care and once a year in subsequent years.

 

(e) If a child leaves foster care by reason of having attained the age of majority under state law, the child must be given at no cost a copy of the child's health and education report.


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Sec. 75. Minnesota Statutes 2006, section 260C.212, subdivision 9, is amended to read:

 

Subd. 9. Review of certain child placements. (a) When a developmentally disabled child or emotionally disturbed child needs placement in a residential facility for the sole reason of accessing services or a level of skilled care that cannot be provided in the parent's home, the child must be placed pursuant to a voluntary placement agreement between the responsible social services agency and the child's parent. The voluntary placement agreement must give the responsible social services agency legal responsibility for the child's physical care, custody, and control, but must not transfer legal custody of the child to the agency. The voluntary placement agreement must be executed in a form developed and promulgated by the commissioner of human services. The responsible social services agency shall report to the commissioner the number of children who are the subject of a voluntary placement agreement under this subdivision and other information regarding these children as the commissioner may require.

 

(b) If a developmentally disabled child or a child diagnosed as emotionally disturbed has been placed in a residential facility pursuant to a voluntary release by the child's parent or parents because of the child's disabling conditions or need for long-term residential treatment or supervision, the social services agency responsible for the placement shall report to the court and bring a petition for review of the child's foster care status as required in section 260C.141, subdivision 2a.

 

(b) (c) If a child is in placement due solely to the child's developmental disability or emotional disturbance, and the court finds compelling reasons not to proceed under section 260C.201, subdivision 11, and custody of the child is not transferred to the responsible social services agency under section 260C.201, subdivision 1, paragraph (a), clause (2), and no petition is required by section 260C.201, subdivision 11.

 

(c) (d) Whenever a petition for review is brought pursuant to this subdivision, a guardian ad litem shall be appointed for the child.

 

Sec. 76. Minnesota Statutes 2006, section 260C.317, subdivision 3, is amended to read:

 

Subd. 3. Order; retention of jurisdiction. (a) A certified copy of the findings and the order terminating parental rights, and a summary of the court's information concerning the child shall be furnished by the court to the commissioner or the agency to which guardianship is transferred. The orders shall be on a document separate from the findings. The court shall furnish the individual to whom guardianship is transferred a copy of the order terminating parental rights.

 

(b) The court shall retain jurisdiction in a case where adoption is the intended permanent placement disposition until the child's adoption is finalized, the child is 18 years of age, or the child is otherwise ordered discharged from the jurisdiction of the court. The guardian ad litem and counsel for the child shall continue on the case until an adoption decree is entered. A hearing must be held every 90 days following termination of parental rights for the court to review progress toward an adoptive placement and the specific recruitment efforts the agency has taken to find an adoptive family or other placement living arrangement for the child and to finalize the adoption or other permanency plan.

 

(c) The responsible social services agency may make a determination of compelling reasons for a child to be in long-term foster care when the agency has made exhaustive efforts to recruit, identify, and place the child in an adoptive home, and the child continues in foster care for at least 24 months after the court has issued the order terminating parental rights. A child of any age who is under the guardianship of the commissioner of the Department of Human Services and is legally available for adoption may not refuse or waive the commissioner's agent's exhaustive efforts to recruit, identify, and place the child in an adoptive home required under paragraph (b) or sign a document relieving county social services agencies of all recruitment efforts on the child's behalf. Upon approving the agency's determination of compelling reasons, the court may order the child placed in long-term foster


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care. At least every 12 months thereafter as long as the child continues in out-of-home placement, the court shall conduct a permanency review hearing to determine the future status of the child using the review requirements of section 260C.201, subdivision 11, paragraph (g).

 

(d) The court shall retain jurisdiction through the child's minority in a case where long-term foster care is the permanent disposition whether under paragraph (c) or section 260C.201, subdivision 11.

 

Sec. 77. Minnesota Statutes 2006, section 260C.331, subdivision 1, is amended to read:

 

Subdivision 1. Care, examination, or treatment. (a) Except where parental rights are terminated,

 

(1) whenever legal custody of a child is transferred by the court to a responsible social services agency,

 

(2) whenever legal custody is transferred to a person other than the responsible social services agency, but under the supervision of the responsible social services agency, or

 

(3) whenever a child is given physical or mental examinations or treatment under order of the court, and no provision is otherwise made by law for payment for the care, examination, or treatment of the child, these costs are a charge upon the welfare funds of the county in which proceedings are held upon certification of the judge of juvenile court.

 

(b) The court shall order, and the responsible social services agency shall require, the parents or custodian of a child, while the child is under the age of 18, to use the total income and resources attributable to the child for the period of care, examination, or treatment, except for clothing and personal needs allowance as provided in section 256B.35, to reimburse the county for the cost of care, examination, or treatment. Income and resources attributable to the child include, but are not limited to, Social Security benefits, supplemental security income (SSI), veterans benefits, railroad retirement benefits and child support. When the child is over the age of 18, and continues to receive care, examination, or treatment, the court shall order, and the responsible social services agency shall require, reimbursement from the child for the cost of care, examination, or treatment from the income and resources attributable to the child less the clothing and personal needs allowance. Income does not include earnings from a child over the age of 18 who is working as part of a plan under section 260C.212, subdivision 1, paragraph (c), clause (8), to transition from foster care.

 

(c) If the income and resources attributable to the child are not enough to reimburse the county for the full cost of the care, examination, or treatment, the court shall inquire into the ability of the parents to support the child and, after giving the parents a reasonable opportunity to be heard, the court shall order, and the responsible social services agency shall require, the parents to contribute to the cost of care, examination, or treatment of the child. When determining the amount to be contributed by the parents, the court shall use a fee schedule based upon ability to pay that is established by the responsible social services agency and approved by the commissioner of human services. The income of a stepparent who has not adopted a child shall be excluded in calculating the parental contribution under this section.

 

(d) The court shall order the amount of reimbursement attributable to the parents or custodian, or attributable to the child, or attributable to both sources, withheld under chapter 518A from the income of the parents or the custodian of the child. A parent or custodian who fails to pay without good reason may be proceeded against for contempt, or the court may inform the county attorney, who shall proceed to collect the unpaid sums, or both procedures may be used.

 

(e) If the court orders a physical or mental examination for a child, the examination is a medically necessary service for purposes of determining whether the service is covered by a health insurance policy, health maintenance contract, or other health coverage plan. Court-ordered treatment shall be subject to policy, contract, or plan


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requirements for medical necessity. Nothing in this paragraph changes or eliminates benefit limits, conditions of coverage, co-payments or deductibles, provider restrictions, or other requirements in the policy, contract, or plan that relate to coverage of other medically necessary services.

 

Sec. 78. Minnesota Statutes 2006, section 270B.14, subdivision 1, is amended to read:

 

Subdivision 1. Disclosure to commissioner of human services. (a) On the request of the commissioner of human services, the commissioner shall disclose return information regarding taxes imposed by chapter 290, and claims for refunds under chapter 290A, to the extent provided in paragraph (b) and for the purposes set forth in paragraph (c).

 

(b) Data that may be disclosed are limited to data relating to the identity, whereabouts, employment, income, and property of a person owing or alleged to be owing an obligation of child support.

 

(c) The commissioner of human services may request data only for the purposes of carrying out the child support enforcement program and to assist in the location of parents who have, or appear to have, deserted their children. Data received may be used only as set forth in section 256.978.

 

(d) The commissioner shall provide the records and information necessary to administer the supplemental housing allowance to the commissioner of human services.

 

(e) At the request of the commissioner of human services, the commissioner of revenue shall electronically match the Social Security numbers and names of participants in the telephone assistance plan operated under sections 237.69 to 237.711, with those of property tax refund filers, and determine whether each participant's household income is within the eligibility standards for the telephone assistance plan.

 

(f) The commissioner may provide records and information collected under sections 295.50 to 295.59 to the commissioner of human services for purposes of the Medicaid Voluntary Contribution and Provider-Specific Tax Amendments of 1991, Public Law 102-234. Upon the written agreement by the United States Department of Health and Human Services to maintain the confidentiality of the data, the commissioner may provide records and information collected under sections 295.50 to 295.59 to the Centers for Medicare and Medicaid Services section of the United States Department of Health and Human Services for purposes of meeting federal reporting requirements.

 

(g) The commissioner may provide records and information to the commissioner of human services as necessary to administer the early refund of refundable tax credits.

 

(h) The commissioner may disclose information to the commissioner of human services necessary to verify income for eligibility and premium payment under the MinnesotaCare program, under section 256L.05, subdivision 2.

 

(i) The commissioner may disclose information to the commissioner of human services necessary to verify whether applicants or recipients for the Minnesota family investment program, general assistance, food support, and Minnesota supplemental aid program, and child care assistance have claimed refundable tax credits under chapter 290 and the property tax refund under chapter 290A, and the amounts of the credits.

 

Sec. 79. Minnesota Statutes 2006, section 626.556, subdivision 2, is amended to read:

 

Subd. 2. Definitions. As used in this section, the following terms have the meanings given them unless the specific content indicates otherwise:


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(a) "Family assessment" means a comprehensive assessment of child safety, risk of subsequent child maltreatment, and family strengths and needs that is applied to a child maltreatment report that does not allege substantial child endangerment. Family assessment does not include a determination as to whether child maltreatment occurred but does determine the need for services to address the safety of family members and the risk of subsequent maltreatment.

 

(b) "Investigation" means fact gathering related to the current safety of a child and the risk of subsequent maltreatment that determines whether child maltreatment occurred and whether child protective services are needed. An investigation must be used when reports involve substantial child endangerment, and for reports of maltreatment in facilities required to be licensed under chapter 245A or 245B; under sections 144.50 to 144.58 and 241.021; in a school as defined in sections 120A.05, subdivisions 9, 11, and 13, and 124D.10; or in a nonlicensed personal care provider association as defined in sections 256B.04, subdivision 16, and 256B.0625, subdivision 19a.

 

(c) "Substantial child endangerment" means a person responsible for a child's care, and in the case of sexual abuse includes a person who has a significant relationship to the child as defined in section 609.341, or a person in a position of authority as defined in section 609.341, who by act or omission commits or attempts to commit an act against a child under their care that constitutes any of the following:

 

(1) egregious harm as defined in section 260C.007, subdivision 14;

 

(2) sexual abuse as defined in paragraph (d);

 

(3) abandonment under section 260C.301, subdivision 2;

 

(4) neglect as defined in paragraph (f), clause (2), that substantially endangers the child's physical or mental health, including a growth delay, which may be referred to as failure to thrive, that has been diagnosed by a physician and is due to parental neglect;

 

(5) murder in the first, second, or third degree under section 609.185, 609.19, or 609.195;

 

(6) manslaughter in the first or second degree under section 609.20 or 609.205;

 

(7) assault in the first, second, or third degree under section 609.221, 609.222, or 609.223;

 

(8) solicitation, inducement, and promotion of prostitution under section 609.322;

 

(9) criminal sexual conduct under sections 609.342 to 609.3451;

 

(10) solicitation of children to engage in sexual conduct under section 609.352;

 

(11) malicious punishment or neglect or endangerment of a child under section 609.377 or 609.378;

 

(12) use of a minor in sexual performance under section 617.246; or

 

(13) parental behavior, status, or condition which mandates that the county attorney file a termination of parental rights petition under section 260C.301, subdivision 3, paragraph (a).

 

(d) "Sexual abuse" means the subjection of a child by a person responsible for the child's care, by a person who has a significant relationship to the child, as defined in section 609.341, or by a person in a position of authority, as defined in section 609.341, subdivision 10, to any act which constitutes a violation of section 609.342 (criminal sexual conduct in the first degree), 609.343 (criminal sexual conduct in the second degree), 609.344 (criminal sexual


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conduct in the third degree), 609.345 (criminal sexual conduct in the fourth degree), or 609.3451 (criminal sexual conduct in the fifth degree). Sexual abuse also includes any act which involves a minor which constitutes a violation of prostitution offenses under sections 609.321 to 609.324 or 617.246. Sexual abuse includes threatened sexual abuse.

 

(e) "Person responsible for the child's care" means (1) an individual functioning within the family unit and having responsibilities for the care of the child such as a parent, guardian, or other person having similar care responsibilities, or (2) an individual functioning outside the family unit and having responsibilities for the care of the child such as a teacher, school administrator, other school employees or agents, or other lawful custodian of a child having either full-time or short-term care responsibilities including, but not limited to, day care, babysitting whether paid or unpaid, counseling, teaching, and coaching.

 

(f) "Neglect" means:

 

(1) failure by a person responsible for a child's care to supply a child with necessary food, clothing, shelter, health, medical, or other care required for the child's physical or mental health when reasonably able to do so;

 

(2) failure to protect a child from conditions or actions that seriously endanger the child's physical or mental health when reasonably able to do so, including a growth delay, which may be referred to as a failure to thrive, that has been diagnosed by a physician and is due to parental neglect;

 

(3) failure to provide for necessary supervision or child care arrangements appropriate for a child after considering factors as the child's age, mental ability, physical condition, length of absence, or environment, when the child is unable to care for the child's own basic needs or safety, or the basic needs or safety of another child in their care;

 

(4) failure to ensure that the child is educated as defined in sections 120A.22 and 260C.163, subdivision 11, which does not include a parent's refusal to provide the parent's child with sympathomimetic medications, consistent with section 125A.091, subdivision 5;

 

(5) nothing in this section shall be construed to mean that a child is neglected solely because the child's parent, guardian, or other person responsible for the child's care in good faith selects and depends upon spiritual means or prayer for treatment or care of disease or remedial care of the child in lieu of medical care; except that a parent, guardian, or caretaker, or a person mandated to report pursuant to subdivision 3, has a duty to report if a lack of medical care may cause serious danger to the child's health. This section does not impose upon persons, not otherwise legally responsible for providing a child with necessary food, clothing, shelter, education, or medical care, a duty to provide that care;

 

(6) prenatal exposure to a controlled substance, as defined in section 253B.02, subdivision 2, used by the mother for a nonmedical purpose, as evidenced by withdrawal symptoms in the child at birth, results of a toxicology test performed on the mother at delivery or the child at birth, or medical effects or developmental delays during the child's first year of life that medically indicate prenatal exposure to a controlled substance;

 

(7) "medical neglect" as defined in section 260C.007, subdivision 6, clause (5);

 

(8) chronic and severe use of alcohol or a controlled substance by a parent or person responsible for the care of the child that adversely affects the child's basic needs and safety; or

 

(9) emotional harm from a pattern of behavior which contributes to impaired emotional functioning of the child which may be demonstrated by a substantial and observable effect in the child's behavior, emotional response, or cognition that is not within the normal range for the child's age and stage of development, with due regard to the child's culture.


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(g) "Physical abuse" means any physical injury, mental injury, or threatened injury, inflicted by a person responsible for the child's care on a child other than by accidental means, or any physical or mental injury that cannot reasonably be explained by the child's history of injuries, or any aversive or deprivation procedures, or regulated interventions, that have not been authorized under section 121A.67 or 245.825. Abuse does not include reasonable and moderate physical discipline of a child administered by a parent or legal guardian which does not result in an injury. Abuse does not include the use of reasonable force by a teacher, principal, or school employee as allowed by section 121A.582. Actions which are not reasonable and moderate include, but are not limited to, any of the following that are done in anger or without regard to the safety of the child:

 

(1) throwing, kicking, burning, biting, or cutting a child;

 

(2) striking a child with a closed fist;

 

(3) shaking a child under age three;

 

(4) striking or other actions which result in any nonaccidental injury to a child under 18 months of age;

 

(5) unreasonable interference with a child's breathing;

 

(6) threatening a child with a weapon, as defined in section 609.02, subdivision 6;

 

(7) striking a child under age one on the face or head;

 

(8) purposely giving a child poison, alcohol, or dangerous, harmful, or controlled substances which were not prescribed for the child by a practitioner, in order to control or punish the child; or other substances that substantially affect the child's behavior, motor coordination, or judgment or that results in sickness or internal injury, or subjects the child to medical procedures that would be unnecessary if the child were not exposed to the substances;

 

(9) unreasonable physical confinement or restraint not permitted under section 609.379, including but not limited to tying, caging, or chaining; or

 

(10) in a school facility or school zone, an act by a person responsible for the child's care that is a violation under section 121A.58.

 

(h) "Report" means any report received by the local welfare agency, police department, county sheriff, or agency responsible for assessing or investigating maltreatment pursuant to this section.

 

(i) "Facility" means:

 

(1) a licensed or unlicensed day care facility, residential facility, agency, hospital, sanitarium, or other facility or institution required to be licensed under sections 144.50 to 144.58, 241.021, or 245A.01 to 245A.16, or chapter 245B;

 

(2) a school as defined in sections 120A.05, subdivisions 9, 11, and 13; and 124D.10; or

 

(3) a nonlicensed personal care provider organization as defined in sections 256B.04, subdivision 16, and 256B.0625, subdivision 19a.

 

(j) "Operator" means an operator or agency as defined in section 245A.02.


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(k) "Commissioner" means the commissioner of human services.

 

(l) "Practice of social services," for the purposes of subdivision 3, includes but is not limited to employee assistance counseling and the provision of guardian ad litem and parenting time expeditor services.

 

(m) "Mental injury" means an injury to the psychological capacity or emotional stability of a child as evidenced by an observable or substantial impairment in the child's ability to function within a normal range of performance and behavior with due regard to the child's culture.

 

(n) "Threatened injury" means a statement, overt act, condition, or status that represents a substantial risk of physical or sexual abuse or mental injury. Threatened injury includes, but is not limited to, exposing a child to a person responsible for the child's care, as defined in paragraph (e), clause (1), who has:

 

(1) subjected a child to, or failed to protect a child from, an overt act or condition that constitutes egregious harm, as defined in section 260C.007, subdivision 14, or a similar law of another jurisdiction;

 

(2) been found to be palpably unfit under section 260C.301, paragraph (b), clause (4), or a similar law of another jurisdiction;

 

(3) committed an act that has resulted in an involuntary termination of parental rights under section 260C.301, or a similar law of another jurisdiction; or

 

(4) committed an act that has resulted in the involuntary transfer of permanent legal and physical custody of a child to a relative under section 260C.201, subdivision 11, paragraph (d), clause (1), or a similar law of another jurisdiction.

 

(o) Persons who conduct assessments or investigations under this section shall take into account accepted child-rearing practices of the culture in which a child participates and accepted teacher discipline practices, which are not injurious to the child's health, welfare, and safety.

 

Sec. 80. Minnesota Statutes 2006, section 626.556, subdivision 3, is amended to read:

 

Subd. 3. Persons mandated to report. (a) A person who knows or has reason to believe a child is being neglected or physically or sexually abused, as defined in subdivision 2, or has been neglected or physically or sexually abused within the preceding three years, shall immediately report the information to the local welfare agency, agency responsible for assessing or investigating the report, police department, or the county sheriff if the person is:

 

(1) a professional or professional's delegate who is engaged in the practice of the healing arts, social services, hospital administration, psychological or psychiatric treatment, child care, education, correctional supervision, probation and correctional services, or law enforcement; or

 

(2) employed as a member of the clergy and received the information while engaged in ministerial duties, provided that a member of the clergy is not required by this subdivision to report information that is otherwise privileged under section 595.02, subdivision 1, paragraph (c).

 

The police department or the county sheriff, upon receiving a report, shall immediately notify the local welfare agency or agency responsible for assessing or investigating the report, orally and in writing. The local welfare agency, or agency responsible for assessing or investigating the report, upon receiving a report, shall immediately notify the local police department or the county sheriff orally and in writing. The county sheriff and the head of every local welfare agency, agency responsible for assessing or investigating reports, and police department shall


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each designate a person within their agency, department, or office who is responsible for ensuring that the notification duties of this paragraph and paragraph (b) are carried out. Nothing in this subdivision shall be construed to require more than one report from any institution, facility, school, or agency.

 

(b) Any person may voluntarily report to the local welfare agency, agency responsible for assessing or investigating the report, police department, or the county sheriff if the person knows, has reason to believe, or suspects a child is being or has been neglected or subjected to physical or sexual abuse. The police department or the county sheriff, upon receiving a report, shall immediately notify the local welfare agency or agency responsible for assessing or investigating the report, orally and in writing. The local welfare agency or agency responsible for assessing or investigating the report, upon receiving a report, shall immediately notify the local police department or the county sheriff orally and in writing.

 

(c) A person mandated to report physical or sexual child abuse or neglect occurring within a licensed facility shall report the information to the agency responsible for licensing the facility under sections 144.50 to 144.58; 241.021; 245A.01 to 245A.16; or chapter 245B; or a nonlicensed personal care provider organization as defined in sections 256B.04, subdivision 16; and 256B.0625, subdivision 19. A health or corrections agency receiving a report may request the local welfare agency to provide assistance pursuant to subdivisions 10, 10a, and 10b. A board or other entity whose licensees perform work within a school facility, upon receiving a complaint of alleged maltreatment, shall provide information about the circumstances of the alleged maltreatment to the commissioner of education. Section 13.03, subdivision 4, applies to data received by the commissioner of education from a licensing entity.

 

(d) Any person mandated to report shall receive a summary of the disposition of any report made by that reporter, including whether the case has been opened for child protection or other services, or if a referral has been made to a community organization, unless release would be detrimental to the best interests of the child. Any person who is not mandated to report shall, upon request to the local welfare agency, receive a concise summary of the disposition of any report made by that reporter, unless release would be detrimental to the best interests of the child.

 

(e) For purposes of this subdivision section, "immediately" means as soon as possible but in no event longer than 24 hours.

 

Sec. 81. Minnesota Statutes 2006, section 626.556, is amended by adding a subdivision to read:

 

Subd. 3e. Agency responsibility for assessing or investigating reports of sexual abuse. The local welfare agency is the agency responsible for investigating allegations of sexual abuse if the alleged offender is the parent, guardian, sibling, or an individual functioning within the family unit as a person responsible for the child's care, or a person with a significant relationship to the child if that person resides in the child's household.

 

Sec. 82. Minnesota Statutes 2006, section 626.556, is amended by adding a subdivision to read:

 

Subd. 3f. Law enforcement agency responsibility for investigating maltreatment. The local law enforcement agency has responsibility for investigating any report of child maltreatment if a violation of a criminal statute is alleged. Law enforcement and the responsible agency must coordinate their investigations or assessments as required under subdivision 10.

 

Sec. 83. Minnesota Statutes 2006, section 626.556, subdivision 10, is amended to read:

 

Subd. 10. Duties of local welfare agency and local law enforcement agency upon receipt of a report. (a) Upon receipt of a report, the local welfare agency shall determine whether to conduct a family assessment or an investigation as appropriate to prevent or provide a remedy for child maltreatment. The local welfare agency:


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(1) shall conduct an investigation on reports involving substantial child endangerment;

 

(2) shall begin an immediate investigation if, at any time when it is using a family assessment response, it determines that there is reason to believe that substantial child endangerment or a serious threat to the child's safety exists;

 

(3) may conduct a family assessment for reports that do not allege substantial child endangerment. In determining that a family assessment is appropriate, the local welfare agency may consider issues of child safety, parental cooperation, and the need for an immediate response; and

 

(4) may conduct a family assessment on a report that was initially screened and assigned for an investigation. In determining that a complete investigation is not required, the local welfare agency must document the reason for terminating the investigation and notify the local law enforcement agency if the local law enforcement agency is conducting a joint investigation.

 

If the report alleges neglect, physical abuse, or sexual abuse by a parent, guardian, or individual functioning within the family unit as a person responsible for the child's care, or sexual abuse by a person with a significant relationship to the child when that person resides in the child's household or by a sibling, the local welfare agency shall immediately conduct a family assessment or investigation as identified in clauses (1) to (4). In conducting a family assessment or investigation, the local welfare agency shall gather information on the existence of substance abuse and domestic violence and offer services for purposes of preventing future child maltreatment, safeguarding and enhancing the welfare of the abused or neglected minor, and supporting and preserving family life whenever possible. If the report alleges a violation of a criminal statute involving sexual abuse, physical abuse, or neglect or endangerment, under section 609.378, the local law enforcement agency and local welfare agency shall coordinate the planning and execution of their respective investigation and assessment efforts to avoid a duplication of fact-finding efforts and multiple interviews. Each agency shall prepare a separate report of the results of its investigation. In cases of alleged child maltreatment resulting in death, the local agency may rely on the fact-finding efforts of a law enforcement investigation to make a determination of whether or not maltreatment occurred. When necessary the local welfare agency shall seek authority to remove the child from the custody of a parent, guardian, or adult with whom the child is living. In performing any of these duties, the local welfare agency shall maintain appropriate records.

 

If the family assessment or investigation indicates there is a potential for abuse of alcohol or other drugs by the parent, guardian, or person responsible for the child's care, the local welfare agency shall conduct a chemical use assessment pursuant to Minnesota Rules, part 9530.6615. The local welfare agency shall report the determination of the chemical use assessment, and the recommendations and referrals for alcohol and other drug treatment services to the state authority on alcohol and drug abuse.

 

(b) When a local agency receives a report or otherwise has information indicating that a child who is a client, as defined in section 245.91, has been the subject of physical abuse, sexual abuse, or neglect at an agency, facility, or program as defined in section 245.91, it shall, in addition to its other duties under this section, immediately inform the ombudsman established under sections 245.91 to 245.97. The commissioner of education shall inform the ombudsman established under sections 245.91 to 245.97 of reports regarding a child defined as a client in section 245.91 that maltreatment occurred at a school as defined in sections 120A.05, subdivisions 9, 11, and 13, and 124D.10.

 

(c) Authority of the local welfare agency responsible for assessing or investigating the child abuse or neglect report, the agency responsible for assessing or investigating the report, and of the local law enforcement agency for investigating the alleged abuse or neglect includes, but is not limited to, authority to interview, without parental consent, the alleged victim and any other minors who currently reside with or who have resided with the alleged offender. The interview may take place at school or at any facility or other place where the alleged victim or other


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minors might be found or the child may be transported to, and the interview conducted at, a place appropriate for the interview of a child designated by the local welfare agency or law enforcement agency. The interview may take place outside the presence of the alleged offender or parent, legal custodian, guardian, or school official. For family assessments, it is the preferred practice to request a parent or guardian's permission to interview the child prior to conducting the child interview, unless doing so would compromise the safety assessment. Except as provided in this paragraph, the parent, legal custodian, or guardian shall be notified by the responsible local welfare or law enforcement agency no later than the conclusion of the investigation or assessment that this interview has occurred. Notwithstanding rule 49.02 32 of the Minnesota Rules of Procedure for Juvenile Courts, the juvenile court may, after hearing on an ex parte motion by the local welfare agency, order that, where reasonable cause exists, the agency withhold notification of this interview from the parent, legal custodian, or guardian. If the interview took place or is to take place on school property, the order shall specify that school officials may not disclose to the parent, legal custodian, or guardian the contents of the notification of intent to interview the child on school property, as provided under this paragraph, and any other related information regarding the interview that may be a part of the child's school record. A copy of the order shall be sent by the local welfare or law enforcement agency to the appropriate school official.

 

(d) When the local welfare, local law enforcement agency, or the agency responsible for assessing or investigating a report of maltreatment determines that an interview should take place on school property, written notification of intent to interview the child on school property must be received by school officials prior to the interview. The notification shall include the name of the child to be interviewed, the purpose of the interview, and a reference to the statutory authority to conduct an interview on school property. For interviews conducted by the local welfare agency, the notification shall be signed by the chair of the local social services agency or the chair's designee. The notification shall be private data on individuals subject to the provisions of this paragraph. School officials may not disclose to the parent, legal custodian, or guardian the contents of the notification or any other related information regarding the interview until notified in writing by the local welfare or law enforcement agency that the investigation or assessment has been concluded, unless a school employee or agent is alleged to have maltreated the child. Until that time, the local welfare or law enforcement agency or the agency responsible for assessing or investigating a report of maltreatment shall be solely responsible for any disclosures regarding the nature of the assessment or investigation.

 

Except where the alleged offender is believed to be a school official or employee, the time and place, and manner of the interview on school premises shall be within the discretion of school officials, but the local welfare or law enforcement agency shall have the exclusive authority to determine who may attend the interview. The conditions as to time, place, and manner of the interview set by the school officials shall be reasonable and the interview shall be conducted not more than 24 hours after the receipt of the notification unless another time is considered necessary by agreement between the school officials and the local welfare or law enforcement agency. Where the school fails to comply with the provisions of this paragraph, the juvenile court may order the school to comply. Every effort must be made to reduce the disruption of the educational program of the child, other students, or school staff when an interview is conducted on school premises.

 

(e) Where the alleged offender or a person responsible for the care of the alleged victim or other minor prevents access to the victim or other minor by the local welfare agency, the juvenile court may order the parents, legal custodian, or guardian to produce the alleged victim or other minor for questioning by the local welfare agency or the local law enforcement agency outside the presence of the alleged offender or any person responsible for the child's care at reasonable places and times as specified by court order.

 

(f) Before making an order under paragraph (e), the court shall issue an order to show cause, either upon its own motion or upon a verified petition, specifying the basis for the requested interviews and fixing the time and place of the hearing. The order to show cause shall be served personally and shall be heard in the same manner as provided in other cases in the juvenile court. The court shall consider the need for appointment of a guardian ad litem to protect the best interests of the child. If appointed, the guardian ad litem shall be present at the hearing on the order to show cause.


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(g) The commissioner of human services, the ombudsman for mental health and developmental disabilities, the local welfare agencies responsible for investigating reports, the commissioner of education, and the local law enforcement agencies have the right to enter facilities as defined in subdivision 2 and to inspect and copy the facility's records, including medical records, as part of the investigation. Notwithstanding the provisions of chapter 13, they also have the right to inform the facility under investigation that they are conducting an investigation, to disclose to the facility the names of the individuals under investigation for abusing or neglecting a child, and to provide the facility with a copy of the report and the investigative findings.

 

(h) The local welfare agency responsible for conducting a family assessment or investigation shall collect available and relevant information to determine child safety, risk of subsequent child maltreatment, and family strengths and needs and share not public information with an Indian's tribal social services agency without violating any law of the state that may otherwise impose duties of confidentiality on the local welfare agency in order to implement the tribal state agreement. The local welfare agency or the agency responsible for investigating the report shall collect available and relevant information to ascertain whether maltreatment occurred and whether protective services are needed. Information collected includes, when relevant, information with regard to the person reporting the alleged maltreatment, including the nature of the reporter's relationship to the child and to the alleged offender, and the basis of the reporter's knowledge for the report; the child allegedly being maltreated; the alleged offender; the child's caretaker; and other collateral sources having relevant information related to the alleged maltreatment. The local welfare agency or the agency responsible for assessing or investigating the report may make a determination of no maltreatment early in an assessment, and close the case and retain immunity, if the collected information shows no basis for a full assessment or investigation.

 

Information relevant to the assessment or investigation must be asked for, and may include:

 

(1) the child's sex and age, prior reports of maltreatment, information relating to developmental functioning, credibility of the child's statement, and whether the information provided under this clause is consistent with other information collected during the course of the assessment or investigation;

 

(2) the alleged offender's age, a record check for prior reports of maltreatment, and criminal charges and convictions. The local welfare agency or the agency responsible for assessing or investigating the report must provide the alleged offender with an opportunity to make a statement. The alleged offender may submit supporting documentation relevant to the assessment or investigation;

 

(3) collateral source information regarding the alleged maltreatment and care of the child. Collateral information includes, when relevant: (i) a medical examination of the child; (ii) prior medical records relating to the alleged maltreatment or the care of the child maintained by any facility, clinic, or health care professional and an interview with the treating professionals; and (iii) interviews with the child's caretakers, including the child's parent, guardian, foster parent, child care provider, teachers, counselors, family members, relatives, and other persons who may have knowledge regarding the alleged maltreatment and the care of the child; and

 

(4) information on the existence of domestic abuse and violence in the home of the child, and substance abuse.

 

Nothing in this paragraph precludes the local welfare agency, the local law enforcement agency, or the agency responsible for assessing or investigating the report from collecting other relevant information necessary to conduct the assessment or investigation. Notwithstanding section 13.384 or 144.335, the local welfare agency has access to medical data and records for purposes of clause (3). Notwithstanding the data's classification in the possession of any other agency, data acquired by the local welfare agency or the agency responsible for assessing or investigating the report during the course of the assessment or investigation are private data on individuals and must be maintained in accordance with subdivision 11. Data of the commissioner of education collected or maintained during and for the purpose of an investigation of alleged maltreatment in a school are governed by this section, notwithstanding the data's classification as educational, licensing, or personnel data under chapter 13.


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In conducting an assessment or investigation involving a school facility as defined in subdivision 2, paragraph (i), the commissioner of education shall collect investigative reports and data that are relevant to a report of maltreatment and are from local law enforcement and the school facility.

 

(i) Upon receipt of a report, the local welfare agency shall conduct a face-to-face contact with the child reported to be maltreated and with the child's primary caregiver sufficient to complete a safety assessment and ensure the immediate safety of the child. The face-to-face contact with the child and primary caregiver shall occur immediately if substantial child endangerment is alleged and within five calendar days for all other reports. If the alleged offender was not already interviewed as the primary caregiver, the local welfare agency shall also conduct a face-to-face interview with the alleged offender in the early stages of the assessment or investigation. At the initial contact, the local child welfare agency or the agency responsible for assessing or investigating the report must inform the alleged offender of the complaints or allegations made against the individual in a manner consistent with laws protecting the rights of the person who made the report. The interview with the alleged offender may be postponed if it would jeopardize an active law enforcement investigation.

 

(j) When conducting an investigation, the local welfare agency shall use a question and answer interviewing format with questioning as nondirective as possible to elicit spontaneous responses. For investigations only, the following interviewing methods and procedures must be used whenever possible when collecting information:

 

(1) audio recordings of all interviews with witnesses and collateral sources; and

 

(2) in cases of alleged sexual abuse, audio-video recordings of each interview with the alleged victim and child witnesses.

 

(k) In conducting an assessment or investigation involving a school facility as defined in subdivision 2, paragraph (i), the commissioner of education shall collect available and relevant information and use the procedures in paragraphs (i), (k), and subdivision 3d, except that the requirement for face-to-face observation of the child and face-to-face interview of the alleged offender is to occur in the initial stages of the assessment or investigation provided that the commissioner may also base the assessment or investigation on investigative reports and data received from the school facility and local law enforcement, to the extent those investigations satisfy the requirements of paragraphs (i) and (k), and subdivision 3d.

 

Sec. 84. Minnesota Statutes 2006, section 626.556, subdivision 10a, is amended to read:

 

Subd. 10a. Abuse outside family unit Law enforcement agency responsibility for investigation; welfare agency reliance on law enforcement fact-finding; welfare agency offer of services. (a) If the report alleges neglect, physical abuse, or sexual abuse by a person who is not a parent, guardian, sibling, person responsible for the child's care functioning outside within the family unit, or a person who lives in the child's household and who has a significant relationship to the child, in a setting other than a facility as defined in subdivision 2, the local welfare agency shall immediately notify the appropriate law enforcement agency, which shall conduct an investigation of the alleged abuse or neglect if a violation of a criminal statute is alleged.

 

(b) The local agency may rely on the fact-finding efforts of the law enforcement investigation conducted under this subdivision to make a determination whether or not threatened harm or other maltreatment has occurred under subdivision 2 if an alleged offender has minor children or lives with minors.

 

(c) The local welfare agency shall offer appropriate social services for the purpose of safeguarding and enhancing the welfare of the abused or neglected minor.


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Sec. 85. Minnesota Statutes 2006, section 626.556, subdivision 10c, is amended to read:

 

Subd. 10c. Duties of local social service agency upon receipt of a report of medical neglect. If the report alleges medical neglect as defined in section 260C.007, subdivision 4 6, clause (5), the local welfare agency shall, in addition to its other duties under this section, immediately consult with designated hospital staff and with the parents of the infant to verify that appropriate nutrition, hydration, and medication are being provided; and shall immediately secure an independent medical review of the infant's medical charts and records and, if necessary, seek a court order for an independent medical examination of the infant. If the review or examination leads to a conclusion of medical neglect, the agency shall intervene on behalf of the infant by initiating legal proceedings under section 260C.141 and by filing an expedited motion to prevent the withholding of medically indicated treatment.

 

Sec. 86. Minnesota Statutes 2006, section 626.556, subdivision 10f, is amended to read:

 

Subd. 10f. Notice of determinations. Within ten working days of the conclusion of a family assessment, the local welfare agency shall notify the parent or guardian of the child of the need for services to address child safety concerns or significant risk of subsequent child maltreatment. The local welfare agency and the family may also jointly agree that family support and family preservation services are needed. Within ten working days of the conclusion of an investigation, the local welfare agency or agency responsible for assessing or investigating the report shall notify the parent or guardian of the child, the person determined to be maltreating the child, and if applicable, the director of the facility, of the determination and a summary of the specific reasons for the determination. The notice must also include a certification that the information collection procedures under subdivision 10, paragraphs (h), (i), and (j), were followed and a notice of the right of a data subject to obtain access to other private data on the subject collected, created, or maintained under this section. In addition, the notice shall include the length of time that the records will be kept under subdivision 11c. The investigating agency shall notify the parent or guardian of the child who is the subject of the report, and any person or facility determined to have maltreated a child, of their appeal or review rights under this section or section 256.022. The notice must also state that a finding of maltreatment may result in denial of a license application or background study disqualification under chapter 245C related to employment or services that are licensed by the Department of Human Services under chapter 245A, the Department of Health under chapter 144 or 144A, the Department of Corrections under section 241.021, and from providing services related to an unlicensed personal care provider organization under chapter 256B.

 

Sec. 87. KINSHIP NAVIGATOR PROGRAM; DEMONSTRATION GRANT.

 

(a) The commissioner of human services shall fund a two-year demonstration grant to be transferred to a nonprofit organization experienced in kinship advocacy and policy that has:

 

(1) experience working with grandparents and relatives who are raising kinship children;

 

(2) an established statewide outreach network;

 

(3) established kinship support groups;

 

(4) an intergenerational approach to programming; and

 

(5) a board of directors consisting of 50 percent grandparents and relatives raising kinship children.


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(b) The purpose of the grant is to provide support to grandparents or relatives raising kinship children. One site must be in the metropolitan area, and the other in the Bemidji region. One-stop services may include, but are not limited to, legal services, education, information, family activities, support groups, mental health access, advocacy, mentors, and information related to foster care licensing. Funds may also be used for a media campaign to inform kinship families about available information and services, support sites, and other program development.

 

Sec. 88. MFIP PILOT PROGRAM; WORKFORCE U.

 

Subdivision 1. Establishment. A pilot program is established in Stearns and Benton Counties to expand the Workforce U program administered by the Stearns-Benton Employment and Training Council.

 

Subd. 2. Evaluation. The Workforce U pilot program must be evaluated by a research and evaluation organization with experience evaluating welfare programs. The evaluation must include information on the total number of persons served, percentage of participants exiting the program, percentage of former participants reentering the program, average wages of program participants, and recommendations to the legislature for possible statewide implementation of the program. The evaluation must be presented to the legislature by February 15, 2011.

 

Subd. 3. Expiration. The Workforce U pilot program expires on June 30, 2011.

 

Sec. 89. LEECH LAKE YOUTH TREATMENT CENTER PROPOSAL.

 

(a) The commissioner of human services shall provide a planning grant to address the unmet need for local, effective, culturally relevant alcohol and drug treatment for American Indian youth, and develop a plan for a family-based youth treatment center in the Leech Lake area. The planning grant must be provided to a volunteer board consisting of at least four members appointed by the commissioner, to include at least the following:

 

(1) two members of the Leech Lake Tribal Council or their designees;

 

(2) one member appointed by the Cass County Social Services administrator; and

 

(3) one member appointed by the Cass Lake-Bena Public School superintendent.

 

(b) The plan must include:

 

(1) an interest, feasibility, and suitability of location study;

 

(2) defining scope of programs and services to be offered;

 

(3) defining site use limitations and restrictions, including physical and capacity;

 

(4) defining facilities required for programs and services offered;

 

(5) identifying partners, partnership roles, and partner resources;

 

(6) developing proposed operating and maintenance budgets;

 

(7) identifying funding sources;

 

(8) developing a long-term funding plan; and

 

(9) developing a formal steering committee, structure, and bylaws.


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(c) The plan is due to the legislative committees having jurisdiction over chemical health issues no later than September 2008 in order to provide the 12 months necessary to complete the plan.

 

Sec. 90. MINNESOTA FOOD SUPPORT PROGRAM SIMPLIFIED APPLICATION.

 

The Department of Human Services shall create a simplified application for the Minnesota food support program for persons over the age of 60 and persons with disabilities. The application must be no longer than three pages in length.

 

EFFECTIVE DATE. This section is effective January 1, 2008.

 

Sec. 91. INSPECTION OF LEGAL UNLICENSED CHILD CARE PROVIDERS.

 

The commissioner of human services, in consultation with the commissioners of health and education and the counties, shall develop and present recommendations to the legislature in January 2008 in order for each legally unlicensed child care provider receiving child care assistance funds to receive a onetime home visit to receive information on health and safety, and school readiness.

 

Sec. 92. COMMISSIONER OF HUMAN SERVICES DUTIES; EARLY CHILDHOOD AND SCHOOL-AGE PROFESSIONAL DEVELOPMENT TRAINING.

 

Subdivision 1. Development and implementation of an early childhood and school-age professional development system. (a) The commissioner of human services, in cooperation with the commissioners of education and health, shall develop and phase-in the implementation of a professional development system for practitioners serving children in early childhood and school-age programs. The system shall provide training options and supports for practitioners to voluntarily choose, as they complete or exceed existing licensing requirements.

 

The system must, at a minimum, include the following features:

 

(1) a continuum of training content based on the early childhood and school-age care practitioner core competencies that translates knowledge into improved practice to support children's school success;

 

(2) training strategies that provide direct feedback about practice to practitioners through ongoing consultation, mentoring, or coaching with special emphasis on early literacy and early mathematics;

 

(3) an approval process for trainers;

 

(4) a professional development registry for early childhood and school-age care practitioners that will provide tracking and recognition of practitioner training/career development progress;

 

(5) a career lattice that includes a range of professional development and educational opportunities that provide appropriate coursework and degree pathways;

 

(6) development of a plan with public higher education institutions for an articulated system of education, training, and professional development that includes credit for prior learning and development of equivalences to two- and four-year degrees;

 

(7) incentives and supports for early childhood and school-age care practitioners to seek additional training and education, including TEACH, other scholarships, and career guidance; and


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(8) coordinated and accessible delivery of training to early childhood and school-age care practitioners.

 

(b) By January 1, 2008, the commissioner, in consultation with the organizations named in subdivision 2 shall develop additional opportunities in order to qualify more licensed family child care providers under section 119B.13, subdivision 3a.

 

(c) The commissioner of human services must evaluate the professional development system and make continuous improvements.

 

(d) Beginning July 1, 2007, as appropriations permit, the commissioner shall phase-in the professional development system.

 

Subd. 2. Two-hour early childhood training. By January 15, 2008, the commissioner of human services, with input from the Minnesota Licensed Family Child Care Association and the Minnesota Professional Development Council, shall identify trainings that qualify for the two-hour early childhood development training requirement for new child care practitioners under Minnesota Statutes, section 245A.14, subdivision 9a, paragraphs (a) and (b). For licensed family child care, the commissioner shall also seek the input of labor unions that serve licensed family child care providers, if the union has been recognized by a county to serve licensed family child care providers.

 

Sec. 93. SCHOOL READINESS SERVICE AGREEMENTS.

 

Subdivision 1. Overview. (a) Effective July 1, 2007, funds must be made available to allow the commissioner to pay higher rates to up to 50 child care providers who are deemed by the commissioner to meet the requirements of a school readiness service agreement (SRSA) provider and perform services that support school readiness for children and economic stability for parents.

 

(b) A provider may be paid a rate above that currently allowed under Minnesota Statutes, section 119B.13, if:

 

(1) the provider has entered into an SRSA with the commissioner;

 

(2) a family using that provider receives child care assistance under any provision in Minnesota Statutes, chapter 119B, except Minnesota Statutes, section 119B.035;

 

(3) the family using that provider meets the criteria in this section; and

 

(4) funding is available under this section.

 

Subd. 2. Provider eligibility. (a) To be considered for an SRSA, a provider shall apply to the commissioner. To be eligible to apply for an SRSA, a provider shall:

 

(1) be eligible for child care assistance payments under Minnesota Statutes, chapter 119B;

 

(2) have at least 25 percent of the children enrolled with the provider subsidized through the child care assistance program;

 

(3) provide full-time, full-year child care services; and

 

(4) serve at least one child who is subsidized through the child care assistance program and who is expected to enter kindergarten within the following 30 months.


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(b) The commissioner may waive the 25 percent requirement in paragraph (a), clause (2), if necessary to achieve geographic distribution of SRSA providers and diversity of types of care provided by SRSA providers.

 

(c) An eligible provider who would like to enter into an SRSA with the commissioner shall submit an SRSA application. To determine whether to enter into an SRSA with a provider, the commissioner shall evaluate the following factors:

 

(1) the qualifications of the provider and the provider's staff;

 

(2) the provider's staff-child ratios;

 

(3) the provider's curriculum;

 

(4) the provider's current or planned parent education activities;

 

(5) the provider's current or planned social service and employment linkages;

 

(6) the provider's child development assessment plan;

 

(7) the geographic distribution needed for SRSA providers;

 

(8) the inclusion of a variety of child care delivery models; and

 

(9) other related factors determined by the commissioner.

 

Subd. 3. Family and child eligibility. (a) A family eligible to choose an SRSA provider for their children shall:

 

(1) be eligible to receive child care assistance under any provision in Minnesota Statutes, chapter 119B, except Minnesota Statutes, section 119B.035;

 

(2) be in an authorized activity for an average of at least 35 hours per week when initial eligibility is determined; and

 

(3) include a child who has not yet entered kindergarten.

 

(b) A family who is determined to be eligible to choose an SRSA provider remains eligible to be paid at a higher rate through the SRSA provider when the following conditions exist:

 

(1) the child attends child care with the SRSA provider a minimum of 25 hours per week, on average;

 

(2) the family has a child who has not yet entered kindergarten; and

 

(3) the family maintains eligibility under Minnesota Statutes, chapter 119B, except Minnesota Statutes, section 119B.035.

 

(c) For the 12 months after initial eligibility has been determined, a decrease in the family's authorized activities to an average of less than 35 hours per week does not result in ineligibility for the SRSA rate.

 

(d) A family that moves between counties but continues to use the same SRSA provider shall continue to receive SRSA funding for the increased payments.


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Subd. 4. Requirements of providers. An SRSA must include assessment, evaluation, and reporting requirements that promote the goals of improved school readiness and movement toward appropriate child development milestones. A provider who enters into an SRSA shall comply with the assessment, evaluation, and reporting requirements in the SRSA.

 

Subd. 5. Relationship to current law. (a) The following provisions in Minnesota Statutes, chapter 119B, must be waived or modified for families receiving services under this section.

 

(b) Notwithstanding Minnesota Statutes, section 119B.13, subdivisions 1 and 1a, maximum weekly rates under this section are 125 percent of the existing maximum weekly rate for like-care. Providers eligible for a differential rate under Minnesota Statutes, section 119B.13, subdivision 3a, remain eligible for the differential above the rate identified in this section. Only care for children who have not yet entered kindergarten may be paid at the maximum rate under this section. The provider's charge for service provided through an SRSA may not exceed the rate that the provider charges a private-pay family for like-care arrangements.

 

(c) A family or child care provider may not be assessed an overpayment for care provided through an SRSA unless:

 

(1) there was an error in the amount of care authorized for the family; or

 

(2) the family or provider did not timely report a change as required under the law.

 

(d) Care provided through an SRSA is authorized on a weekly basis.

 

(e) Funds appropriated under this section to serve families eligible under Minnesota Statutes, section 119B.03, are not allocated through the basic sliding fee formula under Minnesota Statutes, section 119B.03. Funds appropriated under this section are used to offset increased costs when payments are made under SRSA's.

 

(f) Notwithstanding Minnesota Statutes, section 119B.09, subdivision 6, the maximum amount of child care assistance that may be authorized for a child receiving care through an SRSA in a two-week period is 160 hours per child.

 

Subd. 6. Establishment of service agreements. (a) The commissioner shall approve SRSA's for up to 50 providers that represent diverse parts of the state and a variety of child care delivery models. Entering into a service agreement does not guarantee that a provider will receive payment at a higher rate for families receiving child care assistance. A family eligible under this section shall choose a provider participating in an SRSA in order for a higher rate to be paid. Payments through SRSA's are also limited by the availability of SRSA funds.

 

(b) Nothing in this section shall be construed to limit parent choice as defined in Minnesota Statutes, section 119B.09, subdivision 5.

 

(c) The commissioner may allow for startup time for some providers if failing to do so would limit geographic diversity of SRSA providers or a variety of child care delivery models.

 

Sec. 94. FAMILY, FRIEND, AND NEIGHBOR GRANT PROGRAM.

 

Subdivision 1. Establishment. A family, friend, and neighbor (FFN) grant program is established to promote children's early literacy, healthy development, and school readiness, and to foster community partnerships to promote children's school readiness. The commissioner shall attempt to ensure that grants are made in all areas of the state. The commissioner of human services shall make grants available to fund: community-based organizations, nonprofit organizations, and Indian tribes working with FFN caregivers under subdivision 2, paragraph (a); and community-based partnerships to implement early literacy programs under subdivision 2, paragraph (b).


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Subd. 2. Program components. (a)(1) Grants that the commissioner awards under this section must be used by community-based organizations, nonprofit organizations, and Indian tribes working with FFN caregivers in local communities, cultural communities, and Indian tribes to:

 

(i) provide training, support, and resources to FFN caregivers in order to improve and promote children's health, safety, nutrition, and school readiness;

 

(ii) connect FFN caregivers and children's families with appropriate community resources that support the families' health, mental health, economic, and developmental needs;

 

(iii) connect FFN caregivers and children's families to early childhood screening programs and facilitate referrals where appropriate;

 

(iv) provide FFN caregivers and children's families with information about early learning guidelines from the Departments of Human Services and Education;

 

(v) provide FFN caregivers and children's families with information about becoming a licensed family child care provider; and

 

(vi) provide FFN caregivers and children's families with information about early learning allowances and enrollment opportunities in high quality community-based child-care and preschool programs.

 

(2) Grants that the commissioner awards under this paragraph also may be used for:

 

(i) health and safety and early learning kits for FFN caregivers;

 

(ii) play-and-learn groups with FFN caregivers;

 

(iii) culturally appropriate early childhood training for FFN caregivers;

 

(iv) transportation for FFN caregivers and children's families to school readiness and other early childhood training activities;

 

(v) other activities that promote school readiness;

 

(vi) data collection and evaluation;

 

(vii) staff outreach and outreach activities;

 

(viii) translation needs; or

 

(ix) administrative costs that equal up to 12 percent of the recipient's grant award.

 

(b) Grants that the commissioner awards under this section also must be used to fund partnerships among Minnesota public and regional library systems, community-based organizations, nonprofit organizations, and Indian tribes to implement early literacy programs in low-income communities, including tribal communities, to:

 

(1) purchase and equip early childhood read-mobiles that provide FFN caregivers and children's families with books, training, and early literacy activities;


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(2) provide FFN caregivers and children's families with translations of early childhood books, training, and early literacy activities in native languages; or

 

(3) provide FFN caregivers and children's families with early literacy activities in local libraries.

 

Subd. 3. Grant awards. Interested entities eligible to receive a grant under this section may apply to the commissioner in the form and manner the commissioner determines. The commissioner shall awards grants to eligible entities consistent with the requirements of this section.

 

Subd. 4. Evaluation. The commissioner, in consultation with early childhood care and education experts at the University of Minnesota, must evaluate the impact of the grants under subdivision 2 on children's school readiness and submit a written report to the human services and education finance and policy committees of the legislature by February 15, 2010.

 

EFFECTIVE DATE. This section is effective the day following final enactment.

 

Sec. 95. CHILD CARE PROVIDER STUDY.

 

The commissioner of human services is directed to study the implications of restricting the use of state subsidies in center-based child care to centers meeting state quality standards under Minnesota Statutes, section 124D.175, paragraph (c), and to publish the results no later than January 1, 2010. The study must include:

 

(1) the likelihood of there being sufficient child care providers meeting the standards;

 

(2) the cost to bring providers up to the standards and how this cost would be funded;

 

(3) how the standards and the ratings would be communicated to both parents and the general public; and

 

(4) a determination whether a similar system could be implemented for non-center-based care.

 

Sec. 96. DIRECTION TO COMMISSIONER.

 

(a) The commissioner of human services shall offer a request for proposals to identify a research and evaluation firm with experience working with:

 

(1) homeless youth providers;

 

(2) data; and

 

(3) the topics of housing, homelessness, and a continuum of care for youth.

 

(b) The research and evaluation firm identified under paragraph (a) shall monitor and evaluate the programs receiving funding under Minnesota Statutes, section 256K.45.

 

Sec. 97. REVISOR'S INSTRUCTION.

 

(a) The revisor shall renumber Minnesota Statutes, section 626.556, subdivision 3d, as Minnesota Statutes, section 626.556, subdivision 3g.


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(b) The revisor shall change references to Minnesota Statutes, section 260.851, to section 260.853 and references to Minnesota Statutes, section 260.851, article 5, to section 260.853, article 4, wherever those references appear in Minnesota Statutes and Minnesota Rules.

 

Sec. 98. REPEALER.

 

(a) Minnesota Statutes 2006, sections 119B.08, subdivision 4; 256J.29; 256J.37, subdivisions 3a and 3b; and 256J.626, subdivisions 7 and 9, are repealed.

 

(b) Laws 1997, chapter 8, section 1, is repealed.

 

(c) Minnesota Rules, part 9560.0102, subpart 2, item C, is repealed.

 

ARTICLE 2

 

LICENSING

 

Section 1. Minnesota Statutes 2006, section 245A.035, is amended to read:

 

245A.035 RELATIVE FOSTER CARE; UNLICENSED EMERGENCY LICENSE RELATIVE PLACEMENT.

 

Subdivision 1. Grant of Emergency license placement. Notwithstanding section 245A.03, subdivision 2a, or 245C.13, subdivision 2, a county agency may place a child for foster care with a relative who is not licensed to provide foster care, provided the requirements of subdivision 2 this section are met. As used in this section, the term "relative" has the meaning given it under section 260C.007, subdivision 27.

 

Subd. 2. Cooperation with emergency licensing placement process. (a) A county agency that places a child with a relative who is not licensed to provide foster care must begin the process of securing an emergency license for the relative as soon as possible and must conduct the initial inspection required by subdivision 3, clause (1), whenever possible, prior to placing the child in the relative's home, but no later than three working days after placing the child in the home. A child placed in the home of a relative who is not licensed to provide foster care must be removed from that home if the relative fails to cooperate with the county agency in securing an emergency foster care license. The commissioner may issue an emergency foster care license to a relative with whom the county agency wishes to place or has placed a child for foster care, or to a relative with whom a child has been placed by court order.

 

(b) If a child is to be placed in the home of a relative not licensed to provide foster care, either the placing agency or the county agency in the county in which the relative lives shall conduct the emergency licensing placement process as required in this section.

 

Subd. 3. Requirements for emergency license placement. Before an emergency license placement may be issued made, the following requirements must be met:

 

(1) the county agency must conduct an initial inspection of the premises where the foster care placement is to be provided made to ensure the health and safety of any child placed in the home. The county agency shall conduct the inspection using a form developed by the commissioner;

 

(2) at the time of the inspection or placement, whichever is earlier, the county agency must provide the relative being considered for an emergency license shall receive placement an application form for a child foster care license;


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(3) whenever possible, prior to placing the child in the relative's home, the relative being considered for an emergency license placement shall provide the information required by section 245C.05; and

 

(4) if the county determines, prior to the issuance of an emergency license placement, that anyone requiring a background study may be prior to licensure of the home is disqualified under section 245C.14 and chapter 245C, and the disqualification is one which the commissioner cannot set aside, an emergency license shall placement must not be issued made.

 

Subd. 4. Applicant study. When the county agency has received the information required by section 245C.05, the county agency shall begin an applicant study according to the procedures in chapter 245C. The commissioner may issue an emergency license upon recommendation of the county agency once the initial inspection has been successfully completed and the information necessary to begin the applicant background study has been provided. If the county agency does not recommend that the emergency license be granted, the agency shall notify the relative in writing that the agency is recommending denial to the commissioner; shall remove any child who has been placed in the home prior to licensure; and shall inform the relative in writing of the procedure to request review pursuant to subdivision 6. An emergency license shall be effective until a child foster care license is granted or denied, but shall in no case remain in effect more than 120 days from the date of placement submit the information to the commissioner according to section 245C.05.

 

Subd. 5. Child foster care license application. (a) The relatives with whom the emergency license holder placement has been made shall complete the child foster care license application and necessary paperwork within ten days of the placement. The county agency shall assist the emergency license holder applicant to complete the application. The granting of a child foster care license to a relative shall be under the procedures in this chapter and according to the standards set forth by foster care rule in Minnesota Rules, chapter 2960. In licensing a relative, the commissioner shall consider the importance of maintaining the child's relationship with relatives as an additional significant factor in determining whether to a background study disqualification should be set aside a licensing disqualifier under section 245C.22, or to grant a variance of licensing requirements should be granted under sections 245C.21 to 245C.27 section 245C.30.

 

(b) When the county or private child-placing agency is processing an application for child foster care licensure of a relative as defined in section 260B.007, subdivision 12, or 260C.007, subdivision 27, the county agency or child-placing agency must explain the licensing process to the prospective licensee, including the background study process and the procedure for reconsideration of an initial disqualification for licensure. The county or private child-placing agency must also provide the prospective relative licensee with information regarding appropriate options for legal representation in the pertinent geographic area. If a relative is initially disqualified under section 245C.14, the county or child-placing agency commissioner must provide written notice of the reasons for the disqualification and the right to request a reconsideration by the commissioner as required under section 245C.17.

 

(c) The commissioner shall maintain licensing data so that activities related to applications and licensing actions for relative foster care providers may be distinguished from other child foster care settings.

 

Subd. 6. Denial of emergency license. If the commissioner denies an application for an emergency foster care license under this section, that denial must be in writing and must include reasons for the denial. Denial of an emergency license is not subject to appeal under chapter 14. The relative may request a review of the denial by submitting to the commissioner a written statement of the reasons an emergency license should be granted. The commissioner shall evaluate the request for review and determine whether to grant the emergency license. The commissioner's review shall be based on a review of the records submitted by the county agency and the relative. Within 15 working days of the receipt of the request for review, the commissioner shall notify the relative requesting review in written form whether the emergency license will be granted. The commissioner's review shall be based on a review of the records submitted by the county agency and the relative. A child shall not be placed or remain placed in the relative's home while the request for review is pending. Denial of an emergency license shall not preclude an individual from reapplying for an emergency license or from applying for a child foster care license. The decision of the commissioner is the final administrative agency action.


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Sec. 2. Minnesota Statutes 2006, section 245A.10, subdivision 2, is amended to read:

 

Subd. 2. County fees for background studies and licensing inspections. (a) For purposes of family and group family child care licensing under this chapter, a county agency may charge a fee to an applicant or license holder to recover the actual cost of background studies, but in any case not to exceed $100 annually. A county agency may also charge a license fee to an applicant or license holder to recover the actual cost of licensing inspections, but in any case not to exceed $150 annually $50 for a one-year license or $100 for a two-year license.

 

(b) A county agency may charge a fee to a legal nonlicensed child care provider or applicant for authorization to recover the actual cost of background studies completed under section 119B.125, but in any case not to exceed $100 annually.

 

(c) Counties may elect to reduce or waive the fees in paragraph (a) or (b):

 

(1) in cases of financial hardship;

 

(2) if the county has a shortage of providers in the county's area;

 

(3) for new providers; or

 

(4) for providers who have attained at least 16 hours of training before seeking initial licensure.

 

(d) Counties may allow providers to pay the applicant fees in paragraph (a) or (b) on an installment basis for up to one year. If the provider is receiving child care assistance payments from the state, the provider may have the fees under paragraph (a) or (b) deducted from the child care assistance payments for up to one year and the state shall reimburse the county for the county fees collected in this manner.

 

EFFECTIVE DATE. This section is effective the day following final enactment.

 

Sec. 3. Minnesota Statutes 2006, section 245A.16, subdivision 1, is amended to read:

 

Subdivision 1. Delegation of authority to agencies. (a) County agencies and private agencies that have been designated or licensed by the commissioner to perform licensing functions and activities under section 245A.04 and background studies for adult foster care, family adult day services, family child care, and child foster care under chapter 245C,; to recommend denial of applicants under section 245A.05,; to issue correction orders, to issue variances, and recommend a conditional license under section 245A.06, or to recommend suspending or revoking a license or issuing a fine under section 245A.07, shall comply with rules and directives of the commissioner governing those functions and with this section. The following variances are excluded from the delegation of variance authority and may be issued only by the commissioner:

 

(1) dual licensure of family child care and child foster care, dual licensure of child and adult foster care, and adult foster care and family child care;

 

(2) adult foster care maximum capacity;

 

(3) adult foster care minimum age requirement;

 

(4) child foster care maximum age requirement;


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(5) variances regarding disqualified individuals except that county agencies may issue variances under section 245C.30 regarding disqualified individuals when the county is responsible for conducting a consolidated reconsideration according to sections 245C.25 and 245C.27, subdivision 2, clauses (a) and (b), of a county maltreatment determination and a disqualification based on serious or recurring maltreatment; and

 

(6) the required presence of a caregiver in the adult foster care residence during normal sleeping hours.

 

(b) County agencies must report:

 

(1) information about disqualification reconsiderations under sections 245C.25 and 245C.27, subdivision 2, clauses paragraphs (a) and (b), and variances granted under paragraph (a), clause (5), to the commissioner at least monthly in a format prescribed by the commissioner; and.

 

(2) for relative child foster care applicants and license holders, the number of relatives, as defined in section 260C.007, subdivision 27, and household members of relatives who are disqualified under section 245C.14; the disqualifying characteristics under section 245C.15; the number of these individuals who requested reconsideration under section 245C.21; the number of set-asides under section 245C.22; and variances under section 245C.30 issued. This information shall be reported to the commissioner annually by January 15 of each year in a format prescribed by the commissioner.

 

(c) For family day care programs, the commissioner may authorize licensing reviews every two years after a licensee has had at least one annual review.

 

(d) For family adult day services programs, the commissioner may authorize licensing reviews every two years after a licensee has had at least one annual review.

 

(e) A license issued under this section may be issued for up to two years.

 

(f) The commissioner shall work with counties to determine the cost and propose an ongoing funding allocation from the general fund to cover the cost to counties to implement an annual license review for licensed family child care providers. The commissioner shall solicit input from counties to determine the outcome. The commissioner shall report to the committees of the house of representatives and senate having jurisdiction over early childhood programs by January 15, 2008, as to the costs and the funding allocation recommended for future use.

 

EFFECTIVE DATE. This section is effective January 1, 2008.

 

Sec. 4. Minnesota Statutes 2006, section 245A.16, subdivision 3, is amended to read:

 

Subd. 3. Recommendations to the commissioner. The county or private agency shall not make recommendations to the commissioner regarding licensure without first conducting an inspection, and for adult foster care, family adult day services, family child care, and child foster care, a background study of the applicant, and evaluation pursuant to under chapter 245C. The county or private agency must forward its recommendation to the commissioner regarding the appropriate licensing action within 20 working days of receipt of a completed application.

 

EFFECTIVE DATE. This section is effective January 1, 2008.

 

Sec. 5. Minnesota Statutes 2006, section 245C.02, is amended by adding a subdivision to read:

 

Subd. 14a. Private agency. "Private agency" has the meaning given in section 245A.02, subdivision 12.


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Sec. 6. Minnesota Statutes 2006, section 245C.04, subdivision 1, is amended to read:

 

Subdivision 1. Licensed programs. (a) The commissioner shall conduct a background study of an individual required to be studied under section 245C.03, subdivision 1, at least upon application for initial license for all license types.

 

(b) The commissioner shall conduct a background study of an individual required to be studied under section 245C.03, subdivision 1, at reapplication for a license for family child care, child foster care, and adult foster care, and family adult day services.

 

(c) The commissioner is not required to conduct a study of an individual at the time of reapplication for a license if the individual's background study was completed by the commissioner of human services for an adult foster care license holder that is also:

 

(1) registered under chapter 144D; or

 

(2) licensed to provide home and community-based services to people with disabilities at the foster care location and the license holder does not reside in the foster care residence; and

 

(3) the following conditions are met:

 

(i) a study of the individual was conducted either at the time of initial licensure or when the individual became affiliated with the license holder;

 

(ii) the individual has been continuously affiliated with the license holder since the last study was conducted; and

 

(iii) the last study of the individual was conducted on or after October 1, 1995.

 

(d) From July 1, 2007, to June 30, 2009, the commissioner of human services shall conduct a study of an individual required to be studied under section 245C.03, at the time of reapplication for a child foster care license. The county or private agency shall collect and forward to the commissioner the information required under section 245C.05, subdivisions 1, paragraphs (a) and (b), and 5, paragraphs (a) and (b). The background study conducted by the commissioner of human services under this paragraph must include a review of the information required under section 245C.08, subdivisions 1, paragraph (a), clauses (1) to (4), and 3.

 

(e) The commissioner of human services shall conduct a background study of an individual specified under section 245C.03, subdivision 1, paragraph (a), clauses (2) to (6), who is newly affiliated with a child foster care license holder. The county or private agency shall collect and forward to the commissioner the information required under section 245C.05, subdivisions 1 and 5. The background study conducted by the commissioner of human services under this paragraph must include a review of the information required under section 245C.08, subdivisions 1, paragraph (a), and 3.

 

(f) Applicants for licensure, license holders, and other entities as provided in this chapter must submit completed background study forms to the commissioner before individuals specified in section 245C.03, subdivision 1, begin positions allowing direct contact in any licensed program.

 

(e) (g) For purposes of this section, a physician licensed under chapter 147 is considered to be continuously affiliated upon the license holder's receipt from the commissioner of health or human services of the physician's background study results.


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Sec. 7. Minnesota Statutes 2006, section 245C.04, subdivision 1, is amended to read:

 

Subdivision 1. Licensed programs. (a) The commissioner shall conduct a background study of an individual required to be studied under section 245C.03, subdivision 1, at least upon application for initial license for all license types.

 

(b) The commissioner shall conduct a background study of an individual required to be studied under section 245C.03, subdivision 1, at reapplication for a license for family child care, child foster care, and adult foster care.

 

(c) The commissioner is not required to conduct a study of an individual at the time of reapplication for a license if the individual's background study was completed by the commissioner of human services for an adult foster care license holder that is also:

 

(1) registered under chapter 144D; or

 

(2) licensed to provide home and community-based services to people with disabilities at the foster care location and the license holder does not reside in the foster care residence; and

 

(3) the following conditions are met:

 

(i) a study of the individual was conducted either at the time of initial licensure or when the individual became affiliated with the license holder;

 

(ii) the individual has been continuously affiliated with the license holder since the last study was conducted; and

 

(iii) the last study of the individual was conducted on or after October 1, 1995.

 

(d) From January 1, 2008, to December 31, 2009, the commissioner shall conduct a study of an individual required to be studied under section 245C.03, at the time of reapplication for a family child care license. The county shall collect and forward to the commissioner the information required under section 245C.05, subdivisions 1 and 5. The background study conducted by the commissioner under this paragraph must include a review of the information required under section 245C.08, subdivisions 1, paragraph (a), and 3.

 

(e) The commissioner shall conduct a background study of an individual specified under section 245C.03, subdivision 1, paragraph (a), clauses (2) to (6), who is newly affiliated with a family child care license holder. The county shall collect and forward to the commissioner the information required under section 245C.05, subdivisions 1 and 5. The background study conducted by the commissioner under this paragraph must include a review of the information required under section 245C.08, subdivisions 1, paragraph (a), and 3.

 

(f) Applicants for licensure, license holders, and other entities as provided in this chapter must submit completed background study forms to the commissioner before individuals specified in section 245C.03, subdivision 1, begin positions allowing direct contact in any licensed program.

 

(e) (g) For purposes of this section, a physician licensed under chapter 147 is considered to be continuously affiliated upon the license holder's receipt from the commissioner of health or human services of the physician's background study results.

 

EFFECTIVE DATE. This section is effective January 1, 2008.


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Sec. 8. Minnesota Statutes 2006, section 245C.05, subdivision 1, is amended to read:

 

Subdivision 1. Individual studied. (a) The individual who is the subject of the background study must provide the applicant, license holder, or other entity under section 245C.04 with sufficient information to ensure an accurate study, including:

 

(1) the individual's first, middle, and last name and all other names by which the individual has been known;

 

(2) home address, city, and state of residence;

 

(3) zip code;

 

(4) sex;

 

(5) date of birth; and

 

(6) Minnesota driver's license number or state identification number.

 

(b) Every subject of a background study conducted or initiated by counties or private agencies under this chapter must also provide the home address, city, county, and state of residence for the past five years.

 

(c) Every subject of a background study related to child foster care licensed through a private agency shall also provide the commissioner a signed consent for the release of any information received from national crime information databases to the private agency that initiated the background study.

 

(d) The subject of a background study shall provide fingerprints as required in subdivision 5, paragraph (c).

 

Sec. 9. Minnesota Statutes 2006, section 245C.05, is amended by adding a subdivision to read:

 

Subd. 2a. County or private agency. For background studies related to child foster care, county and private agencies must collect the information under subdivision 1 and forward it to the commissioner.

 

Sec. 10. Minnesota Statutes 2006, section 245C.05, is amended by adding a subdivision to read:

 

Subd. 2b. County agency. For background studies related to family child care, county agencies must collect the information under subdivision 1 and forward it to the commissioner.

 

EFFECTIVE DATE. This section is effective January 1, 2008.

 

Sec. 11. Minnesota Statutes 2006, section 245C.05, subdivision 4, is amended to read:

 

Subd. 4. Electronic transmission. For background studies conducted by the Department of Human Services, the commissioner shall implement a system for the electronic transmission of:

 

(1) background study information to the commissioner; and

 

(2) background study results to the license holder; and

 

(3) background study results to county and private agencies for background studies conducted by the commissioner for family child care and child foster care.

 

EFFECTIVE DATE. This section is effective January 1, 2008.


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Sec. 12. Minnesota Statutes 2006, section 245C.05, subdivision 5, is amended to read:

 

Subd. 5. Fingerprints. (a) Except as provided in paragraph (c), for any background study completed under this chapter, when the commissioner has reasonable cause to believe that further pertinent information may exist on the subject of the background study, the subject shall provide the commissioner with a set of classifiable fingerprints obtained from an authorized law enforcement agency.

 

(b) For purposes of requiring fingerprints, the commissioner has reasonable cause when, but not limited to, the:

 

(1) information from the Bureau of Criminal Apprehension indicates that the subject is a multistate offender;

 

(2) information from the Bureau of Criminal Apprehension indicates that multistate offender status is undetermined; or

 

(3) commissioner has received a report from the subject or a third party indicating that the subject has a criminal history in a jurisdiction other than Minnesota.

 

(c) Except as specified under section 245C.04, subdivision 1, paragraph (d), for background studies conducted by the commissioner for child foster care, the subject of the background study shall provide the commissioner with a set of classifiable fingerprints obtained from an authorized agency.

 

Sec. 13. Minnesota Statutes 2006, section 245C.05, subdivision 7, is amended to read:

 

Subd. 7. Probation officer and corrections agent. (a) A probation officer or corrections agent shall notify the commissioner of an individual's conviction if the individual is:

 

(1) affiliated with a program or facility regulated by the Department of Human Services or Department of Health, a facility serving children or youth licensed by the Department of Corrections, or any type of home care agency or provider of personal care assistance services; and

 

(2) convicted of a crime constituting a disqualification under section 245C.14.

 

(b) For the purpose of this subdivision, "conviction" has the meaning given it in section 609.02, subdivision 5.

 

(c) The commissioner, in consultation with the commissioner of corrections, shall develop forms and information necessary to implement this subdivision and shall provide the forms and information to the commissioner of corrections for distribution to local probation officers and corrections agents.

 

(d) The commissioner shall inform individuals subject to a background study that criminal convictions for disqualifying crimes will be reported to the commissioner by the corrections system.

 

(e) A probation officer, corrections agent, or corrections agency is not civilly or criminally liable for disclosing or failing to disclose the information required by this subdivision.

 

(f) Upon receipt of disqualifying information, the commissioner shall provide the notice required under section 245C.17, as appropriate, to agencies on record as having initiated a background study or making a request for documentation of the background study status of the individual.

 

(g) This subdivision does not apply to family child care and child foster care programs.


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Sec. 14. Minnesota Statutes 2006, section 245C.05, subdivision 7, is amended to read:

 

Subd. 7. Probation officer and corrections agent. (a) A probation officer or corrections agent shall notify the commissioner of an individual's conviction if the individual is:

 

(1) affiliated with a program or facility regulated by the Department of Human Services or Department of Health, a facility serving children or youth licensed by the Department of Corrections, or any type of home care agency or provider of personal care assistance services; and

 

(2) convicted of a crime constituting a disqualification under section 245C.14.

 

(b) For the purpose of this subdivision, "conviction" has the meaning given it in section 609.02, subdivision 5.

 

(c) The commissioner, in consultation with the commissioner of corrections, shall develop forms and information necessary to implement this subdivision and shall provide the forms and information to the commissioner of corrections for distribution to local probation officers and corrections agents.

 

(d) The commissioner shall inform individuals subject to a background study that criminal convictions for disqualifying crimes will be reported to the commissioner by the corrections system.

 

(e) A probation officer, corrections agent, or corrections agency is not civilly or criminally liable for disclosing or failing to disclose the information required by this subdivision.

 

(f) Upon receipt of disqualifying information, the commissioner shall provide the notice required under section 245C.17, as appropriate, to agencies on record as having initiated a background study or making a request for documentation of the background study status of the individual.

 

(g) This subdivision does not apply to family child care and child foster care programs.

 

EFFECTIVE DATE. This section is effective January 1, 2008.

 

Sec. 15. Minnesota Statutes 2006, section 245C.08, subdivision 1, is amended to read:

 

Subdivision 1. Background studies conducted by commissioner of human services. (a) For a background study conducted by the commissioner, the commissioner shall review:

 

(1) information related to names of substantiated perpetrators of maltreatment of vulnerable adults that has been received by the commissioner as required under section 626.557, subdivision 9c, paragraph (i);

 

(2) the commissioner's records relating to the maltreatment of minors in licensed programs, and from county agency findings of maltreatment of minors as indicated through the social service information system;

 

(3) information from juvenile courts as required in subdivision 4 for individuals listed in section 245C.03, subdivision 1, clauses (2), (5), and (6); and

 

(4) information from the Bureau of Criminal Apprehension.;

 

(5) except as provided in clause (6), information from the national crime information system when the commissioner has reasonable cause as defined under section 245C.05, subdivision 5; and


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(6) for a background study related to a child foster care application for licensure, the commissioner shall also review:

 

(i) information from the child abuse and neglect registry for any state in which the background study subject has resided in for the past five years; and

 

(ii) information from national crime information databases.

 

(b) Notwithstanding expungement by a court, the commissioner may consider information obtained under paragraph (a), clauses (3) and (4), unless the commissioner received notice of the petition for expungement and the court order for expungement is directed specifically to the commissioner.

 

Sec. 16. Minnesota Statutes 2006, section 245C.08, subdivision 2, is amended to read:

 

Subd. 2. Background studies conducted by a county or private agency. (a) For a background study conducted by a county or private agency for child foster care, adult foster care, family adult day services, and family child care homes, the commissioner shall review:

 

(1) information from the county agency's record of substantiated maltreatment of adults and the maltreatment of minors;

 

(2) information from juvenile courts as required in subdivision 4 for individuals listed in section 245C.03, subdivision 1, clauses (2), (5), and (6);

 

(3) information from the Bureau of Criminal Apprehension; and

 

(4) arrest and investigative records maintained by the Bureau of Criminal Apprehension, county attorneys, county sheriffs, courts, county agencies, local police, the National Criminal Records Repository, and criminal records from other states.

 

(b) If the individual has resided in the county for less than five years, the study shall include the records specified under paragraph (a) for the previous county or counties of residence for the past five years.

 

(c) Notwithstanding expungement by a court, the county or private agency may consider information obtained under paragraph (a), clauses (3) and (4), unless the commissioner received notice of the petition for expungement and the court order for expungement is directed specifically to the commissioner.

 

Sec. 17. Minnesota Statutes 2006, section 245C.08, subdivision 2, is amended to read:

 

Subd. 2. Background studies conducted by a county or private agency. (a) For a background study conducted by a county or private agency for child foster care, and adult foster care, and family child care homes, the commissioner shall review:

 

(1) information from the county agency's record of substantiated maltreatment of adults and the maltreatment of minors;

 

(2) information from juvenile courts as required in subdivision 4 for individuals listed in section 245C.03, subdivision 1, clauses (2), (5), and (6);

 

(3) information from the Bureau of Criminal Apprehension; and


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(4) arrest and investigative records maintained by the Bureau of Criminal Apprehension, county attorneys, county sheriffs, courts, county agencies, local police, the National Criminal Records Repository, and criminal records from other states.

 

(b) If the individual has resided in the county for less than five years, the study shall include the records specified under paragraph (a) for the previous county or counties of residence for the past five years.

 

(c) Notwithstanding expungement by a court, the county or private agency may consider information obtained under paragraph (a), clauses (3) and (4), unless the commissioner received notice of the petition for expungement and the court order for expungement is directed specifically to the commissioner.

 

EFFECTIVE DATE. This section is effective January 1, 2008.

 

Sec. 18. Minnesota Statutes 2006, section 245C.10, is amended by adding a subdivision to read:

 

Subd. 4. Temporary personnel agencies, educational programs, and professional services agencies. The commissioner shall recover the cost of the background studies initiated by temporary personnel agencies, educational programs, and professional services agencies that initiate background studies under section 245C.03, subdivision 4, through a fee of no more than $20 per study charged to the agency. In fiscal years 2008 and 2009, the fees collected under this subdivision are appropriated to the commissioner for the purpose of conducting background studies.

 

Sec. 19. Minnesota Statutes 2006, section 245C.11, subdivision 1, is amended to read:

 

Subdivision 1. Adult foster care; criminal conviction data. For individuals who are required to have background studies under section 245C.03, subdivisions 1 and 2, and who have been continuously affiliated with a an adult foster care provider that is licensed in more than one county, criminal conviction data may be shared among those counties in which the adult foster care programs are licensed. A county agency's receipt of criminal conviction data from another county agency shall meet the criminal data background study requirements of this chapter.

 

Sec. 20. Minnesota Statutes 2006, section 245C.11, subdivision 2, is amended to read:

 

Subd. 2. Jointly licensed programs. A county agency may accept a background study completed by the commissioner under this chapter in place of the background study required under section 245A.16, subdivision 3, in programs with joint licensure as home and community-based services and adult foster care for people with developmental disabilities when the license holder does not reside in the adult foster care residence and the subject of the study has been continuously affiliated with the license holder since the date of the commissioner's study.

 

Sec. 21. Minnesota Statutes 2006, section 245C.12, is amended to read:

 

245C.12 BACKGROUND STUDY; TRIBAL ORGANIZATIONS.

 

(a) For the purposes of background studies completed by tribal organizations performing licensing activities otherwise required of the commissioner under this chapter, after obtaining consent from the background study subject, tribal licensing agencies shall have access to criminal history data in the same manner as county licensing agencies and private licensing agencies under this chapter.


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(b) Tribal organizations may contract with the commissioner to obtain background study data on individuals under tribal jurisdiction related to adoptions according to section 245C.34. Tribal organizations may also contract with the commissioner to obtain background study data on individuals under tribal jurisdiction related to child foster care according to section 245C.34.

 

Sec. 22. Minnesota Statutes 2006, section 245C.16, subdivision 1, is amended to read:

 

Subdivision 1. Determining immediate risk of harm. (a) If the commissioner determines that the individual studied has a disqualifying characteristic, the commissioner shall review the information immediately available and make a determination as to the subject's immediate risk of harm to persons served by the program where the individual studied will have direct contact.

 

(b) The commissioner shall consider all relevant information available, including the following factors in determining the immediate risk of harm:

 

(1) the recency of the disqualifying characteristic;

 

(2) the recency of discharge from probation for the crimes;

 

(3) the number of disqualifying characteristics;

 

(4) the intrusiveness or violence of the disqualifying characteristic;

 

(5) the vulnerability of the victim involved in the disqualifying characteristic;

 

(6) the similarity of the victim to the persons served by the program where the individual studied will have direct contact; and

 

(7) whether the individual has a disqualification from a previous background study that has not been set aside.

 

(c) This section does not apply when the subject of a background study is regulated by a health-related licensing board as defined in chapter 214, and the subject is determined to be responsible for substantiated maltreatment under section 626.556 or 626.557.

 

(d) This section does not apply to a background study related to an initial application for a child foster care license.

 

(e) If the commissioner has reason to believe, based on arrest information or an active maltreatment investigation, that an individual poses an imminent risk of harm to persons receiving services, the commissioner may order that the person be continuously supervised or immediately removed pending the conclusion of the maltreatment investigation or criminal proceedings.

 

Sec. 23. Minnesota Statutes 2006, section 245C.17, is amended by adding a subdivision to read:

 

Subd. 5. Notice to county or private agency. For studies on individuals related to a license to provide child foster care, the commissioner shall also provide a notice of the background study results to the county or private agency that initiated the background study.


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Sec. 24. Minnesota Statutes 2006, section 245C.17, is amended by adding a subdivision to read:

 

Subd. 5a. Notice to county agency. For studies on individuals related to a license to provide family child care, the commissioner shall also provide a notice of the background study results to the county or private agency that initiated the background study.

 

EFFECTIVE DATE. This section is effective January 1, 2008.

 

Sec. 25. Minnesota Statutes 2006, section 245C.21, is amended by adding a subdivision to read:

 

Subd. 1a. Submission of reconsideration request to county or private agency. (a) For disqualifications related to studies conducted by county agencies, and for disqualifications related to studies conducted by the commissioner for child foster care, the individual shall submit the request for reconsideration to the county or private agency that initiated the background study.

 

(b) A reconsideration request shall be submitted within the time frames specified in subdivision 2.

 

(c) The county or private agency shall forward the individual's request for reconsideration and provide the commissioner with a recommendation whether to set aside the individual's disqualification.

 

Sec. 26. Minnesota Statutes 2006, section 245C.21, is amended by adding a subdivision to read:

 

Subd. 1a. Submission of reconsideration request to county agency. (a) For disqualifications related to studies conducted by county agencies, and for disqualifications related to studies conducted by the commissioner for family child care, the individual shall submit the request for reconsideration to the county that initiated the background study.

 

(b) A reconsideration request shall be submitted within the time frames specified in subdivision 2.

 

(c) The county agency shall forward the individual's request for reconsideration and provide the commissioner with a recommendation whether to set aside the individual's disqualification.

 

EFFECTIVE DATE. This section is effective January 1, 2008.

 

Sec. 27. Minnesota Statutes 2006, section 245C.23, subdivision 2, is amended to read:

 

Subd. 2. Commissioner's notice of disqualification that is not set aside. (a) The commissioner shall notify the license holder of the disqualification and order the license holder to immediately remove the individual from any position allowing direct contact with persons receiving services from the license holder if:

 

(1) the individual studied does not submit a timely request for reconsideration under section 245C.21;

 

(2) the individual submits a timely request for reconsideration, but the commissioner does not set aside the disqualification for that license holder under section 245C.22;

 

(3) an individual who has a right to request a hearing under sections 245C.27 and 256.045, or 245C.28 and chapter 14 for a disqualification that has not been set aside, does not request a hearing within the specified time; or

 

(4) an individual submitted a timely request for a hearing under sections 245C.27 and 256.045, or 245C.28 and chapter 14, but the commissioner does not set aside the disqualification under section 245A.08, subdivision 5, or 256.045.


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(b) If the commissioner does not set aside the disqualification under section 245C.22, and the license holder was previously ordered under section 245C.17 to immediately remove the disqualified individual from direct contact with persons receiving services or to ensure that the individual is under continuous, direct supervision when providing direct contact services, the order remains in effect pending the outcome of a hearing under sections 245C.27 and 256.045, or 245C.28 and chapter 14.

 

(c) For background studies related to child foster care, the commissioner shall also notify the county or private agency that initiated the study of the results of the reconsideration.

 

Sec. 28. Minnesota Statutes 2006, section 245C.23, subdivision 2, is amended to read:

 

Subd. 2. Commissioner's notice of disqualification that is not set aside. (a) The commissioner shall notify the license holder of the disqualification and order the license holder to immediately remove the individual from any position allowing direct contact with persons receiving services from the license holder if:

 

(1) the individual studied does not submit a timely request for reconsideration under section 245C.21;

 

(2) the individual submits a timely request for reconsideration, but the commissioner does not set aside the disqualification for that license holder under section 245C.22;

 

(3) an individual who has a right to request a hearing under sections 245C.27 and 256.045, or 245C.28 and chapter 14 for a disqualification that has not been set aside, does not request a hearing within the specified time; or

 

(4) an individual submitted a timely request for a hearing under sections 245C.27 and 256.045, or 245C.28 and chapter 14, but the commissioner does not set aside the disqualification under section 245A.08, subdivision 5, or 256.045.

 

(b) If the commissioner does not set aside the disqualification under section 245C.22, and the license holder was previously ordered under section 245C.17 to immediately remove the disqualified individual from direct contact with persons receiving services or to ensure that the individual is under continuous, direct supervision when providing direct contact services, the order remains in effect pending the outcome of a hearing under sections 245C.27 and 256.045, or 245C.28 and chapter 14.

 

(c) For background studies related to family child care, the commissioner shall also notify the county that initiated the study of the results of the reconsideration.

 

EFFECTIVE DATE. This section is effective January 1, 2008.

 

Sec. 29. Minnesota Statutes 2006, section 245C.24, subdivision 2, is amended to read:

 

Subd. 2. Permanent bar to set aside a disqualification. (a) Except as provided in paragraph (b), the commissioner may not set aside the disqualification of any individual disqualified pursuant to this chapter, in connection with a license to provide family child care for children, foster care for children in the provider's home, or foster care or day care services for adults in the provider's home regardless of how much time has passed, if the individual was disqualified for a crime or conduct listed in section 245C.15, subdivision 1.

 

(b) For an individual in the chemical dependency field who was disqualified for a crime or conduct listed under section 245C.15, subdivision 1, and whose disqualification was set aside prior to July 1, 2005, the commissioner must consider granting a variance pursuant to section 245C.30 for the license holder for a program dealing primarily with adults. A request for reconsideration evaluated under this paragraph must include a letter of recommendation from the license holder that was subject to the prior set-aside decision addressing the individual's quality of care to children or vulnerable adults and the circumstances of the individual's departure from that service.


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Sec. 30. [245C.33] ADOPTION BACKGROUND STUDY REQUIREMENTS.

 

Subdivision 1. Background studies conducted by commissioner. Before placement of a child for purposes of adoption, the commissioner shall conduct a background study on individuals listed in section 259.41, subdivision 3, for county agencies and private agencies licensed to place children for adoption.

 

Subd. 2. Information and data provided to county or private agency. The subject of the background study shall provide the following information to the county or private agency:

 

(1) the information specified in section 245C.05;

 

(2) a set of classifiable fingerprints obtained from an authorized agency; and

 

(3) for studies initiated by a private agency, a signed consent for the release of information received from national crime information databases to the private agency.

 

Subd. 3. Information and data provided to commissioner. The county or private agency shall forward the data collected under subdivision 2 to the commissioner.

 

Subd. 4. Information commissioner reviews. (a) The commissioner shall review the following information regarding the background study subject:

 

(1) the information under section 245C.08, subdivisions 1, 3, and 4;

 

(2) information from the child abuse and neglect registry for any state in which the subject has resided for the past five years; and

 

(3) information from national crime information databases.

 

(b) The commissioner shall provide any information collected under this subdivision to the county or private agency that initiated the background study. The commissioner shall indicate if the information collected shows that the subject of the background study has a conviction listed in United States Code, title 42, section 671(a)(20)(A).

 

Sec. 31. [245C.34] ADOPTION AND CHILD FOSTER CARE BACKGROUND STUDIES; TRIBAL ORGANIZATIONS.

 

Subdivision 1. Background studies may be conducted by commissioner. (a) Tribal organizations may contract with the commissioner under section 245C.12 to obtain background study data on individuals under tribal jurisdiction related to adoptions.

 

(b) Tribal organizations may contract with the commissioner under section 245C.12 to obtain background study data on individuals under tribal jurisdiction related to child foster care.

 

(c) Background studies initiated by tribal organizations under paragraphs (a) and (b) must be conducted as provided in subdivisions 2 and 3.

 

Subd. 2. Information and data provided to tribal organization. The background study subject must provide the following information to the tribal organization:

 

(1) for background studies related to adoptions, the information under section 245C.05;


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(2) for background studies related to child foster care, the information under section 245C.05;

 

(3) a set of classifiable fingerprints obtained from an authorized agency; and

 

(4) a signed consent for the release of information received from national crime information databases to the tribal organization.

 

Subd. 3. Information and data provided to commissioner. The tribal organization shall forward the data collected under subdivision 2 to the commissioner.

 

Subd. 4. Information commissioner reviews. (a) The commissioner shall review the following information regarding the background study subject:

 

(1) the information under section 245C.08, subdivisions 1, 3, and 4;

 

(2) information from the child abuse and neglect registry for any state in which the subject has resided for the past five years; and

 

(3) information from national crime information databases.

 

(b) The commissioner shall provide any information collected under this subdivision to the tribal organization that initiated the background study. The commissioner shall indicate if the information collected shows that the subject of the background study has a conviction listed in United States Code, title 42, section 671(a)(20)(A).

 

Sec. 32. Minnesota Statutes 2006, section 259.20, subdivision 2, is amended to read:

 

Subd. 2. Other applicable law. (a) Portions of chapters 245A, 245C, 257, 260, and 317A may also affect the adoption of a particular child.

 

(b) Provisions of the Indian Child Welfare Act, United States Code, title 25, chapter 21, sections 1901-1923, may also apply in the adoption of an Indian child, and may preempt specific provisions of this chapter.

 

(c) Consistent with section 245C.33 and Public Law 109-248, a completed background study is required before the approval of any foster or adoptive placement in a related or an unrelated home.

 

Sec. 33. Minnesota Statutes 2006, section 259.29, subdivision 1, is amended to read:

 

Subdivision 1. Best interests of the child. (a) The policy of the state of Minnesota is to ensure that the best interests of the child are met by requiring individualized determination of the needs of the child and of how the adoptive placement will serve the needs of the child.

 

(b) Among the factors the agency shall consider in determining the needs of the child are those specified under section 260C.193, subdivision 3, paragraph (b).

 

(c) Except for emergency placements provided for in section 245A.035, a completed background study is required under section 245C.33 before the approval of an adoptive placement in a home.


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Sec. 34. Minnesota Statutes 2006, section 259.41, is amended to read:

 

259.41 ADOPTION STUDY.

 

Subdivision 1. Study required before placement; certain relatives excepted. (a) An approved adoption study; completed background study, as required under section 245C.33; and written report must be completed before the child is placed in a prospective adoptive home under this chapter, except as allowed by section 259.47, subdivision 6. In an agency placement, the report must be filed with the court at the time the adoption petition is filed. In a direct adoptive placement, the report must be filed with the court in support of a motion for temporary preadoptive custody under section 259.47, subdivision 3, or, if the study and report are complete, in support of an emergency order under section 259.47, subdivision 6. The study and report shall be completed by a licensed child-placing agency and must be thorough and comprehensive. The study and report shall be paid for by the prospective adoptive parent, except as otherwise required under section 259.67 or 259.73.

 

(b) A placement for adoption with an individual who is related to the child, as defined by section 245A.02, subdivision 13, is not subject to this section except as required by section sections 245C.33 and 259.53, subdivision 2, paragraph (c).

 

(c) In the case of a licensed foster parent seeking to adopt a child who is in the foster parent's care, any portions of the foster care licensing process that duplicate requirements of the home study may be submitted in satisfaction of the relevant requirements of this section.

 

Subd. 2. Form of study. (a) The adoption study must include at least one in-home visit with the prospective adoptive parent. At a minimum, the study must include document the following information about the prospective adoptive parent:

 

(1) a background check study as required by subdivision 3 and section 245C.33, and including:

 

(i) an evaluation assessment of the data and information provided by section 245C.33, subdivision 4, to determine if the prospective adoptive parent and any other person over the age of 13 living in the home has a felony conviction consistent with subdivision 3 and section 471(a)(2) of the Social Security Act; and

 

(ii) an assessment of the effect of a any conviction or finding of substantiated maltreatment on the ability to capacity of the prospective adoptive parent to safely care for and parent a child;

 

(2) a medical and social history and assessment of current health;

 

(3) an assessment of potential parenting skills;

 

(4) an assessment of ability to provide adequate financial support for a child; and

 

(5) an assessment of the level of knowledge and awareness of adoption issues including, where appropriate, matters relating to interracial, cross-cultural, and special needs adoptions.

 

(b) The adoption study is the basis for completion of a written report. The report must be in a format specified by the commissioner and must contain recommendations regarding the suitability of the subject of the study to be an adoptive parent.

 

Subd. 3. Background check; affidavit of history study. (a) At the time an adoption study is commenced, each prospective adoptive parent must:


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(1) authorize access by the agency to any private data needed to complete the study;

 

(2) provide all addresses at which the prospective adoptive parent and anyone in the household over the age of 13 has resided in the previous five years; and

 

(3) disclose any names used previously other than the name used at the time of the study.

 

(b) When the requirements of paragraph (a) have been met, the agency shall immediately begin initiate a background check, study under section 245C.33 to be completed by the commissioner on each person over the age of 13 living in the home, consisting, at a minimum, of the following:. As required under section 245C.33 and Public Law 109-248, a completed background study is required before the approval of any foster or adoptive placement in a related or an unrelated home. The required background study must be completed as part of the home study.

 

(1) a check of criminal conviction data with the Bureau of Criminal Apprehension and local law enforcement authorities;

 

(2) a check for data on substantiated maltreatment of a child or vulnerable adult and domestic violence data with local law enforcement and social services agencies and district courts; and

 

(3) for those persons under the age of 25, a check of juvenile court records.

 

Notwithstanding the provisions of section 260B.171 or 260C.171, the Bureau of Criminal Apprehension, local law enforcement and social services agencies, district courts, and juvenile courts shall release the requested information to the agency completing the adoption study.

 

(c) When paragraph (b) requires checking the data or records of local law enforcement and social services agencies and district and juvenile courts, the agency shall check with the law enforcement and social services agencies and courts whose jurisdictions cover the addresses under paragraph (a), clause (2). In the event that the agency is unable to complete any of the record checks required by paragraph (b), the agency shall document the fact and the agency's efforts to obtain the information.

 

(d) For a study completed under this section, when the agency has reasonable cause to believe that further information may exist on the prospective adoptive parent or household member over the age of 13 that may relate to the health, safety, or welfare of the child, the prospective adoptive parent or household member over the age of 13 shall provide the agency with a set of classifiable fingerprints obtained from an authorized law enforcement agency and the agency may obtain criminal history data from the National Criminal Records Repository by submitting fingerprints to the Bureau of Criminal Apprehension. The agency has reasonable cause when, but not limited to, the:

 

(1) information from the Bureau of Criminal Apprehension indicates that the prospective adoptive parent or household member over the age of 13 is a multistate offender;

 

(2) information from the Bureau of Criminal Apprehension indicates that multistate offender status is undetermined;

 

(3) the agency has received a report from the prospective adoptive parent or household member over the age of 13 or a third party indicating that the prospective adoptive parent or household member over the age of 13 has a criminal history in a jurisdiction other than Minnesota; or

 

(4) the prospective adoptive parent or household member over the age of 13 is or has been a resident of a state other than Minnesota in the prior five years.


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(e) At any time prior to completion of the background check required under paragraph (b), a prospective adoptive parent may submit to the agency conducting the study a sworn affidavit stating whether they or any person residing in the household have been convicted of a crime. The affidavit shall also state whether the adoptive parent or any other person residing in the household is the subject of an open investigation of, or have been the subject of a substantiated allegation of, child or vulnerable-adult maltreatment within the past ten years. A complete description of the crime, open investigation, or substantiated abuse, and a complete description of any sentence, treatment, or disposition must be included. The affidavit must contain an acknowledgment that if, at any time before the adoption is final, a court receives evidence leading to a conclusion that a prospective adoptive parent knowingly gave false information in the affidavit, it shall be determined that the adoption of the child by the prospective adoptive parent is not in the best interests of the child.

 

(f) For the purposes of subdivision 1 and section 259.47, subdivisions 3 and 6, an adoption study is complete for placement, even though the background checks required by paragraph (b) have not been completed, if each prospective adoptive parent has completed the affidavit allowed by paragraph (e) and the other requirements of this section have been met. The background checks required by paragraph (b) must be completed before an adoption petition is filed. If an adoption study has been submitted to the court under section 259.47, subdivision 3 or 6, before the background checks required by paragraph (b) were complete, an updated adoption study report which includes the results of the background check must be filed with the adoption petition. In the event that an agency is unable to complete any of the records checks required by paragraph (b), the agency shall submit with the petition to adopt an affidavit documenting the agency's efforts to complete the checks.

 

(c) A home study under paragraph (b) used to consider placement of any child on whose behalf Title IV-E adoption assistance payments are to be made must not be approved if a background study reveals a felony conviction at any time for:

 

(1) child abuse or neglect;

 

(2) spousal abuse;

 

(3) a crime against children, including child pornography; or

 

(4) a crime involving violence, including rape, sexual assault, or homicide, but not including other physical assault or battery.

 

(d) A home study under paragraph (b) used to consider placement of any child on whose behalf Title IV-E adoption assistance payments are to be made must not be approved if a background study reveals a felony conviction within the past five years for:

 

(1) physical assault or battery; or

 

(2) a drug-related offense.

 

Subd. 4. Updates to adoption study; period of validity. An agency may update an adoption study and report as needed, regardless of when the original study and report or most recent update was completed. An update must be in a format specified by the commissioner and must verify the continuing accuracy of the elements of the original report and document any changes to elements of the original report. An update to a study and report not originally completed under this section must ensure that the study and report, as updated, meet the requirements of this section. An adoption study is valid if the report has been completed or updated within the previous 12 months.


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Sec. 35. Minnesota Statutes 2006, section 259.53, subdivision 2, is amended to read:

 

Subd. 2. Adoption agencies; postplacement assessment and report. (a) The agency to which the petition has been referred under subdivision 1 shall conduct a postplacement assessment and file a report with the court within 90 days of receipt of a copy of the adoption petition. The agency shall send a copy of the report to the commissioner at the time it files the report with the court. The assessment and report must evaluate the environment and antecedents of the child to be adopted, the home of the petitioners, whether placement with the petitioners meets the needs of the child as described in section 259.57, subdivision 2. The report must include a recommendation to the court as to whether the petition should or should not be granted.

 

In making evaluations and recommendations, the postplacement assessment and report must, at a minimum, address the following:

 

(1) the level of adaptation by the prospective adoptive parents to parenting the child;

 

(2) the health and well-being of the child in the prospective adoptive parents' home;

 

(3) the level of incorporation by the child into the prospective adoptive parents' home, extended family, and community; and

 

(4) the level of inclusion of the child's previous history into the prospective adoptive home, such as cultural or ethnic practices, or contact with former foster parents or biological relatives.

 

(b) A postplacement adoption report is valid for 12 months following its date of completion.

 

(c) If the petitioner is an individual who is related to the child, as defined by section 245A.02, subdivision 13, the agency, as part of its postplacement assessment and report under paragraph (a), shall conduct a background check meeting the requirements of section 259.41, subdivision 3, paragraph (b). The prospective adoptive parent shall cooperate in the completion of the background check by supplying the information and authorizations described in section 259.41, subdivision 3, paragraph (a).

 

(d) (c) If the report recommends that the court not grant the petition to adopt the child, the provisions of this paragraph apply. Unless the assessment and report were completed by the local social services agency, the agency completing the report, at the time it files the report with the court under paragraph (a), must provide a copy of the report to the local social services agency in the county where the prospective adoptive parent lives. The agency or local social services agency may recommend that the court dismiss the petition. If the local social services agency determines that continued placement in the home endangers the child's physical or emotional health, the agency shall seek a court order to remove the child from the home.

 

(e) (d) If, through no fault of the petitioner, the agency to whom the petition was referred under subdivision 1, paragraph (b), fails to complete the assessment and file the report within 90 days of the date it received a copy of the adoption petition, the court may hear the petition upon giving the agency and the local social services agency, if different, five days' notice by mail of the time and place of the hearing.

 

Sec. 36. Minnesota Statutes 2006, section 259.57, subdivision 2, is amended to read:

 

Subd. 2. Protection of child's best interests. (a) The policy of the state of Minnesota is to ensure that the best interests of children are met by requiring an individualized determination of the needs of the child and how the adoptive placement will serve the needs of the child.


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(b) Among the factors the court shall consider in determining the needs of the child are those specified under section 260C.193, subdivision 3, paragraph (b). Consistent with section 245C.33 and Public Law 109-248, a complete background study is required before the approval of an adoptive placement in a home.

 

(c) In reviewing adoptive placement and in determining appropriate adoption, the court shall consider placement, consistent with the child's best interests and in the following order, with (1) a relative or relatives of the child, or (2) an important friend with whom the child has resided or had significant contact. Placement of a child cannot be delayed or denied based on race, color, or national origin of the adoptive parent or the child. Whenever possible, siblings should be placed together unless it is determined not to be in the best interests of a sibling.

 

(d) If the child's birth parent or parents explicitly request that relatives and important friends not be considered, the court shall honor that request consistent with the best interests of the child.

 

If the child's birth parent or parents express a preference for placing the child in an adoptive home of the same or a similar religious background to that of the birth parent or parents, the court shall place the child with a family that also meets the birth parent's religious preference. Only if no family is available as described in clause (a) or (b) may the court give preference to a family described in clause (c) that meets the parent's religious preference.

 

(e) This subdivision does not affect the Indian Child Welfare Act, United States Code, title 25, sections 1901 to 1923, and the Minnesota Indian Family Preservation Act, sections 260.751 to 260.835.

 

Sec. 37. Minnesota Statutes 2006, section 260C.209, is amended to read:

 

260C.209 BACKGROUND CHECKS.

 

Subdivision 1. Subjects. The responsible social services agency must conduct initiate a background check study to be completed by the commissioner under this section of chapter 245C on the following individuals:

 

(1) a noncustodial parent or nonadjudicated parent who is being assessed for purposes of providing day-to-day care of a child temporarily or permanently under section 260C.212, subdivision 4, and any member of the parent's household who is over the age of 13 when there is a reasonable cause to believe that the parent or household member over age 13 has a criminal history or a history of maltreatment of a child or vulnerable adult which would endanger the child's health, safety, or welfare;

 

(2) an individual whose suitability for relative placement under section 260C.212, subdivision 5, is being determined and any member of the relative's household who is over the age of 13 when:

 

(i) the relative must be licensed for foster care; or

 

(ii) the agency must conduct a background study is required under section 259.53, subdivision 2; or

 

(iii) the agency or the commissioner has reasonable cause to believe the relative or household member over the age of 13 has a criminal history which would not make transfer of permanent legal and physical custody to the relative under section 260C.201, subdivision 11, in the child's best interest; and

 

(3) a parent, following an out-of-home placement, when the responsible social services agency has reasonable cause to believe that the parent has been convicted of a crime directly related to the parent's capacity to maintain the child's health, safety, or welfare or the parent is the subject of an open investigation of, or has been the subject of a substantiated allegation of, child or vulnerable-adult maltreatment within the past ten years.


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"Reasonable cause" means that the agency has received information or a report from the subject or a third person that creates an articulable suspicion that the individual has a history that may pose a risk to the health, safety, or welfare of the child. The information or report must be specific to the potential subject of the background check and shall not be based on the race, religion, ethnic background, age, class, or lifestyle of the potential subject.

 

Subd. 2. General procedures. (a) When conducting initiating a background check under subdivision 1, the agency may shall require the individual being assessed to provide sufficient information to ensure an accurate assessment under this section, including:

 

(1) the individual's first, middle, and last name and all other names by which the individual has been known;

 

(2) home address, zip code, city, county, and state of residence for the past ten five years;

 

(3) sex;

 

(4) date of birth; and

 

(5) driver's license number or state identification number.

 

(b) When notified by the commissioner or the responsible social services agency that it is conducting an assessment under this section, the Bureau of Criminal Apprehension, commissioners of health and human services, law enforcement, and county agencies must provide the commissioner or the responsible social services agency or county attorney with the following information on the individual being assessed: criminal history data, reports about the maltreatment of adults substantiated under section 626.557, and reports of maltreatment of minors substantiated under section 626.556.

 

Subd. 3. Multistate information. (a) For any assessment every background study completed under this section, if the responsible social services agency has reasonable cause to believe that the individual is a multistate offender, the individual must the subject of the background study shall provide the responsible social services agency or the county attorney with a set of classifiable fingerprints obtained from an authorized law enforcement agency. The responsible social services agency or county attorney may shall provide the fingerprints to the commissioner, and the commissioner shall obtain criminal history data from the National Criminal Records Repository by submitting the fingerprints to the Bureau of Criminal Apprehension.

 

(b) For purposes of this subdivision, the responsible social services agency has reasonable cause when, but not limited to:

 

(1) information from the Bureau of Criminal Apprehension indicates that the individual is a multistate offender;

 

(2) information from the Bureau of Criminal Apprehension indicates that multistate offender status is undetermined;

 

(3) the social services agency has received a report from the individual or a third party indicating that the individual has a criminal history in a jurisdiction other than Minnesota; or

 

(4) the individual is or has been a resident of a state other than Minnesota at any time during the prior ten years.

 

Subd. 4. Notice upon receipt. The responsible social services agency commissioner must provide the subject of the background study with the results of the study as required under this section within 15 business days of receipt or at least 15 days prior to the hearing at which the results will be presented, whichever comes first. The subject may provide written information to the agency that the results are incorrect and may provide additional or clarifying information to the agency and to the court through a party to the proceeding. This provision does not apply to any background study conducted under chapters 245A and chapter 245C.


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Sec. 38. Minnesota Statutes 2006, section 260C.212, subdivision 2, is amended to read:

 

Subd. 2. Placement decisions based on best interest of the child. (a) The policy of the state of Minnesota is to ensure that the child's best interests are met by requiring an individualized determination of the needs of the child and of how the selected placement will serve the needs of the child being placed. The authorized child-placing agency shall place a child, released by court order or by voluntary release by the parent or parents, in a family foster home selected by considering placement with relatives and important friends in the following order:

 

(1) with an individual who is related to the child by blood, marriage, or adoption; or

 

(2) with an individual who is an important friend with whom the child has resided or had significant contact.

 

(b) Among the factors the agency shall consider in determining the needs of the child are the following:

 

(1) the child's current functioning and behaviors;

 

(2) the medical, educational, and developmental needs of the child;

 

(3) the child's history and past experience;

 

(4) the child's religious and cultural needs;

 

(5) the child's connection with a community, school, and church;

 

(6) the child's interests and talents;

 

(7) the child's relationship to current caretakers, parents, siblings, and relatives; and

 

(8) the reasonable preference of the child, if the court, or the child-placing agency in the case of a voluntary placement, deems the child to be of sufficient age to express preferences.

 

(c) Placement of a child cannot be delayed or denied based on race, color, or national origin of the foster parent or the child.

 

(d) Siblings should be placed together for foster care and adoption at the earliest possible time unless it is determined not to be in the best interests of a sibling or unless it is not possible after appropriate efforts by the responsible social services agency.

 

(e) Except for emergency placement as provided for in section 245A.035, a completed background study is required under section 245C.08 before the approval of a foster placement in a related or unrelated home.

 

ARTICLE 3

 

HEALTH CARE

 

Section 1. Minnesota Statutes 2006, section 16A.724, subdivision 2, is amended to read:

 

Subd. 2. Transfers. (a) Notwithstanding section 295.581, to the extent available resources in the health care access fund exceed expenditures in that fund, effective with the biennium beginning July 1, 2007, the commissioner shall transfer funds from the health care access fund to the general fund to offset the costs of MinnesotaCare enrollees shifting to medical assistance due to the implementation of an automated eligibility determination system. The medical assistance costs shall be identified and updated in the November and February forecasts.


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(b) In addition to the amounts in paragraph (a), the commissioner of finance shall transfer the excess funds from the health care access fund to the general fund on June 30 of each year, provided that the amount transferred in any fiscal biennium shall not exceed $96,000,000. For the biennium ending June 30, 2011, the transfer shall not exceed $48,000,000.

 

(b) (c) For fiscal years 2006 to 2009, MinnesotaCare shall be a forecasted program, and, if necessary, the commissioner shall reduce these transfers from the health care access fund to the general fund to meet annual MinnesotaCare expenditures or, if necessary, transfer sufficient funds from the general fund to the health care access fund to meet annual MinnesotaCare expenditures.

 

Sec. 2. Minnesota Statutes 2006, section 256.969, subdivision 3a, is amended to read:

 

Subd. 3a. Payments. (a) Acute care hospital billings under the medical assistance program must not be submitted until the recipient is discharged. However, the commissioner shall establish monthly interim payments for inpatient hospitals that have individual patient lengths of stay over 30 days regardless of diagnostic category. Except as provided in section 256.9693, medical assistance reimbursement for treatment of mental illness shall be reimbursed based on diagnostic classifications. Individual hospital payments established under this section and sections 256.9685, 256.9686, and 256.9695, in addition to third party and recipient liability, for discharges occurring during the rate year shall not exceed, in aggregate, the charges for the medical assistance covered inpatient services paid for the same period of time to the hospital. This payment limitation shall be calculated separately for medical assistance and general assistance medical care services. The limitation on general assistance medical care shall be effective for admissions occurring on or after July 1, 1991. Services that have rates established under subdivision 11 or 12, must be limited separately from other services. After consulting with the affected hospitals, the commissioner may consider related hospitals one entity and may merge the payment rates while maintaining separate provider numbers. The operating and property base rates per admission or per day shall be derived from the best Medicare and claims data available when rates are established. The commissioner shall determine the best Medicare and claims data, taking into consideration variables of recency of the data, audit disposition, settlement status, and the ability to set rates in a timely manner. The commissioner shall notify hospitals of payment rates by December 1 of the year preceding the rate year. The rate setting data must reflect the admissions data used to establish relative values. Base year changes from 1981 to the base year established for the rate year beginning January 1, 1991, and for subsequent rate years, shall not be limited to the limits ending June 30, 1987, on the maximum rate of increase under subdivision 1. The commissioner may adjust base year cost, relative value, and case mix index data to exclude the costs of services that have been discontinued by the October 1 of the year preceding the rate year or that are paid separately from inpatient services. Inpatient stays that encompass portions of two or more rate years shall have payments established based on payment rates in effect at the time of admission unless the date of admission preceded the rate year in effect by six months or more. In this case, operating payment rates for services rendered during the rate year in effect and established based on the date of admission shall be adjusted to the rate year in effect by the hospital cost index.

 

(b) For fee-for-service admissions occurring on or after July 1, 2002, the total payment, before third-party liability and spenddown, made to hospitals for inpatient services is reduced by .5 percent from the current statutory rates.

 

(c) In addition to the reduction in paragraph (b), the total payment for fee-for-service admissions occurring on or after July 1, 2003, made to hospitals for inpatient services before third-party liability and spenddown, is reduced five percent from the current statutory rates. Mental health services within diagnosis related groups 424 to 432, and facilities defined under subdivision 16, and, effective for admissions occurring on or after July 1, 2007, a long-term hospital as designated by the Medicare program that is located in a city of the first class as defined in section 410.01, are excluded from this paragraph.


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(d) In addition to the reduction in paragraphs (b) and (c), the total payment for fee-for-service admissions occurring on or after July 1, 2005, made to hospitals for inpatient services before third-party liability and spenddown, is reduced 6.0 percent from the current statutory rates. Mental health services within diagnosis related groups 424 to 432 and, facilities defined under subdivision 16, and, effective for admissions occurring on or after July 1, 2007, a long-term hospital as designated by the Medicare program that is located in a city of the first class as defined in section 410.01, are excluded from this paragraph. Notwithstanding section 256.9686, subdivision 7, for purposes of this paragraph, medical assistance does not include general assistance medical care. Payments made to managed care plans shall be reduced for services provided on or after January 1, 2006, to reflect this reduction.

 

Sec. 3. Minnesota Statutes 2006, section 256.969, subdivision 9, is amended to read:

 

Subd. 9. Disproportionate numbers of low-income patients served. (a) For admissions occurring on or after October 1, 1992, through December 31, 1992, the medical assistance disproportionate population adjustment shall comply with federal law and shall be paid to a hospital, excluding regional treatment centers and facilities of the federal Indian Health Service, with a medical assistance inpatient utilization rate in excess of the arithmetic mean. The adjustment must be determined as follows:

 

(1) for a hospital with a medical assistance inpatient utilization rate above the arithmetic mean for all hospitals excluding regional treatment centers and facilities of the federal Indian Health Service but less than or equal to one standard deviation above the mean, the adjustment must be determined by multiplying the total of the operating and property payment rates by the difference between the hospital's actual medical assistance inpatient utilization rate and the arithmetic mean for all hospitals excluding regional treatment centers and facilities of the federal Indian Health Service; and

 

(2) for a hospital with a medical assistance inpatient utilization rate above one standard deviation above the mean, the adjustment must be determined by multiplying the adjustment that would be determined under clause (1) for that hospital by 1.1. If federal matching funds are not available for all adjustments under this subdivision, the commissioner shall reduce payments on a pro rata basis so that all adjustments qualify for federal match. The commissioner may establish a separate disproportionate population operating payment rate adjustment under the general assistance medical care program. For purposes of this subdivision medical assistance does not include general assistance medical care. The commissioner shall report annually on the number of hospitals likely to receive the adjustment authorized by this paragraph. The commissioner shall specifically report on the adjustments received by public hospitals and public hospital corporations located in cities of the first class.

 

(b) For admissions occurring on or after July 1, 1993, the medical assistance disproportionate population adjustment shall comply with federal law and shall be paid to a hospital, excluding regional treatment centers and facilities of the federal Indian Health Service, with a medical assistance inpatient utilization rate in excess of the arithmetic mean. The adjustment must be determined as follows:

 

(1) for a hospital with a medical assistance inpatient utilization rate above the arithmetic mean for all hospitals excluding regional treatment centers and facilities of the federal Indian Health Service but less than or equal to one standard deviation above the mean, the adjustment must be determined by multiplying the total of the operating and property payment rates by the difference between the hospital's actual medical assistance inpatient utilization rate and the arithmetic mean for all hospitals excluding regional treatment centers and facilities of the federal Indian Health Service;

 

(2) for a hospital with a medical assistance inpatient utilization rate above one standard deviation above the mean, the adjustment must be determined by multiplying the adjustment that would be determined under clause (1) for that hospital by 1.1. The commissioner may establish a separate disproportionate population operating payment rate adjustment under the general assistance medical care program. For purposes of this subdivision, medical assistance does not include general assistance medical care. The commissioner shall report annually on the number of hospitals likely to receive the adjustment authorized by this paragraph. The commissioner shall specifically report on the adjustments received by public hospitals and public hospital corporations located in cities of the first class;


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(3) for a hospital that had medical assistance fee-for-service payment volume during calendar year 1991 in excess of 13 percent of total medical assistance fee-for-service payment volume, a medical assistance disproportionate population adjustment shall be paid in addition to any other disproportionate payment due under this subdivision as follows: $1,515,000 due on the 15th of each month after noon, beginning July 15, 1995. For a hospital that had medical assistance fee-for-service payment volume during calendar year 1991 in excess of eight percent of total medical assistance fee-for-service payment volume and was the primary hospital affiliated with the University of Minnesota, a medical assistance disproportionate population adjustment shall be paid in addition to any other disproportionate payment due under this subdivision as follows: $505,000 due on the 15th of each month after noon, beginning July 15, 1995; and

 

(4) effective August 1, 2005, the payments in paragraph (b), clause (3), shall be reduced to zero.

 

(c) The commissioner shall adjust rates paid to a health maintenance organization under contract with the commissioner to reflect rate increases provided in paragraph (b), clauses (1) and (2), on a nondiscounted hospital-specific basis but shall not adjust those rates to reflect payments provided in clause (3).

 

(d) If federal matching funds are not available for all adjustments under paragraph (b), the commissioner shall reduce payments under paragraph (b), clauses (1) and (2), on a pro rata basis so that all adjustments under paragraph (b) qualify for federal match.

 

(e) For purposes of this subdivision, medical assistance does not include general assistance medical care.

 

(f) For hospital services occurring on or after July 1, 2005, to June 30, 2007, general assistance medical care expenditures for fee-for-service inpatient and outpatient hospital services made by the department and by prepaid health plans participating in general assistance medical care effective July 1, 2007, payments under section 256B.199 shall be considered Medicaid disproportionate share hospital payments, except as limited below: by clauses (1) to (5);

 

(1) only the portion of Minnesota's disproportionate share hospital allotment under section 1923(f) of the Social Security Act that is not spent on the disproportionate population adjustments in paragraph (b), clauses (1) and (2), may be used for general assistance medical care expenditures;

 

(2) only those general assistance medical care expenditures made to hospitals that qualify for disproportionate share payments under section 1923 of the Social Security Act and the Medicaid state plan may be considered disproportionate share hospital payments;

 

(3) only those general assistance medical care expenditures made to an individual hospital that would not cause the hospital to exceed its individual hospital limits under section 1923 of the Social Security Act may be considered; and

 

(4) general assistance medical care expenditures may be considered only to the extent of Minnesota's aggregate allotment under section 1923 of the Social Security Act.

 

All hospitals and prepaid health plans participating in general assistance medical care must provide any necessary expenditure, cost, and revenue information required by the commissioner as necessary for purposes of obtaining federal Medicaid matching funds for general assistance medical care expenditures. Medicaid disproportionate share payments; and

 

(5) expenditures under general assistance medical care shall be used to the fullest extent before payments under section 256B.199.


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(g) Upon federal approval of the related state plan amendment, paragraph (f) is effective retroactively from July 1, 2005, or the earliest effective date approved by the Centers for Medicare and Medicaid Services.

 

Sec. 4. Minnesota Statutes 2006, section 256.969, is amended by adding a subdivision to read:

 

Subd. 28. Long-term hospital payment adjustment. For admissions occurring on or after July 1, 2009, the commissioner shall increase the medical assistance payments to a long-term hospital with a medical assistance inpatient utilization rate of 17.95 percent of total patient days as of the base year in effect on July 1, 2005, by an amount equal to 13 percent of the total of the operating and property payment rates. Payments made to managed care plans shall not reflect this payment increase. For purposes of this subdivision, medical assistance does not include general assistance medical care. Payments to a hospital under this subdivision shall be reduced by the amount of any payments made under subdivision 27.

 

Sec. 5. Minnesota Statutes 2006, section 256B.04, subdivision 14, is amended to read:

 

Subd. 14. Competitive bidding. (a) When determined to be effective, economical, and feasible, the commissioner may utilize volume purchase through competitive bidding and negotiation under the provisions of chapter 16C, to provide items under the medical assistance program including but not limited to the following:

 

(1) eyeglasses;

 

(2) oxygen. The commissioner shall provide for oxygen needed in an emergency situation on a short-term basis, until the vendor can obtain the necessary supply from the contract dealer;

 

(3) hearing aids and supplies; and

 

(4) durable medical equipment, including but not limited to:

 

(i) hospital beds;

 

(ii) commodes;

 

(iii) glide-about chairs;

 

(iv) patient lift apparatus;

 

(v) wheelchairs and accessories;

 

(vi) oxygen administration equipment;

 

(vii) respiratory therapy equipment;

 

(viii) electronic diagnostic, therapeutic and life support systems;

 

(5) special nonemergency transportation services level of need determinations, disbursement of public transportation passes and tokens, and volunteer and recipient mileage and parking reimbursements; and

 

(6) drugs.

 

(b) Rate changes under this chapter and chapters 256D and 256L do not affect contract payments under this subdivision unless specifically identified.


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Sec. 6. Minnesota Statutes 2006, section 256B.04, is amended by adding a subdivision to read:

 

Subd. 14a. Level of need determination. Nonemergency medical transportation level of need determinations must be performed by a physician, a registered nurse working under direct supervision of a physician, a physician's assistant, a nurse practitioner, a licensed practical nurse, or a discharge planner. Nonemergency medical transportation level of need determinations must not be performed more than semiannually on any individual, unless the individual's circumstances have sufficiently changed so as to require a new level of need determination. Individuals residing in licensed nursing facilities and individuals requiring stretcher transportation are exempt from a level of need determination and are eligible for special transportation services until the individual no longer resides in a licensed nursing facility or no longer requires stretcher transportation.

 

Sec. 7. Minnesota Statutes 2006, section 256B.056, is amended by adding a subdivision to read:

 

Subd. 1d. Treatment of certain monetary gifts. The commissioner shall disregard as income any portion of a monetary gift received by an applicant or enrollee that is designated to purchase a prosthetic device not covered by insurance, other third-party payers, or medical assistance.

 

Sec. 8. Minnesota Statutes 2006, section 256B.0625, subdivision 3f, is amended to read:

 

Subd. 3f. Circumcision for newborns. Newborn Circumcision is not covered, unless the procedure is medically necessary or required because of a well-established religious practice.

 

Sec. 9. Minnesota Statutes 2006, section 256B.0625, is amended by adding a subdivision to read:

 

Subd. 8d. Chiropractic services. Medical assistance covers the following medically necessary chiropractic services: one initial or progress exam per year, manual manipulation of the spine, and x-rays.

 

EFFECTIVE DATE. This section is effective July 1, 2007.

 

Sec. 10. Minnesota Statutes 2006, section 256B.0625, subdivision 13c, is amended to read:

 

Subd. 13c. Formulary committee. The commissioner, after receiving recommendations from professional medical associations and professional pharmacy associations, and consumer groups shall designate a Formulary Committee to carry out duties as described in subdivisions 13 to 13g. The Formulary Committee shall be comprised of four licensed physicians actively engaged in the practice of medicine in Minnesota one of whom must be actively engaged in the treatment of persons with mental illness; at least three licensed pharmacists actively engaged in the practice of pharmacy in Minnesota; and one consumer representative; the remainder to be made up of health care professionals who are licensed in their field and have recognized knowledge in the clinically appropriate prescribing, dispensing, and monitoring of covered outpatient drugs. Members of the Formulary Committee shall not be employed by the Department of Human Services, but the committee shall be staffed by an employee of the department who shall serve as an ex officio, nonvoting member of the board committee. The department's medical director shall also serve as an ex officio, nonvoting member for the committee. Committee members shall serve three-year terms and may be reappointed by the commissioner. The Formulary Committee shall meet at least quarterly. The commissioner may require more frequent Formulary Committee meetings as needed. An honorarium of $100 per meeting and reimbursement for mileage shall be paid to each committee member in attendance.

 

Sec. 11. Minnesota Statutes 2006, section 256B.0625, subdivision 13d, is amended to read:

 

Subd. 13d. Drug formulary. (a) 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.


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(b) The formulary shall not include:

 

(1) drugs or products for which there is no federal funding;

 

(2) over-the-counter drugs, except as provided in subdivision 13;

 

(3) drugs used for weight loss, except that medically necessary lipase inhibitors may be covered for a recipient with type II diabetes;

 

(4) drugs when used for the treatment of impotence or erectile dysfunction;

 

(5) drugs for which medical value has not been established; and

 

(6) drugs from manufacturers who have not signed a rebate agreement with the Department of Health and Human Services pursuant to section 1927 of title XIX of the Social Security Act.

 

(c) If a single-source drug used by at least two percent of the fee-for-service medical assistance recipients is removed from the formulary due to the failure of the manufacturer to sign a rebate agreement with the Department of Health and Human Services, the commissioner shall notify prescribing practitioners within 30 days of receiving notification from the Centers for Medicare and Medicaid Services (CMS) that a rebate agreement was not signed.

 

EFFECTIVE DATE. This section is effective the day following final enactment.

 

Sec. 12. Minnesota Statutes 2006, section 256B.0625, is amended by adding a subdivision to read:

 

Subd. 13i. Medicare Part D. Notwithstanding subdivision 13, paragraph (d), for recipients who are enrolled in a Medicare Part D prescription drug plan or Medicare Advantage special needs plan, medical assistance covers co-payments which the recipient is responsible for under a Medicare Part D prescription drug plan or Medicare Advantage special needs plan, once the recipient has paid $12 per month in prescription drug co-payments, and according to the requirements of the plan.

 

Sec. 13. Minnesota Statutes 2006, 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 eligible persons in obtaining emergency or nonemergency medical care when paid directly to an ambulance company, common carrier, or other recognized providers of transportation services.

 

(b) Medical assistance covers special transportation, as defined in Minnesota Rules, part 9505.0315, subpart 1, item F, if 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.

 

The commissioner may use an order by the recipient's attending physician to certify that the recipient requires special transportation services. 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. Special transportation providers must obtain written documentation from the health care service provider who is serving the recipient being transported, identifying the time that the recipient arrived. Special transportation providers may not bill for separate base rates for the continuation of a trip beyond the original destination. Special transportation providers must take recipients to the nearest appropriate health care provider, using the most direct quickest route available as determined by a commercially available mileage software program approved by the commissioner. The maximum medical assistance reimbursement rates for special transportation services are:


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(1) $17 for the base rate and $1.35 $1.43 per mile for services to eligible persons who need a wheelchair-accessible van;

 

(2) $11.50 for the base rate and $1.30 per mile for services to eligible persons who do not need a wheelchair-accessible van; and

 

(3) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, for services to eligible persons who need a stretcher-accessible vehicle.

 

Sec. 14. Minnesota Statutes 2006, section 256B.0625, subdivision 18a, is amended to read:

 

Subd. 18a. Access to medical services. (a) Medical assistance reimbursement for meals for persons traveling to receive medical care may not exceed $5.50 for breakfast, $6.50 for lunch, or $8 for dinner.

 

(b) Medical assistance reimbursement for lodging for persons traveling to receive medical care may not exceed $50 per day unless prior authorized by the local agency.

 

(c) Medical assistance direct mileage reimbursement to the an eligible person or the an eligible person's driver may not exceed 20 cents per mile friend, neighbor, or relative that is providing direct transportation to a covered service shall be at 15 cents below the current Internal Revenue Service mileage reimbursement for business purposes.

 

(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. 15. Minnesota Statutes 2006, section 256B.0625, is amended by adding a subdivision to read:

 

Subd. 49. Community health worker. (a) Medical assistance covers the care coordination and patient education services provided by a community health worker if the community health worker has:

 

(1) received a certificate from the Minnesota State Colleges and Universities System approved community health worker curriculum; or

 

(2) at least five years of supervised experience with an enrolled physician or advanced practice registered nurse.

 

Community health workers eligible for payment under clause (2) must complete the certification program by January 1, 2010, to continue to be eligible for payment.

 

(b) Community health workers must work under the supervision of a medical assistance enrolled physician or advanced practice registered nurse.

 

Sec. 16. Minnesota Statutes 2006, section 256B.0644, is amended to read:

 

256B.0644 REIMBURSEMENT UNDER OTHER STATE HEALTH CARE PROGRAMS.

 

(a) A vendor of medical care, as defined in section 256B.02, subdivision 7, and a health maintenance organization, as defined in chapter 62D, must participate as a provider or contractor in the medical assistance program, general assistance medical care program, and MinnesotaCare as a condition of participating as a provider in health insurance plans and programs or contractor for state employees established under section 43A.18, the public employees insurance program under section 43A.316, for health insurance plans offered to local statutory or


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home rule charter city, county, and school district employees, the workers' compensation system under section 176.135, and insurance plans provided through the Minnesota Comprehensive Health Association under sections 62E.01 to 62E.19. The limitations on insurance plans offered to local government employees shall not be applicable in geographic areas where provider participation is limited by managed care contracts with the Department of Human Services.

 

(b) For providers other than health maintenance organizations, participation in the medical assistance program means that:

 

(1) the provider accepts new medical assistance, general assistance medical care, and MinnesotaCare patients or;

 

(2) for providers other than dental service providers, at least 20 percent of the provider's patients are covered by medical assistance, general assistance medical care, and MinnesotaCare as their primary source of coverage, or; or

 

(3) for dental service providers, at least ten percent of the provider's patients are covered by medical assistance, general assistance medical care, and MinnesotaCare as their primary source of coverage, or the provider accepts new medical assistance and MinnesotaCare patients who are children with special health care needs. For purposes of this section, "children with special health care needs" means children up to age 18 who: (i) require health and related services beyond that required by children generally; and (ii) have or are at risk for a chronic physical, developmental, behavioral, or emotional condition, including: bleeding and coagulation disorders; immunodeficiency disorders; cancer; endocrinopathy; developmental disabilities; epilepsy, cerebral palsy, and other neurological diseases; visual impairment or deafness; Down syndrome and other genetic disorders; autism; fetal alcohol syndrome; and other conditions designated by the commissioner after consultation with representatives of pediatric dental providers and consumers.

 

(c) Patients seen on a volunteer basis by the provider at a location other than the provider's usual place of practice may be considered in meeting this the participation requirement in this section. The commissioner shall establish participation requirements for health maintenance organizations. The commissioner shall provide lists of participating medical assistance providers on a quarterly basis to the commissioner of employee relations, the commissioner of labor and industry, and the commissioner of commerce. Each of the commissioners shall develop and implement procedures to exclude as participating providers in the program or programs under their jurisdiction those providers who do not participate in the medical assistance program. The commissioner of employee relations shall implement this section through contracts with participating health and dental carriers.

 

Sec. 17. [256B.0751] CARE COORDINATION FOR CHILDREN WITH HIGH-COST MEDICAL CONDITIONS.

 

Subdivision 1. Care coordination required. (a) The commissioner of human services shall contract with the U special kids program to provide care coordination, beginning October 1, 2007, for medical assistance enrollees who are children with high-cost medical conditions, and to perform the other duties specified in this section.

 

(b) For purposes of this section, "care coordination" means collaboration with primary care physicians and specialists to manage care, development of medical management plans for recurrent acute illnesses, oversight and coordination of all aspects of care in partnership with families, organization of medical information into a summary of critical information, coordination and appropriate sequencing of tests and multiple appointments, information and assistance with accessing resources, and telephone triage for acute illnesses or problems.

 

Subd. 2. Referrals. The commissioner shall develop a mechanism to refer children to the U special kids program for care coordination. Beginning October 1, 2007, and subject to the limits on total program enrollment specified in subdivision 3, the commissioner shall refer to the U special kids program children who:


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(1) incur medical expenses that exceed the qualifying level specified in subdivision 3;

 

(2) have medical conditions that involve four or more major systems; require multiple specialists; require use of technology such as G-tube, trach, central line, or oxygen; and require multiple medications;

 

(3) do not have a medical case manager for cancer, organ transplantation, epilepsy, or bone marrow replacement; and

 

(4) voluntarily agree to participate in the program.

 

Subd. 3. Qualifying level of medical expenses. (a) For the period October 1, 2007, through September 30, 2008, the commissioner shall refer children for care coordination under this section if they incurred medical expenses of $500,000 or more during the fiscal year ending June 30, 2007.

 

(b) For the period October 1, 2008, through September 30, 2009, the commissioner shall refer children for care coordination under this section if they incurred medical expenses of $400,000 or more during the fiscal year ending June 30, 2008.

 

(c) For the period October 1, 2009, through September 30, 2010, the commissioner shall refer children for care coordination under this section if they incurred medical expenses of $300,000 or more during the fiscal year ending June 30, 2009.

 

(d) Beginning October 1, 2010, the commissioner shall refer children for care coordination under this section if they incurred medical expenses of $250,000 or more during the previous fiscal year.

 

(e) The commissioner shall limit referrals to the extent necessary to ensure that total enrollment in the U special kids program does not exceed 100 children for the period October 1, 2007, through September 30, 2008, and does not exceed 150 children beginning October 1, 2008.

 

Subd. 4. Case management. Beginning October 1, 2007, the U special kids program shall coordinate all nonmedical case management services provided to children who are required to receive care coordination under this section. The program may require all nonmedical case managers, including, but not limited to, county case managers and case managers for children served under a home and community-based waiver, to submit care plans for approval, and to document client compliance with the care plans. The U special kids program, beginning October 1, 2008, may employ or contract with nonmedical case managers to provide all nonmedical case management services to children required to receive care coordination under this section. The commissioner shall reimburse the U special kids program for case management services through the medical assistance program.

 

Subd. 5. Statewide availability of care coordination. The U special kids program may contract with other entities to provide care coordination services as defined in subdivision 1, in order to ensure the availability of these services in all regions of the state.

 

Subd. 6. Advance practice nurse telephone triage system. The U special kids program shall establish and operate an advance practice nurse telephone triage system that is available statewide, 24 hours a day, seven days per week. The system must provide advance practice nurses with access to a Web-based information system to appropriately triage medical problems, manage care, and reduce unnecessary hospitalizations.

 

Subd. 7. Monitoring and evaluation. The commissioner shall monitor program outcomes and evaluate the extent to which referrals to the U special kids program have improved the quality and coordination of care and provided financial savings to the medical assistance program. The U special kids program shall submit to the commissioner, in the form and manner specified by the commissioner, all data and information necessary to monitor program outcomes and evaluate the program. The commissioner shall present a preliminary evaluation to the legislature by January 15, 2008, and a final evaluation to the legislature by January 15, 2010.


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EFFECTIVE DATE. This section is effective October 1, 2007, or upon federal approval, whichever is later.

 

Sec. 18. [256B.0752] CARE COORDINATION FOR CHILDREN WITH HIGH-COST MENTAL HEALTH CONDITIONS.

 

Subdivision 1. Care coordination required. (a) The commissioner of human services shall contract with the U special kids program to provide care coordination, beginning October 1, 2007, for medical assistance enrollees who are children with high-cost mental health conditions and behavioral problems, and to perform the other duties specified in this section.

 

(b) For purposes of this section, "care coordination" means: collaboration with primary care physicians and specialists to manage care; development of mental health management plans for recurrent mental health issues; oversight and coordination of all aspects of care in partnership with families; organization of medical, treatment, and therapy information into a summary of critical information; coordination and appropriate sequencing of evaluations and multiple appointments; information and assistance with accessing resources; and telephone triage for behavior or other problems.

 

Subd. 2. Referrals. The commissioner shall develop a mechanism to refer children to the program for care coordination. Beginning October 1, 2007, and subject to the limits on total program enrollment specified in subdivision 3, the commissioner shall refer to the U special kids program children who:

 

(1) incur mental health expenses that exceed the qualifying level specified in subdivision 3;

 

(2) are currently receiving or at risk of needing inpatient mental health treatment, foster home care, or both; and

 

(3) voluntarily agree to participate in the program.

 

Subd. 3. Qualifying level of medical expenses. (a) Beginning October 1, 2007, the commissioner shall refer children for care coordination under this section if they incurred medical and mental health expenses of $250,000 or more in the previous fiscal year.

 

(b) The commissioner shall limit referrals to the extent necessary to ensure that total enrollment in the U special kids program does not exceed 25 children for the period October 1, 2007, through September 30, 2008; does not exceed 75 children for the period October 1, 2008, through September 30, 2009; and does not exceed 125 children beginning October 1, 2009.

 

Subd. 4. Case management. The U special kids program, beginning October 1, 2007, shall coordinate all nonmedical case management services provided to children who are required to receive care coordination under this section. The program may require all nonmedical case managers, including but not limited to county case managers and case managers for children served under a home and community-based waiver, to submit care plans for approval, and to document client compliance with the care plans. The U special kids program, beginning October 1, 2008, may employ or contract with nonmedical case managers to provide all nonmedical case management services to children required to receive care coordination under this section. The commissioner shall reimburse the U special kids program for case management services through the medical assistance program.

 

Subd. 5. Statewide availability of care coordination. The program may contract with other entities to provide care coordination services as defined in subdivision 1, in order to ensure the availability of these services in all regions of the state.

 

Subd. 6. Monitoring and evaluation. The commissioner shall monitor program outcomes and shall evaluate the extent to which referrals to the U special kids program have improved the quality and coordination of care and provided financial savings to the medical assistance program. The U special kids program shall submit to the commissioner, in the form and manner specified by the commissioner, all data and information necessary to monitor program outcomes and evaluate the program. The commissioner shall present a preliminary evaluation to the legislature by January 15, 2008, and a final evaluation to the legislature by January 15, 2010.


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EFFECTIVE DATE. This section is effective October 1, 2007, or upon federal approval, whichever is later. The commissioner shall notify the Office of the Revisor of Statutes when federal approval is obtained.

 

Sec. 19. [256B.194] FEDERAL PAYMENTS.

 

Subdivision 1. Payments at actual cost. If the Centers for Medicare & Medicaid Services (CMS) promulgates a final rule consistent with its stated intent in the proposed rule published at 72 Federal Register, No. 11, January 18, 2007, regarding limiting payments to units of government, and notwithstanding Minnesota Statutes or Minnesota Rules to the contrary, for providers that are units of government, the commissioner may limit medical assistance and MinnesotaCare payments to a provider's actual cost of providing services, in accordance with the CMS final rule. If a final rule is promulgated, the commissioner may also require medical assistance and MinnesotaCare providers to provide any information necessary to determine Medicaid-related costs, and require the cooperation of providers in any audit or review necessary to ensure payments are limited to cost. This section does not apply to providers who are exempt from the provisions of the CMS final rule.

 

Subd. 2. Loss of federal financial participation. For all transfers, certified expenditures, and medical assistance payments listed below, if the commissioner determines that federal financial participation is no longer available for the medical assistance payments listed, then related obligations for the nonfederal share of payments and the medical assistance payments shall terminate. The commissioner shall notify all affected parties of the loss of federal financial participation, and the resulting payments and obligations that are terminated. If the commissioner determines that federal financial participation is no longer available for any medical assistance payments or contributions to the nonfederal share of medical assistance payments that have already been made, the commissioner may collect the medical assistance payments from providers and return contributions of the nonfederal share to its source. The transfers, certified expenditures, and medical assistance payments subject to this section are those specified in: sections 62J.692, subdivision 7, paragraphs (b) and (c); 256B.19, subdivisions 1c and 1d; 256B.195; 256B.431, subdivision 23; and 256B.69, subdivision 5c, paragraph (a), clauses (2), (3), and (4); Laws 2002, chapter 220, article 17, section 2, subdivision 3; and Laws 2005, First Special Session chapter 4, article 9, section 2, subdivision 1.

 

Sec. 20. Minnesota Statutes 2006, section 256B.199, is amended to read:

 

256B.199 PAYMENTS REPORTED BY GOVERNMENTAL ENTITIES.

 

(a) Hennepin County, and Hennepin County Medical Center, Ramsey County, Regions Hospital, the University of Minnesota, and Fairview-University Medical Center shall report quarterly to the commissioner beginning June 1, 2007, payments made during the second previous quarter that may qualify for reimbursement under federal law.

 

(b) Based on these reports, the commissioner shall apply for federal matching funds. These funds are appropriated to the commissioner for the payments under section 256.969, subdivision 27 to Hennepin County Medical Center.

 

(c) By May 1 of each year, beginning May 1, 2007, the commissioner shall inform the nonstate entities listed in paragraph (a) of the amount of federal disproportionate share hospital payment money expected to be available in the current federal fiscal year.

 

(d) This section sunsets on June 30, 2009. The commissioner shall report to the legislature by December 15, 2008, with recommendations for maximizing federal disproportionate share hospital payments after June 30, 2009.


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Sec. 21. Minnesota Statutes 2006, 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 (10), shall be paid on a cost-based payment system that is based on the cost-finding methods and allowable costs of the Medicare program. All hospital outpatient services provided by any hospital exclusively devoted to the care of pediatric patients under age 21 that is located in a Minnesota metropolitan statistical area must be paid for using the methodology established for critical access hospitals at a rate equal to fee-for-service rates plus 46 percent, as limited by allowable costs.

 

(c) Effective for services provided on or after July 1, 2003, 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 commissioner shall provide a proposal to the 2003 legislature to define and implement this provision.

 

(d) For fee-for-service services provided on or after July 1, 2002, the total payment, before third-party liability and spenddown, made to hospitals for outpatient hospital facility services is reduced by .5 percent from the current statutory rate.

 

(e) In addition to the reduction in paragraph (d), the total payment for fee-for-service services provided on or after July 1, 2003, made to hospitals for outpatient hospital facility services before third-party liability and spenddown, is reduced five percent from the current statutory rates. Facilities defined under section 256.969, subdivision 16, are excluded from this paragraph.

 

EFFECTIVE DATE. This section is effective July 1, 2007, and applies to services provided on or after that date.

 

Sec. 22. Minnesota Statutes 2006, section 256B.76, is amended to read:

 

256B.76 PHYSICIAN AND DENTAL REIMBURSEMENT.

 

(a) Effective for services rendered on or after October 1, 1992, the commissioner shall make payments for physician services as follows:

 

(1) payment for level one Centers for Medicare and Medicaid Services' common procedural coding system codes titled "office and other outpatient services," "preventive medicine new and established patient," "delivery, antepartum, and postpartum care," "critical care," cesarean delivery and pharmacologic management provided to


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psychiatric patients, and level three codes for enhanced services for prenatal high risk, shall be paid at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June 30, 1992. If the rate on any procedure code within these categories is different than the rate that would have been paid under the methodology in section 256B.74, subdivision 2, then the larger rate shall be paid;

 

(2) payments for all other services shall be paid at the lower of (i) submitted charges, or (ii) 15.4 percent above the rate in effect on June 30, 1992;

 

(3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th percentile of 1989, less the percent in aggregate necessary to equal the above increases except that payment rates for home health agency services shall be the rates in effect on September 30, 1992;

 

(4) effective for services rendered on or after January 1, 2000, payment rates for physician and professional services shall be increased by three percent over the rates in effect on December 31, 1999, except for home health agency and family planning agency services; and

 

(5) the increases in clause (4) shall be implemented January 1, 2000, for managed care.

 

(b) Effective for services rendered on or after October 1, 1992, the commissioner shall make payments for dental services as follows:

 

(1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June 30, 1992;

 

(2) dental rates shall be converted from the 50th percentile of 1982 to the 50th percentile of 1989, less the percent in aggregate necessary to equal the above increases;

 

(3) effective for services rendered on or after January 1, 2000, payment rates for dental services shall be increased by three percent over the rates in effect on December 31, 1999;

 

(4) the commissioner shall award grants to community clinics or other nonprofit community organizations, political subdivisions, professional associations, or other organizations that demonstrate the ability to provide dental services effectively to public program recipients. Grants may be used to fund the costs related to coordinating access for recipients, developing and implementing patient care criteria, upgrading or establishing new facilities, acquiring furnishings or equipment, recruiting new providers, or other development costs that will improve access to dental care in a region. In awarding grants, the commissioner shall give priority to applicants that plan to serve areas of the state in which the number of dental providers is not currently sufficient to meet the needs of recipients of public programs or uninsured individuals. The commissioner shall consider the following in awarding the grants:

 

(i) potential to successfully increase access to an underserved population;

 

(ii) the ability to raise matching funds;

 

(iii) the long-term viability of the project to improve access beyond the period of initial funding;

 

(iv) the efficiency in the use of the funding; and

 

(v) the experience of the proposers in providing services to the target population.

 

The commissioner shall monitor the grants and may terminate a grant if the grantee does not increase dental access for public program recipients. The commissioner shall consider grants for the following:


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(i) implementation of new programs or continued expansion of current access programs that have demonstrated success in providing dental services in underserved areas;

 

(ii) a pilot program for utilizing hygienists outside of a traditional dental office to provide dental hygiene services; and

 

(iii) a program that organizes a network of volunteer dentists, establishes a system to refer eligible individuals to volunteer dentists, and through that network provides donated dental care services to public program recipients or uninsured individuals;

 

(5) beginning October 1, 1999, the payment for tooth sealants and fluoride treatments shall be the lower of (i) submitted charge, or (ii) 80 percent of median 1997 charges;

 

(6) the increases listed in clauses (3) and (5) shall be implemented January 1, 2000, for managed care; and

 

(7) effective for services provided on or after January 1, 2002, payment for diagnostic examinations and dental x-rays provided to children under age 21 shall be the lower of (i) the submitted charge, or (ii) 85 percent of median 1999 charges.

 

(c) Effective for dental services rendered on or after January 1, 2002, the commissioner may, within the limits of available appropriation, 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 For dental services rendered after June 30, 2007, the commissioner shall increase reimbursement by 33 percent above the reimbursement rate that would otherwise be paid to the provider. The commissioner shall pay the health plan companies shall be adjusted in amounts sufficient 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.

 

The commissioner shall annually establish a reimbursement schedule for critical access dental providers and provider-specific limits on total reimbursement received under the reimbursement schedule, and shall notify each critical access dental provider of the schedule and limit.

 

(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


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calendar year are medical assistance recipients, shall be reimbursed by the commissioner for rehabilitation services at rates that are 38 percent greater than the maximum reimbursement rate allowed under paragraph (a), clause (2), when those services are (1) provided within the comprehensive outpatient rehabilitation facility and (2) provided to residents of nursing facilities owned by the entity.

 

(e) Effective for services rendered on or after January 1, 2007, the commissioner shall make payments for physician and professional services based on the Medicare relative value units (RVU's). This change shall be budget neutral and the cost of implementing RVU's will be incorporated in the established conversion factor.

 

Sec. 23. Minnesota Statutes 2006, section 256D.03, subdivision 4, is amended to read:

 

Subd. 4. General assistance medical care; services. (a)(i) For a person who is eligible under subdivision 3, paragraph (a), clause (2), item (i), general assistance medical care covers, except as provided in paragraph (c):

 

(1) inpatient hospital services;

 

(2) outpatient hospital services;

 

(3) services provided by Medicare certified rehabilitation agencies;

 

(4) prescription drugs and other products recommended through the process established in section 256B.0625, subdivision 13;

 

(5) equipment necessary to administer insulin and diagnostic supplies and equipment for diabetics to monitor blood sugar level;

 

(6) eyeglasses and eye examinations provided by a physician or optometrist;

 

(7) hearing aids;

 

(8) prosthetic devices;

 

(9) laboratory and X-ray services;

 

(10) physician's services;

 

(11) medical transportation except special transportation;

 

(12) chiropractic services as covered under the medical assistance program;

 

(13) podiatric services;

 

(14) dental services as covered under the medical assistance program;

 

(15) outpatient services provided by a mental health center or clinic that is under contract with the county board and is established under section 245.62;

 

(16) day treatment services for mental illness provided under contract with the county board;

 

(17) prescribed medications for persons who have been diagnosed as mentally ill as necessary to prevent more restrictive institutionalization;


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(18) psychological services, medical supplies and equipment, and Medicare premiums, coinsurance and deductible payments;

 

(19) medical equipment not specifically listed in this paragraph when the use of the equipment will prevent the need for costlier services that are reimbursable under this subdivision;

 

(20) services performed by a certified pediatric nurse practitioner, a certified family nurse practitioner, a certified adult nurse practitioner, a certified obstetric/gynecological nurse practitioner, a certified neonatal nurse practitioner, or a certified geriatric nurse practitioner in independent practice, if (1) the service is otherwise covered under this chapter as a physician service, (2) the service provided on an inpatient basis is not included as part of the cost for inpatient services included in the operating payment rate, and (3) the service is within the scope of practice of the nurse practitioner's license as a registered nurse, as defined in section 148.171;

 

(21) services of a certified public health nurse or a registered nurse practicing in a public health nursing clinic that is a department of, or that operates under the direct authority of, a unit of government, if the service is within the scope of practice of the public health nurse's license as a registered nurse, as defined in section 148.171;

 

(22) telemedicine consultations, to the extent they are covered under section 256B.0625, subdivision 3b; and

 

(23) mental health telemedicine and psychiatric consultation as covered under section 256B.0625, subdivisions 46 and 48.;

 

(24) care coordination and patient education services provided by a community health worker according to section 256B.0625, subdivision 49; and

 

(25) regardless of the number of employees that an enrolled health care provider may have, sign language interpreter services when provided by an enrolled health care provider during the course of providing a direct, person-to-person covered health care service to an enrolled recipient who has a hearing loss and uses interpreting services.

 

(ii) Effective October 1, 2003, for a person who is eligible under subdivision 3, paragraph (a), clause (2), item (ii), general assistance medical care coverage is limited to inpatient hospital services, including physician services provided during the inpatient hospital stay. A $1,000 deductible is required for each inpatient hospitalization.

 

(b) Effective August 1, 2005, sex reassignment surgery is not covered under this subdivision.

 

(c) In order to contain costs, the commissioner of human services shall select vendors of medical care who can provide the most economical care consistent with high medical standards and shall where possible contract with organizations on a prepaid capitation basis to provide these services. The commissioner shall consider proposals by counties and vendors for prepaid health plans, competitive bidding programs, block grants, or other vendor payment mechanisms designed to provide services in an economical manner or to control utilization, with safeguards to ensure that necessary services are provided. Before implementing prepaid programs in counties with a county operated or affiliated public teaching hospital or a hospital or clinic operated by the University of Minnesota, the commissioner shall consider the risks the prepaid program creates for the hospital and allow the county or hospital the opportunity to participate in the program in a manner that reflects the risk of adverse selection and the nature of the patients served by the hospital, provided the terms of participation in the program are competitive with the terms of other participants considering the nature of the population served. Payment for services provided pursuant to this subdivision shall be as provided to medical assistance vendors of these services under sections 256B.02, subdivision 8, and 256B.0625. For payments made during fiscal year 1990 and later years, the commissioner shall consult with an independent actuary in establishing prepayment rates, but shall retain final control over the rate methodology.


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(d) Effective January 1, 2008, drug coverage under general assistance medical care is limited to prescription drugs that:

 

(i) are covered under the medical assistance program as described in section 256B.0625, subdivisions 13 and 13d; and

 

(ii) are provided by manufacturers that have fully executed general assistance medical care rebate agreements with the commissioner and comply with the agreements. Prescription drug coverage under general assistance medical care must conform to coverage under the medical assistance program according to section 256B.0625, subdivisions 13 to 13g.

 

(d) (e) Recipients eligible under subdivision 3, paragraph (a), shall pay the following co-payments for services provided on or after October 1, 2003:

 

(1) $25 for eyeglasses;

 

(2) $25 for nonemergency visits to a hospital-based emergency room;

 

(3) $3 per brand-name drug prescription and $1 per generic drug prescription, subject to a $12 per month maximum for prescription drug co-payments. No co-payments shall apply to antipsychotic drugs when used for the treatment of mental illness; and

 

(4) 50 percent coinsurance on restorative dental services.

 

(e) (f) Co-payments shall be limited to one per day per provider for nonpreventive visits, eyeglasses, and nonemergency visits to a hospital-based emergency room. Recipients of general assistance medical care are responsible for all co-payments in this subdivision. The general assistance medical care reimbursement to the provider shall be reduced by the amount of the co-payment, except that reimbursement for prescription drugs shall not be reduced once a recipient has reached the $12 per month maximum for prescription drug co-payments. The provider collects the co-payment from the recipient. Providers may not deny services to recipients who are unable to pay the co-payment, except as provided in paragraph (f).

 

(f) (g) If it is the routine business practice of a provider to refuse service to an individual with uncollected debt, the provider may include uncollected co-payments under this section. A provider must give advance notice to a recipient with uncollected debt before services can be denied.

 

(g) (h) Any county may, from its own resources, provide medical payments for which state payments are not made.

 

(h) (i) Chemical dependency services that are reimbursed under chapter 254B must not be reimbursed under general assistance medical care.

 

(i) (j) The maximum payment for new vendors enrolled in the general assistance medical care program after the base year shall be determined from the average usual and customary charge of the same vendor type enrolled in the base year.

 

(j) (k) 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.


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(k) (l) Inpatient and outpatient payments shall be reduced by five percent, effective July 1, 2003. This reduction is in addition to the five percent reduction effective July 1, 2003, and incorporated by reference in paragraph (i).

 

(l) (m) Payments for all other health services except inpatient, outpatient, and pharmacy services shall be reduced by five percent, effective July 1, 2003.

 

(m) (n) Payments to managed care plans shall be reduced by five percent for services provided on or after October 1, 2003.

 

(n) (o) A hospital receiving a reduced payment as a result of this section may apply the unpaid balance toward satisfaction of the hospital's bad debts.

 

(o) (p) Fee-for-service payments for nonpreventive visits shall be reduced by $3 for services provided on or after January 1, 2006. For purposes of this subdivision, a visit means an episode of service which is required because of a recipient's symptoms, diagnosis, or established illness, and which is delivered in an ambulatory setting by a physician or physician ancillary, chiropractor, podiatrist, advance practice nurse, audiologist, optician, or optometrist.

 

(p) (q) Payments to managed care plans shall not be increased as a result of the removal of the $3 nonpreventive visit co-payment effective January 1, 2006.

 

Sec. 24. Minnesota Statutes 2006, section 256L.03, subdivision 5, is amended to read:

 

Subd. 5. Co-payments and coinsurance. (a) Except as provided in paragraphs (b) and (c), the MinnesotaCare benefit plan shall include the following co-payments and coinsurance requirements for all enrollees:

 

(1) ten percent of the paid charges for inpatient hospital services for adult enrollees, subject to an annual inpatient out-of-pocket maximum of $1,000 per individual and $3,000 per family;

 

(2) $3 per prescription for adult enrollees;

 

(3) $25 for eyeglasses for adult enrollees;

 

(4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an episode of service which is required because of a recipient's symptoms, diagnosis, or established illness, and which is delivered in an ambulatory setting by a physician or physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse, audiologist, optician, or optometrist; and

 

(5) $6 for nonemergency visits to a hospital-based emergency room.

 

(b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of children under the age of 21 in households with family income equal to or less than 175 percent of the federal poverty guidelines. Paragraph (a), clause (1), does not apply to parents and relative caretakers of children under the age of 21 in households with family income greater than 175 percent of the federal poverty guidelines for inpatient hospital admissions occurring on or after January 1, 2001.

 

(c) Paragraph (a), clauses (1) to (4), do does not apply to pregnant women and children under the age of 21.

 

(d) Adult enrollees with family gross income that exceeds 175 percent of the federal poverty guidelines and who are not pregnant shall be financially responsible for the coinsurance amount, if applicable, and amounts which exceed the $10,000 inpatient hospital benefit limit.


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(e) When a MinnesotaCare enrollee becomes a member of a prepaid health plan, or changes from one prepaid health plan to another during a calendar year, any charges submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket expenses incurred by the enrollee for inpatient services, that were submitted or incurred prior to enrollment, or prior to the change in health plans, shall be disregarded.

 

Sec. 25. Minnesota Statutes 2006, section 256L.04, subdivision 1, is amended to read:

 

Subdivision 1. Families with children. (a) Families with children with family income equal to or less than 275 percent of the federal poverty guidelines for the applicable family size shall be eligible for MinnesotaCare according to this section. All other provisions of sections 256L.01 to 256L.18, including the insurance-related barriers to enrollment under section 256L.07, shall apply unless otherwise specified.

 

(b) Parents who enroll in the MinnesotaCare program must also enroll their children, if the children are eligible. Children may be enrolled separately without enrollment by parents. However, if one parent in the household enrolls, both parents must enroll, unless other insurance is available. If one child from a family is enrolled, all children must be enrolled, unless other insurance is available. If one spouse in a household enrolls, the other spouse in the household must also enroll, unless other insurance is available. Families cannot choose to enroll only certain uninsured members.

 

(c) Beginning October 1, 2003, the dependent sibling definition no longer applies to the MinnesotaCare program. These persons are no longer counted in the parental household and may apply as a separate household.

 

(d) Beginning July 1, 2003, or upon federal approval, whichever is later, parents are not eligible for MinnesotaCare if their gross income exceeds $50,000 $25,000 for the six-month period of eligibility.

 

Sec. 26. Minnesota Statutes 2006, section 256L.04, subdivision 12, is amended to read:

 

Subd. 12. Persons in detention. Beginning January 1, 1999, an applicant residing in a correctional or detention facility is not eligible for MinnesotaCare. An enrollee residing in a correctional or detention facility is not eligible at renewal of eligibility under section 256L.05, subdivision 3b 3a.

 

Sec. 27. Minnesota Statutes 2006, section 256L.11, subdivision 7, is amended to read:

 

Subd. 7. Critical access dental providers. Effective for dental services provided to MinnesotaCare enrollees on or after between January 1, 2007, and June 30, 2007, the commissioner shall increase payment rates to dentists and dental clinics deemed by the commissioner to be critical access providers under section 256B.76, paragraph (c), by 50 percent above the payment rate that would otherwise be paid to the provider. Effective for dental services provided to MinnesotaCare enrollees on or after July 1, 2007, the commissioner shall increase payment rates to dentists and dental clinics deemed by the commissioner to be critical access providers under section 256B.76, paragraph (c), by 33 percent above the payment rate that would otherwise be paid to the provider. The commissioner shall adjust the rates paid on or after January 1, 2007, to pay the prepaid health plans under contract with the commissioner amounts sufficient to reflect this rate increase. The prepaid health plan must pass this rate increase to providers who have been identified by the commissioner as critical access dental providers under section 256B.76, paragraph (c).

 

Sec. 28. HENNEPIN COUNTY PILOT PROJECT.

 

The commissioner of human services shall support a pilot project in Hennepin County to demonstrate the effectiveness of alternative strategies to redetermine eligibility for certain recipient populations in the medical assistance program. The target populations for the demonstration are persons who are eligible based upon disability or age, who have chronic medical conditions, and who are expected to experience minimal change in income or


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assets from month to month. The commissioner and the county shall analyze the issues and strategies employed and the outcomes to determine reasonable efforts to streamline eligibility statewide. The duration of the pilot project shall be no more than two years. The commissioner shall apply for any federal waivers needed to implement this section.

 

Sec. 29. COUNTY-BASED PURCHASING STUDY.

 

The commissioner of health shall study county-based purchasing initiatives established under Minnesota Statutes, section 256B.692, and compare these initiatives to managed care plans serving medical assistance, general assistance medical care, and MinnesotaCare enrollees. The study must:

 

(1) provide a history and description of county-based purchasing initiatives, including state and federal requirements and any federal waivers Minnesota counties have applied for or received;

 

(2) provide a history and description of managed care plan participation in the prepaid medical assistance, prepaid general assistance medical care, and prepaid Minnesota programs, and the provision by managed care plans of third-party administrator services for county-based purchasing initiatives;

 

(3) provide relevant data, including limitations on data, data that was requested but not received, and explanations for why requested data was not received;

 

(4) provide recommendations for further data collection and research;

 

(5) summarize successes and challenges of the two service delivery methods;

 

(6) provide recommendations for possible expansion of county-based purchasing in rural and urban settings; and

 

(7) identify and describe features of county-based purchasing and managed care plans serving medical assistance, general assistance medical care, and MinnesotaCare enrollees, to provide a comparison of cost, quality, access, and community health improvement that includes, but is not limited to:

 

(i) descriptions of how health care and social services are integrated and coordinated for persons with complex care needs, including persons with high-risk pregnancies, adolescents, persons who are disabled, persons who are elderly, and persons with chronic health care and social needs;

 

(ii) use of monetary grants and surpluses to:

 

(A) increase provider reimbursement, including dental care reimbursement, in order to improve health care access; and

 

(B) improve community health beyond the requirements of the public health care programs, such as the funding of public education, research, and community initiatives to enhance utilization of preventive services, social services, or mental health care;

 

(iii) administrative costs, including billing and collection of unpaid fees, co-pays or other charges, and top five management salaries;

 

(iv) reporting requirements of contracts with the Department of Human Services;


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(v) public access to all information about management and administration, including but not limited to provider contracts and reimbursement, models of care management and coordination, utilization review, contracts with consultants and other vendors, handling of monetary grants and surpluses, and health outcomes data;

 

(vi) provider reimbursement by clinical practice area;

 

(vii) populations served, described by age, disability, income, race, language, occupation, and other demographic characteristics;

 

(viii) utilization of community-based prevention interventions, including but not limited to public health nursing visits to new parents, use of nurse-managed interventions to reduce cardiac hospitalizations, and the use of medical homes for chronic disease management;

 

(ix) utilization of cancer screening;

 

(x) utilization of interpreter services;

 

(xi) immunization rates for children age five and under;

 

(xii) hospitalization rates for conditions related to diabetes, asthma, or cardiac illnesses;

 

(xiii) rates of rehospitalization within a month of hospital discharge;

 

(xiv) coordination with county agencies to increase enrollment;

 

(xv) number of new program enrollees and the rate of enrollment, including the percentage of eligible persons who become enrollees;

 

(xvi) enrollee satisfaction with their care; and

 

(xvii) number of enrollees who do not receive care.

 

Managed care plans, county-based purchasing initiatives, health care providers, counties, and the commissioner of human services shall, upon request, provide data to the commissioner of health that is necessary to complete the study. The commissioner of health shall submit the study to the legislature by December 31, 2007.

 

Sec. 30. GRANT FOR TOLL-FREE HEALTH CARE ACCESS NUMBER.

 

The commissioner of human services shall award a grant to the Neighborhood Health Care Network to pay the costs of maintaining and staffing a toll-free telephone number to provide callers with information on health coverage options, eligibility for MinnesotaCare and other health care programs, and health care providers that offer free or reduced-cost health care services.

 

Sec. 31. IMPLEMENTATION OF PHARMACY DISPENSING FEE INCREASE.

 

The commissioner, after consulting with the Pharmacy Payment Reform Advisory Committee established under Laws 2006, chapter 282, article 16, section 15, may proportionally increase or decrease the dispensing fee for multiple-source generic drugs under Minnesota Statutes, section 256B.0625, subdivision 13e, paragraph (a), to reflect the actual amount of reductions in program cost for ingredient reimbursement savings obtained.


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EFFECTIVE DATE. This section is effective upon implementation of changes to the federal upper reimbursement limit under title VI, chapter IV of the federal Deficit Reduction Act of 2005, United States Code, title 42, section 1396r-8(e)(5).

 

Sec. 32. REPEALER.

 

Minnesota Statutes 2006, section 256.969, subdivision 27, is repealed effective July 1, 2007.

 

ARTICLE 4

 

CONTINUING CARE

 

Section 1. Minnesota Statutes 2006, section 144A.071, subdivision 4c, is amended to read:

 

Subd. 4c. Exceptions for replacement beds after June 30, 2003. (a) The commissioner of health, in coordination with the commissioner of human services, may approve the renovation, replacement, upgrading, or relocation of a nursing home or boarding care home, under the following conditions:

 

(1) to license and certify an 80-bed city-owned facility in Nicollet County to be constructed on the site of a new city-owned hospital to replace an existing 85-bed facility attached to a hospital that is also being replaced. The threshold allowed for this project under section 144A.073 shall be the maximum amount available to pay the additional medical assistance costs of the new facility;

 

(2) to license and certify 29 beds to be added to an existing 69-bed facility in St. Louis County, provided that the 29 beds must be transferred from active or layaway status at an existing facility in St. Louis County that had 235 beds on April 1, 2003.

 

The licensed capacity at the 235-bed facility must be reduced to 206 beds, but the payment rate at that facility shall not be adjusted as a result of this transfer. The operating payment rate of the facility adding beds after completion of this project shall be the same as it was on the day prior to the day the beds are licensed and certified. This project shall not proceed unless it is approved and financed under the provisions of section 144A.073;

 

(3) to license and certify a new 60-bed facility in Austin, provided that: (i) 45 of the new beds are transferred from a 45-bed facility in Austin under common ownership that is closed and 15 of the new beds are transferred from a 182-bed facility in Albert Lea under common ownership; (ii) the commissioner of human services is authorized by the 2004 legislature to negotiate budget-neutral planned nursing facility closures; and (iii) money is available from planned closures of facilities under common ownership to make implementation of this clause budget-neutral to the state. The bed capacity of the Albert Lea facility shall be reduced to 167 beds following the transfer. Of the 60 beds at the new facility, 20 beds shall be used for a special care unit for persons with Alzheimer's disease or related dementias; and

 

(4) to license and certify up to 80 beds transferred from an existing state-owned nursing facility in Cass County to a new facility located on the grounds of the Ah-Gwah-Ching campus. The operating cost payment rates for the new facility shall be determined based on the interim and settle-up payment provisions of Minnesota Rules, part 9549.0057, and the reimbursement provisions of section 256B.431. The property payment rate for the first three years of operation shall be $35 per day. For subsequent years, the property payment rate of $35 per day shall be adjusted for inflation as provided in section 256B.434, subdivision 4, paragraph (c), as long as the facility has a contract under section 256B.434.; and

 

(5) to license and certify 180 beds transferred from an existing facility in Minneapolis to a new facility in Robbinsdale; provided that the beds are transferred from a 219-bed facility under common ownership that shall be closed following the transfer. The operating payment rate of the new facility after completion of this project shall be adjusted upward by $35 per day and the property payment rate shall be $34.049 per day.


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(b) Projects approved under this subdivision shall be treated in a manner equivalent to projects approved under subdivision 4a.

 

EFFECTIVE DATE. This section is effective the day following final enactment.

 

Sec. 2. Minnesota Statutes 2006, section 252.27, subdivision 2a, is amended to read:

 

Subd. 2a. Contribution amount. (a) The natural or adoptive parents of a minor child, including a child determined eligible for medical assistance without consideration of parental income, must contribute to the cost of services used by making monthly payments on a sliding scale based on income, unless the child is married or has been married, parental rights have been terminated, or the child's adoption is subsidized according to section 259.67 or through title IV-E of the Social Security Act. The parental contribution is a partial or full payment for medical services provided for diagnostic, therapeutic, curing, treating, mitigating, rehabilitation, and maintenance and personal care services as defined in United States Code, title 26, section 213, needed by the child with a chronic illness or disability.

 

(b) For households with adjusted gross income equal to or greater than 100 percent of federal poverty guidelines, the parental contribution shall be computed by applying the following schedule of rates to the adjusted gross income of the natural or adoptive parents:

 

(1) if the adjusted gross income is equal to or greater than 100 percent of federal poverty guidelines and less than 175 percent of federal poverty guidelines, the parental contribution is $4 per month;

 

(2) if the adjusted gross income is equal to or greater than 175 percent of federal poverty guidelines and less than or equal to 545 percent of federal poverty guidelines, the parental contribution shall be determined using a sliding fee scale established by the commissioner of human services which begins at one percent of adjusted gross income at 175 percent of federal poverty guidelines and increases to 7.5 percent of adjusted gross income for those with adjusted gross income up to 545 percent of federal poverty guidelines;

 

(3) if the adjusted gross income is greater than 545 percent of federal poverty guidelines and less than 675 percent of federal poverty guidelines, the parental contribution shall be 7.5 percent of adjusted gross income;

 

(4) if the adjusted gross income is equal to or greater than 675 percent of federal poverty guidelines and less than 975 percent of federal poverty guidelines, the parental contribution shall be determined using a sliding fee scale established by the commissioner of human services which begins at 7.5 percent of adjusted gross income at 675 percent of federal poverty guidelines and increases to ten percent of adjusted gross income for those with adjusted gross income up to 975 percent of federal poverty guidelines; and

 

(5) if the adjusted gross income is equal to or greater than 975 percent of federal poverty guidelines, the parental contribution shall be 12.5 percent of adjusted gross income.

 

If the child lives with the parent, the annual adjusted gross income parental contribution is reduced by $2,400 prior to calculating the parental contribution $100 per month. If the child resides in an institution specified in section 256B.35, the parent is responsible for the personal needs allowance specified under that section in addition to the parental contribution determined under this section. The parental contribution is reduced by any amount required to be paid directly to the child pursuant to a court order, but only if actually paid.

 

(c) The household size to be used in determining the amount of contribution under paragraph (b) includes natural and adoptive parents and their dependents, including the child receiving services. Adjustments in the contribution amount due to annual changes in the federal poverty guidelines shall be implemented on the first day of July following publication of the changes.


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(d) For purposes of paragraph (b), "income" means the adjusted gross income of the natural or adoptive parents determined according to the previous year's federal tax form, except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds have been used to purchase a home shall not be counted as income.

 

(e) The contribution shall be explained in writing to the parents at the time eligibility for services is being determined. The contribution shall be made on a monthly basis effective with the first month in which the child receives services. Annually upon redetermination or at termination of eligibility, if the contribution exceeded the cost of services provided, the local agency or the state shall reimburse that excess amount to the parents, either by direct reimbursement if the parent is no longer required to pay a contribution, or by a reduction in or waiver of parental fees until the excess amount is exhausted.

 

(f) The monthly contribution amount must be reviewed at least every 12 months; when there is a change in household size; and when there is a loss of or gain in income from one month to another in excess of ten percent. The local agency shall mail a written notice 30 days in advance of the effective date of a change in the contribution amount. A decrease in the contribution amount is effective in the month that the parent verifies a reduction in income or change in household size.

 

(g) Parents of a minor child who do not live with each other shall each pay the contribution required under paragraph (a). An amount equal to the annual court-ordered child support payment actually paid on behalf of the child receiving services shall be deducted from the adjusted gross income of the parent making the payment prior to calculating the parental contribution under paragraph (b).

 

(h) The contribution under paragraph (b) shall be increased by an additional five percent if the local agency determines that insurance coverage is available but not obtained for the child. For purposes of this section, "available" means the insurance is a benefit of employment for a family member at an annual cost of no more than five percent of the family's annual income. For purposes of this section, "insurance" means health and accident insurance coverage, enrollment in a nonprofit health service plan, health maintenance organization, self-insured plan, or preferred provider organization.

 

Parents who have more than one child receiving services shall not be required to pay more than the amount for the child with the highest expenditures. There shall be no resource contribution from the parents. The parent shall not be required to pay a contribution in excess of the cost of the services provided to the child, not counting payments made to school districts for education-related services. Notice of an increase in fee payment must be given at least 30 days before the increased fee is due.

 

(i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if, in the 12 months prior to July 1:

 

(1) the parent applied for insurance for the child;

 

(2) the insurer denied insurance;

 

(3) the parents submitted a complaint or appeal, in writing to the insurer, submitted a complaint or appeal, in writing, to the commissioner of health or the commissioner of commerce, or litigated the complaint or appeal; and

 

(4) as a result of the dispute, the insurer reversed its decision and granted insurance.

 

For purposes of this section, "insurance" has the meaning given in paragraph (h).

 

A parent who has requested a reduction in the contribution amount under this paragraph shall submit proof in the form and manner prescribed by the commissioner or county agency, including, but not limited to, the insurer's denial of insurance, the written letter or complaint of the parents, court documents, and the written response of the insurer approving insurance. The determinations of the commissioner or county agency under this paragraph are not rules subject to chapter 14.


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Sec. 3. Minnesota Statutes 2006, section 252.32, subdivision 3, is amended to read:

 

Subd. 3. Amount of support grant; use. Support grant amounts shall be determined by the county social service agency. Services and items purchased with a support grant must:

 

(1) be over and above the normal costs of caring for the dependent if the dependent did not have a disability;

 

(2) be directly attributable to the dependent's disabling condition; and

 

(3) enable the family to delay or prevent the out-of-home placement of the dependent.

 

The design and delivery of services and items purchased under this section must suit the dependent's chronological age and be provided in the least restrictive environment possible, consistent with the needs identified in the individual service plan.

 

Items and services purchased with support grants must be those for which there are no other public or private funds available to the family. Fees assessed to parents for health or human services that are funded by federal, state, or county dollars are not reimbursable through this program.

 

In approving or denying applications, the county shall consider the following factors:

 

(1) the extent and areas of the functional limitations of the disabled child;

 

(2) the degree of need in the home environment for additional support; and

 

(3) the potential effectiveness of the grant to maintain and support the person in the family environment.

 

The maximum monthly grant amount shall be $250 per eligible dependent, or $3,000 per eligible dependent per state fiscal year, within the limits of available funds and as adjusted by any legislatively authorized cost of living adjustment. The county social service agency may consider the dependent's supplemental security income in determining the amount of the support grant.

 

Any adjustments to their monthly grant amount must be based on the needs of the family and funding availability.

 

Sec. 4. Minnesota Statutes 2006, section 252.46, is amended by adding a subdivision to read:

 

Subd. 22. Provider rate increase; St. Louis County. A day training and habilitation provider in St. Louis County licensed to provide services to up to 80 individuals shall receive a per diem rate increase that does not exceed 95 percent of the greater of 125 percent of the current statewide median or 125 percent of the regional average per diem rate, whichever is higher.

 

Sec. 5. Minnesota Statutes 2006, section 256.01, is amended by adding a subdivision to read:

 

Subd. 24. Disability linkage line. The commissioner shall establish the disability linkage line, a statewide consumer information, referral, and assistance system for people with disabilities and chronic illnesses that:

 

(1) provides information about state and federal eligibility requirements, benefits, and service options;

 

(2) makes referrals to appropriate support entities;


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(3) delivers information and assistance based on national and state standards;

 

(4) assists people to make well-informed decisions; and

 

(5) supports the timely resolution of service access and benefit issues.

 

Sec. 6. Minnesota Statutes 2006, section 256.476, subdivision 1, is amended to read:

 

Subdivision 1. Purpose and goals. The commissioner of human services shall establish a consumer support grant program for individuals with functional limitations and their families who wish to purchase and secure their own supports. 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 the developmental disability family support program, personal care attendant services, home health aide services, and private duty nursing services;

 

(2) provide consumers more control, flexibility, and responsibility over their services and supports;

 

(3) promote local program management and decision making; and

 

(4) encourage the use of informal and typical community supports.

 

Sec. 7. Minnesota Statutes 2006, section 256.476, subdivision 2, is amended to read:

 

Subd. 2. Definitions. For purposes of this section, the following terms have the meanings given them:

 

(a) "County board" means the county board of commissioners for the county of financial responsibility as defined in section 256G.02, subdivision 4, or its designated representative. When a human services board has been established under sections 402.01 to 402.10, it shall be considered the county board for the purposes of this section.

 

(b) "Family" means the person's birth parents, adoptive parents or stepparents, siblings or stepsiblings, children or stepchildren, grandparents, grandchildren, niece, nephew, aunt, uncle, or spouse. For the purposes of this section, a family member is at least 18 years of age.

 

(c) "Functional limitations" means the long-term inability to perform an activity or task in one or more areas of major life activity, including self-care, understanding and use of language, learning, mobility, self-direction, and capacity for independent living. For the purpose of this section, the inability to perform an activity or task results from a mental, emotional, psychological, sensory, or physical disability, condition, or illness.

 

(d) "Informed choice" means a voluntary decision made by the person or, the person's legal representative, or other authorized 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 or, for counties not participating in the consumer grant program by July 1, 2002, the commissioner, to carry out the provisions of this section.


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(f) "Person" or "persons" means a person or persons meeting the eligibility criteria in subdivision 3.

 

(g) "Authorized representative" means an individual designated by the person or their legal representative to act on their behalf. This individual may be a family member, guardian, representative payee, or other individual designated by the person or their legal representative, if any, to assist in purchasing and arranging for supports. For the purposes of this section, an authorized representative is at least 18 years of age.

 

(h) "Screening" means the screening of a person's service needs under sections 256B.0911 and 256B.092.

 

(i) "Supports" means services, care, aids, environmental modifications, or assistance purchased by the person or the person's family, the person's legal representative, or other authorized representative. Examples of supports include respite care, assistance with daily living, and assistive technology. For the purpose of this section, notwithstanding the provisions of section 144A.43, supports purchased under the consumer support program are not considered home care services.

 

(j) "Program of origination" means the program the individual transferred from when approved for the consumer support grant program.

 

Sec. 8. Minnesota Statutes 2006, section 256.476, subdivision 3, is amended to read:

 

Subd. 3. Eligibility to apply for grants. (a) A person is eligible to apply for a consumer support grant if the person meets all of the following criteria:

 

(1) the person is eligible for and has been approved to receive services under medical assistance as determined under sections 256B.055 and 256B.056 or the person has been approved to receive a grant under the 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 personal care attendant and home health aide services, or private duty nursing 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) Individuals receiving home and community-based waivers under United States Code, title 42, section 1396h(c), are not eligible for the consumer support grant, except for individuals receiving consumer support grants before July 1, 2003, as long as other eligibility criteria are met.


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(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. 9. Minnesota Statutes 2006, section 256.476, subdivision 4, is amended to read:

 

Subd. 4. Support grants; criteria and limitations. (a) A county board may choose to participate in the consumer support grant program. If a county has not chosen to participate by July 1, 2002, the commissioner shall contract with another county or other entity to provide access to residents of the nonparticipating county who choose the consumer support grant option. The commissioner shall notify the county board in a county that has declined to participate of the commissioner's intent to enter into a contract with another county or other entity at least 30 days in advance of entering into the contract. The local agency shall establish written procedures and criteria to determine the amount and use of support grants. These procedures must include, at least, the availability of respite care, assistance with daily living, and adaptive aids. The local agency may establish monthly or annual maximum amounts for grants and procedures where exceptional resources may be required to meet the health and safety needs of the person on a time-limited basis, however, the total amount awarded to each individual may not exceed the limits established in subdivision 11.

 

(b) Support grants to a person or a person's family, a person's legal representative, or other authorized representative 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, a person's legal representative, or other authorized representative to delay or prevent out-of-home placement of the person; and

 

(4) it must be consistent with the needs identified in the service agreement, when applicable.

 

(c) Items and services purchased with support grants must be those for which there are no other public or private funds available to the person or the person's family, a person's legal representative, or other authorized representative. 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, a person's legal representative, or other authorized representative shall be provided sufficient information to ensure an informed choice of alternatives by the person, the person's legal representative, or other authorized representative, if


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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.

 

(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. 10. Minnesota Statutes 2006, section 256.476, subdivision 5, is amended to read:

 

Subd. 5. Reimbursement, allocations, and reporting. (a) For the purpose of transferring persons to the consumer support grant program from the developmental disability family support program and personal care assistant services, home health aide services, or private duty nursing services, the amount of funds transferred by the commissioner between the developmental disability family support program account, the medical assistance account, or the consumer support grant account shall be based on each county's participation in transferring persons to the consumer support grant program from those programs and services.

 

(b) At the beginning of each fiscal year, county allocations for consumer support grants shall be based on:

 

(1) the number of persons to whom the county board expects to provide consumer supports grants;

 

(2) their eligibility for current program and services;

 

(3) the amount of nonfederal dollars allowed under subdivision 11; and

 

(4) projected dates when persons will start receiving grants. County allocations shall be adjusted periodically by the commissioner based on the actual transfer of persons or service openings, and the nonfederal dollars associated with those persons or service openings, to the consumer support grant program.

 

(c) The amount of funds transferred by the commissioner from the medical assistance account for an individual may be changed if it is determined by the county or its agent that the individual's need for support has changed.

 

(d) The authority to utilize funds transferred to the consumer support grant account for the purposes of implementing and administering the consumer support grant program will not be limited or constrained by the spending authority provided to the program of origination.


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(e) The commissioner may use up to five percent of each county's allocation, as adjusted, for payments for administrative expenses, to be paid as a proportionate addition to reported direct service expenditures.

 

(f) The county allocation for each individual or individual's family cannot exceed the amount allowed under subdivision 11.

 

(g) The commissioner may recover, suspend, or withhold payments if the county board, local agency, or grantee does not comply with the requirements of this section.

 

(h) Grant funds unexpended by consumers shall return to the state once a year. The annual return of unexpended grant funds shall occur in the quarter following the end of the state fiscal year.

 

Sec. 11. Minnesota Statutes 2006, section 256.476, subdivision 10, is amended to read:

 

Subd. 10. Consumer responsibilities. Persons receiving grants under this section shall:

 

(1) spend the grant money in a manner consistent with their agreement with the local agency;

 

(2) notify the local agency of any necessary changes in the grant or the items on which it is spent;

 

(3) notify the local agency of any decision made by the person, the a person's legal representative, or the person's family or other authorized representative that would change their eligibility for consumer support grants;

 

(4) arrange and pay for supports; and

 

(5) inform the local agency of areas where they have experienced difficulty securing or maintaining supports.

 

Sec. 12. Minnesota Statutes 2006, section 256.974, is amended to read:

 

256.974 OFFICE OF OMBUDSMAN FOR OLDER MINNESOTANS LONG-TERM CARE; LOCAL PROGRAMS.

 

The ombudsman for older Minnesotans long-term care serves in the classified service under section 256.01, subdivision 7, in an office within the Minnesota Board on Aging that incorporates the long-term care ombudsman program required by the Older Americans Act, Public Law 100-75 as amended, United States Code, title 42, section 3027(a)(12) (9) and 3058g (a), and established within the Minnesota Board on Aging. The Minnesota Board on Aging may make grants to and designate local programs for the provision of ombudsman services to clients in county or multicounty areas. The local program may not be an agency engaged in the provision of nursing home care, hospital care, or home care services either directly or by contract, or have the responsibility for planning, coordinating, funding, or administering nursing home care, hospital care, or home care services.

 

Sec. 13. Minnesota Statutes 2006, section 256.9741, subdivision 1, is amended to read:

 

Subdivision 1. Long-term care facility. "Long-term care facility" means a nursing home licensed under sections 144A.02 to 144A.10 or; a boarding care home licensed under sections 144.50 to 144.56; or a licensed or registered residential setting which provides or arranges for the provision of home care services.

 

Sec. 14. Minnesota Statutes 2006, section 256.9741, subdivision 3, is amended to read:

 

Subd. 3. Client. "Client" means an individual who requests, or on whose behalf a request is made for, ombudsman services and is (a) a resident of a long-term care facility or (b) a Medicare beneficiary who requests assistance relating to access, discharge, or denial of inpatient or outpatient services, or (c) an individual reserving, receiving, or requesting a home care service.


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Sec. 15. Minnesota Statutes 2006, section 256.9742, subdivision 3, is amended to read:

 

Subd. 3. Posting. Every long-term care facility and acute care facility shall post in a conspicuous place the address and telephone number of the office. A home care service provider shall provide all recipients, including those in elderly housing with services under chapter 144D, with the address and telephone number of the office. Counties shall provide clients receiving a consumer support grant or a service allowance long-term care consultation services under section 256B.0911 or home and community-based services through a state or federally funded program with the name, address, and telephone number of the office. The posting or notice is subject to approval by the ombudsman.

 

Sec. 16. Minnesota Statutes 2006, section 256.9742, subdivision 4, is amended to read:

 

Subd. 4. Access to long-term care and acute care facilities and clients. The ombudsman or designee may:

 

(1) enter any long-term care facility without notice at any time;

 

(2) enter any acute care facility without notice during normal business hours;

 

(3) enter any acute care facility without notice at any time to interview a patient or observe services being provided to the patient as part of an investigation of a matter that is within the scope of the ombudsman's authority, but only if the ombudsman's or designee's presence does not intrude upon the privacy of another patient or interfere with routine hospital services provided to any patient in the facility;

 

(4) communicate privately and without restriction with any client in accordance with section 144.651, as long as the ombudsman has the client's consent for such communication;

 

(5) inspect records of a long-term care facility, home care service provider, or acute care facility that pertain to the care of the client according to sections section 144.335 and 144.651; and

 

(6) with the consent of a client or client's legal guardian, the ombudsman or designated staff shall have access to review records pertaining to the care of the client according to sections section 144.335 and 144.651. If a client cannot consent and has no legal guardian, access to the records is authorized by this section.

 

A person who denies access to the ombudsman or designee in violation of this subdivision or aids, abets, invites, compels, or coerces another to do so is guilty of a misdemeanor.

 

Sec. 17. Minnesota Statutes 2006, section 256.9742, subdivision 6, is amended to read:

 

Subd. 6. Prohibition against discrimination or retaliation. (a) No entity shall take discriminatory, disciplinary, or retaliatory action against an employee or volunteer, or a patient, resident, or guardian or family member of a patient, resident, or guardian for filing in good faith a complaint with or providing information to the ombudsman or designee including volunteers. A person who violates this subdivision or who aids, abets, invites, compels, or coerces another to do so is guilty of a misdemeanor.

 

(b) There shall be a rebuttable presumption that any adverse action, as defined below, within 90 days of report, is discriminatory, disciplinary, or retaliatory. For the purpose of this clause, the term "adverse action" refers to action taken by the entity involved in a report against the person making the report or the person with respect to whom the report was made because of the report, and includes, but is not limited to:

 

(1) discharge or transfer from a facility;


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(2) termination of service;

 

(3) restriction or prohibition of access to the facility or its residents;

 

(4) discharge from or termination of employment;

 

(5) demotion or reduction in remuneration for services; and

 

(6) any restriction of rights set forth in section 144.651 or, 144A.44, or 144A.751.

 

Sec. 18. Minnesota Statutes 2006, section 256.9744, subdivision 1, is amended to read:

 

Subdivision 1. Classification. Except as provided in this section, data maintained by the office under sections 256.974 to 256.9744 are private data on individuals or nonpublic data as defined in section 13.02, subdivision 9 or 12, and must be maintained in accordance with the requirements of Public Law 100-75 the Older Americans Act, as amended, United States Code, title 42, section 3027(a)(12)(D) 3058g(d).

 

Sec. 19. Minnesota Statutes 2006, section 256.975, subdivision 7, is amended to read:

 

Subd. 7. Consumer information and assistance; senior linkage. (a) The Minnesota Board on Aging shall operate a statewide information and assistance service to aid older Minnesotans and their families in making informed choices about long-term care options and health care benefits. Language services to persons with limited English language skills may be made available. The service, known as Senior LinkAge Line, must be available during business hours through a statewide toll-free number and must also be available through the Internet.

 

(b) The service must assist older adults, caregivers, and providers in accessing information about choices in long-term care services that are purchased through private providers or available through public options. The service must:

 

(1) develop a comprehensive database that includes detailed listings in both consumer- and provider-oriented formats;

 

(2) make the database accessible on the Internet and through other telecommunication and media-related tools;

 

(3) link callers to interactive long-term care screening tools and make these tools available through the Internet by integrating the tools with the database;

 

(4) develop community education materials with a focus on planning for long-term care and evaluating independent living, housing, and service options;

 

(5) conduct an outreach campaign to assist older adults and their caregivers in finding information on the Internet and through other means of communication;

 

(6) implement a messaging system for overflow callers and respond to these callers by the next business day;

 

(7) link callers with county human services and other providers to receive more in-depth assistance and consultation related to long-term care options; and

 

(8) link callers with quality profiles for nursing facilities and other providers developed by the commissioner of health.; and


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(9) incorporate information about housing with services and consumer rights within the MinnesotaHelp.info network long-term care database to facilitate consumer comparison of services and costs among housing with services establishments and with other in-home services and to support financial self-sufficiency as long as possible. Housing with services establishments and their arranged home care providers shall provide information to the commissioner of human services that is consistent with information required by the commissioner of health under section 144G.06, the Uniform Consumer Information Guide. The commissioner of human services shall provide the data to the Minnesota Board on Aging for inclusion in the MinnesotaHelp.info network long-term care database.

 

(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.

 

EFFECTIVE DATE. This section is effective the day following final enactment.

 

Sec. 20. Minnesota Statutes 2006, 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, except as provided under subdivision 3, paragraph (f). Increases in benefits under title II of the Social Security Act shall not be counted as income for purposes of this subdivision until July 1 of each year. 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, and Social Security payments 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 104-193, shall be used, except that effective October 1, 2003, the earned income disregards and deductions are limited to those in subdivision 1c. For these purposes, a "methodology" does not include an asset or income standard, or accounting method, or method of determining effective dates.

 

Sec. 21. Minnesota Statutes 2006, section 256B.056, subdivision 3, is amended to read:

 

Subd. 3. Asset limitations for aged, blind, or disabled individuals and families. To be eligible for medical assistance, a person whose eligibility is based on blindness, disability, or age of 65 or more years must not individually own more than $3,000 $6,000 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 $12,000 in assets, plus $200 $400 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 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.


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(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. Burial expenses funded by annuity contracts or life insurance policies must irrevocably designate the individual's estate as contingent beneficiary to the extent proceeds are not used for payment of selected burial expenses.

 

(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).

 

(f) When a person enrolled in medical assistance under section 256B.057, subdivision 9, reaches age 65 and has been enrolled during each of the 24 consecutive months before the person's 65th birthday, the assets owned by the person and the person's spouse must be disregarded, up to the limits of section 256B.057, subdivision 9, paragraph (b), when determining eligibility for medical assistance under section 256B.055, subdivision 7. The income of a spouse of a person enrolled in medical assistance under section 256B.057, subdivision 9, during each of the 24 consecutive months before the person's 65th birthday must be disregarded when determining eligibility for medical assistance under section 256B.055, subdivision 7, when the person reaches age 65. This paragraph does not apply at the time the person or the person's spouse requests medical assistance payment for long-term care services.

 

EFFECTIVE DATE. This section is effective July 1, 2007, except that the increase in the asset standard for persons whose eligibility for medical assistance is based on blindness, disability, or age of 65 or more years is effective July 1, 2008.

 

Sec. 22. Minnesota Statutes 2006, section 256B.056, subdivision 5c, is amended to read:

 

Subd. 5c. Excess income standard. (a) The excess income standard for families with children is the standard specified in subdivision 4.

 

(b) The excess income standard for a person whose eligibility is based on blindness, disability, or age of 65 or more years is 70 percent of the federal poverty guidelines for the family size. Effective July 1, 2002, the excess income standard for this paragraph shall equal 75 percent of the federal poverty guidelines. Effective July 1, 2007, the excess income standard for this paragraph shall equal 85 percent of the federal poverty guidelines. The excess income standard for this paragraph shall be increased by five percentage points on July 1 of each of the next three years, so that the excess income standard shall equal 100 percent of the federal poverty guidelines effective July 1, 2010.

 

EFFECTIVE DATE. This section is effective July 1, 2007.

 

Sec. 23. Minnesota Statutes 2006, section 256B.0621, subdivision 11, is amended to read:

 

Subd. 11. Data use agreement; Notice of relocation assistance. The commissioner shall execute a data use agreement with the Centers for Medicare and Medicaid Services to obtain the long-term care minimum data set data to assist residents of nursing facilities who have establish a process with the Centers for Independent Living that allows a person residing in a Minnesota nursing facility to receive needed information, consultation, and assistance from one of the centers about the available community support options that may enable the person to relocate to the community, if the person: (1) is under the age of 65, (2) has indicated a desire to live in the community. The commissioner shall in turn enter into agreements with the Centers for Independent Living to provide information about assistance for persons who want to move to the community. The commissioner shall work with the Centers


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for Independent Living on both the content of the information to be provided and privacy protections for the individual residents, and (3) has signed a release of information authorized by the person or the person's appointed legal representative. The process established under this subdivision shall be coordinated with the long-term care consultation service activities established in section 256B.0911.

 

Sec. 24. Minnesota Statutes 2006, section 256B.0625, subdivision 18a, is amended to read:

 

Subd. 18a. Access to medical services. (a) Medical assistance reimbursement for meals for persons traveling to receive medical care may not exceed $5.50 for breakfast, $6.50 for lunch, or $8 for dinner.

 

(b) Medical assistance reimbursement for lodging for persons traveling to receive medical care may not exceed $50 per day unless prior authorized by the local agency.

 

(c) Medical assistance direct mileage reimbursement to the eligible person or the eligible person's driver may not exceed 20 cents per mile.

 

(d) Regardless of the number of employees that an enrolled health care provider may have, medical assistance covers sign and 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 or who has a hearing loss and uses interpreting services.

 

Sec. 25. Minnesota Statutes 2006, section 256B.0625, is amended by adding a subdivision to read:

 

Subd. 49. Self-directed supports option. Upon federal approval, medical assistance covers the self-directed supports option as defined under section 256B.0657 and section 6087 of the Federal Deficit Reduction Act of 2005, Public Law 109-171.

 

EFFECTIVE DATE. This section is effective upon federal approval of the state Medicaid plan amendment. The commissioner of human services shall inform the Office of the Revisor of Statutes when approval is obtained.

 

Sec. 26. [256B.0657] SELF-DIRECTED SUPPORTS OPTION.

 

Subdivision 1. Definition. "Self-directed supports option" means personal assistance, supports, items, and related services purchased under an approved budget plan and budget by a recipient.

 

Subd. 2. Eligibility. (a) The self-directed supports option is available to a person who:

 

(1) is a recipient of medical assistance as determined under sections 256B.055, 256B.056, and 256B.057, subdivision 9;

 

(2) is eligible for personal care assistant services under section 256B.0655;

 

(3) lives in the person's own apartment or home, which is not owned, operated, or controlled by a provider of services not related by blood or marriage;

 

(4) has the ability to hire, fire, supervise, establish staff compensation for, and manage the individuals providing services, and to choose and obtain items, related services, and supports as described in the participant's plan. If the recipient is not able to carry out these functions but has a legal guardian or parent to carry them out, the guardian or parent may fulfill these functions on behalf of the recipient; and

 

(5) has not been excluded or disenrolled by the commissioner.


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(b) The commissioner may disenroll or exclude recipients, including guardians and parents, under the following circumstances:

 

(1) recipients who have been restricted by the Primary Care Utilization Review Committee may be excluded for a specified time period; and

 

(2) recipients who exit the self-directed supports option during the recipient's service plan year shall not access the self-directed supports option for the remainder of that service plan year.

 

Subd. 3. Eligibility for other services. Selection of the self-directed supports option by a recipient shall not restrict access to other medically necessary care and services furnished under the state plan medical assistance benefit, including home care targeted case management, except that a person receiving home and community-based waiver services, a family support grant or a consumer support grant is not eligible for funding under the self-directed supports option.

 

Subd. 4. Assessment requirements. (a) The self-directed supports option assessment must meet the following requirements:

 

(1) it shall be conducted by the county public health nurse or a certified public health nurse under contract with the county;

 

(2) it shall be conducted face-to-face in the recipient's home initially, and at least annually thereafter; when there is a significant change in the recipient's condition; and when there is a change in the need for personal care assistant services. A recipient who is residing in a facility may be assessed for the self-directed support option for the purpose of returning to the community using this option; and

 

(3) it shall be completed using the format established by the commissioner.

 

(b) The results of the assessment and recommendations shall be communicated to the commissioner and the recipient by the county public health nurse or certified public health nurse under contract with the county.

 

Subd. 5. Self-directed supports option plan requirements. (a) The plan for the self-directed supports option must meet the following requirements:

 

(1) the plan must be completed using a person-centered process that:

 

(i) builds upon the recipient's capacity to engage in activities that promote community life;

 

(ii) respects the recipient's preferences, choices, and abilities;

 

(iii) involves families, friends, and professionals in the planning or delivery of services or supports as desired or required by the recipient; and

 

(iv) addresses the need for personal care assistant services identified in the recipient's self-directed supports option assessment;

 

(2) the plan shall be developed by the recipient or by the guardian of an adult recipient or by a parent or guardian of a minor child, with the assistance of an enrolled medical assistance home care targeted case manager provider who meets the requirements established for using a person-centered planning process and shall be reviewed at least annually upon reassessment or when there is a significant change in the recipient's condition; and


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(3) the plan must include the total budget amount available divided into monthly amounts that cover the number of months of personal care assistant services authorization included in the budget. The amount used each month may vary, but additional funds shall not be provided above the annual personal care assistant services authorized amount unless a change in condition is documented.

 

(b) The commissioner shall:

 

(1) establish the format and criteria for the plan as well as the requirements for providers who assist with plan development;

 

(2) review the assessment and plan and, within 30 days after receiving the assessment and plan, make a decision on approval of the plan;

 

(3) notify the recipient, parent, or guardian of approval or denial of the plan and provide notice of the right to appeal under section 256.045; and

 

(4) provide a copy of the plan to the fiscal support entity selected by the recipient.

 

Subd. 6. Services covered. (a) Services covered under the self-directed supports option include:

 

(1) personal care assistant services under section 256B.0655; and

 

(2) items, related services, and supports, including assistive technology, that increase independence or substitute for human assistance to the extent expenditures would otherwise be used for human assistance.

 

(b) Items, supports, and related services purchased under this option shall not be considered home care services for the purposes of section 144A.43.

 

Subd. 7. Noncovered services. Services or supports that are not eligible for payment under the self-directed supports option include:

 

(1) services, goods, or supports that do not benefit the recipient;

 

(2) any fees incurred by the recipient, such as Minnesota health care program fees and co-pays, legal fees, or costs related to advocate agencies;

 

(3) insurance, except for insurance costs related to employee coverage or fiscal support entity payments;

 

(4) room and board and personal items that are not related to the disability, except that medically prescribed specialized diet items may be covered if they reduce the need for human assistance;

 

(5) home modifications that add square footage;

 

(6) home modifications for a residence other than the primary residence of the recipient, or in the event of a minor with parents not living together, the primary residences of the parents;

 

(7) expenses for travel, lodging, or meals related to training the recipient, the parent or guardian of an adult recipient, or the parent or guardian of a minor child, or paid or unpaid caregivers that exceed $500 in a 12-month period;

 

(8) experimental treatment;


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(9) any service or item covered by other medical assistance state plan services, including prescription and over-the-counter medications, compounds, and solutions and related fees, including premiums and co-payments;

 

(10) membership dues or costs, except when the service is necessary and appropriate to treat a physical condition or to improve or maintain the recipient's physical condition. The condition must be identified in the recipient's plan of care and monitored by a Minnesota health care program enrolled physician;

 

(11) vacation expenses other than the cost of direct services;

 

(12) vehicle maintenance or modifications not related to the disability;

 

(13) tickets and related costs to attend sporting or other recreational events; and

 

(14) costs related to Internet access, except when necessary for operation of assistive technology, to increase independence, or to substitute for human assistance.

 

Subd. 8. Self-directed budget requirements. The budget for the provision of the self-directed service option shall be equal to the greater of either:

 

(1) the annual amount of personal care assistant services under section 256B.0655 that the recipient has used in the most recent 12-month period; or

 

(2) the amount determined using the consumer support grant methodology under section 256.476, subdivision 11, except that the budget amount shall include the federal and nonfederal share of the average service costs.

 

Subd. 9. Quality assurance and risk management. (a) The commissioner shall establish quality assurance and risk management measures for use in developing and implementing self-directed plans and budgets that (1) recognize the roles and responsibilities involved in obtaining services in a self-directed manner, and (2) assure the appropriateness of such plans and budgets based upon a recipient's resources and capabilities. These measures must include (i) background studies, and (ii) backup and emergency plans, including disaster planning.

 

(b) The commissioner shall provide ongoing technical assistance and resource and educational materials for families and recipients selecting the self-directed option.

 

(c) Performance assessments measures, such as of a recipient's satisfaction with the services and supports, and ongoing monitoring of health and well-being shall be identified in consultation with the stakeholder group.

 

Subd. 10. Fiscal support entity. (a) Each recipient shall choose a fiscal support entity provider certified by the commissioner to make payments for services, items, supports, and administrative costs related to managing a self-directed service plan authorized for payment in the approved plan and budget. Recipients shall also choose the payroll, agency with choice, or the fiscal conduit model of financial and service management.

 

(b) The fiscal support entity:

 

(1) may not limit or restrict the recipient's choice of service or support providers, including use of the payroll, agency with choice, or fiscal conduit model of financial and service management;

 

(2) must have a written agreement with the recipient or the recipient's representative that identifies the duties and responsibilities to be performed and the specific related charges;


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(3) must provide the recipient and the home care targeted case manager with a monthly written summary of the self-directed supports option services that were billed, including charges from the fiscal support entity;

 

(4) must be knowledgeable of and comply with Internal Revenue Service requirements necessary to process employer and employee deductions, provide appropriate and timely submission of employer tax liabilities, and maintain documentation to support medical assistance claims;

 

(5) must have current and adequate liability insurance and bonding and sufficient cash flow and have on staff or under contract a certified public accountant or an individual with a baccalaureate degree in accounting; and

 

(6) must maintain records to track all self-directed supports option services expenditures, including time records of persons paid to provide supports and receipts for any goods purchased. The records must be maintained for a minimum of five years from the claim date and be available for audit or review upon request. Claims submitted by the fiscal support entity must correspond with services, amounts, and time periods as authorized in the recipient's self-directed supports option plan.

 

(c) The commissioner shall have authority to:

 

(1) set or negotiate rates with fiscal support entities;

 

(2) limit the number of fiscal support entities;

 

(3) identify a process to certify and recertify fiscal support entities and assure fiscal support entities are available to recipients throughout the state; and

 

(4) establish a uniform format and protocol to be used by eligible fiscal support entities.

 

Subd. 11. Stakeholder consultation. The commissioner shall consult with a statewide consumer-directed services stakeholder group, including representatives of all types of consumer-directed service users, advocacy organizations, counties, and consumer-directed service providers. The commissioner shall seek recommendations from this stakeholder group in developing:

 

(1) the self-directed plan format;

 

(2) requirements and guidelines for the person-centered plan assessment and planning process;

 

(3) implementation of the option and the quality assurance and risk management techniques; and

 

(4) standards and requirements, including rates for the personal support plan development provider and the fiscal support entity; policies; training; and implementation. The stakeholder group shall provide recommendations on the repeal of the personal care assistant choice option, transition issues, and whether the consumer support grant program under section 256.476 should be modified. The stakeholder group shall meet at least three times each year to provide advice on policy, implementation, and other aspects of consumer and self-directed services.

 

EFFECTIVE DATE. Subdivisions 1 to 10 are effective upon federal approval of the state Medicaid plan amendment. The commissioner of human services shall inform the Office of the Revisor of Statutes when federal approval is obtained. Subdivision 11 is effective July 1, 2007.


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Sec. 27. Minnesota Statutes 2006, section 256B.0911, subdivision 3a, is amended to read:

 

Subd. 3a. Assessment and support planning. (a) Persons requesting assessment, services planning, or other assistance intended to support community-based living, including persons who need assessment in order to determine waiver or alternative care program eligibility, 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) (i).

 

(b) The county may utilize a team of either the social worker or public health nurse, or both, to conduct the assessment in a face-to-face interview. The consultation team members must confer regarding the most appropriate care for each individual screened or assessed.

 

(c) The long-term care consultation team must assess the health and social needs of the person, using an assessment form provided by the commissioner.

 

(d) The team must conduct the assessment in a face-to-face interview with the person being assessed and the person's legal representative, if applicable.

 

(e) The team must provide the person, or the person's legal representative, with written recommendations for facility- or community-based services. The team must document that the most cost-effective alternatives available were offered to the individual. For purposes of this requirement, "cost-effective alternatives" means community services and living arrangements that cost the same as or less than nursing facility care.

 

(f) If the person chooses to use community-based services, the team must provide the person or the person's legal representative with a written community support plan, regardless of whether the individual is eligible for Minnesota health care programs. The person may request assistance in developing a community support plan without participating in a complete assessment.

 

(g) The person has the right to make the final decision between nursing facility placement and community placement after the screening team's recommendation, except as provided in subdivision 4a, paragraph (c).

 

(h) The team must give the person receiving assessment or support planning, or the person's legal representative, materials, and forms supplied by the commissioner containing the following information:

 

(1) the need for and purpose of preadmission screening and assessment if the person selects nursing facility placement;

 

(2) the role of the long-term care consultation assessment and support planning in waiver and alternative care program eligibility determination;

 

(2) (3) information about Minnesota health care programs;

 

(3) (4) the person's freedom to accept or reject the recommendations of the team;

 

(4) (5) the person's right to confidentiality under the Minnesota Government Data Practices Act, chapter 13; and

 

(6) the long-term care consultant's decision regarding the person's need for nursing facility level of care;

 

(5) (7) 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.


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(i) Face-to-face assessment completed as part of eligibility determination for the alternative care, elderly waiver, community alternatives for disabled individuals, community alternative care, and traumatic brain injury waiver programs under sections 256B.0915, 256B.0917, and 256B.49 is valid to establish service eligibility for no more than 60 calendar days after the date of assessment. The effective eligibility start date for these programs can never be prior to the date of assessment. If an assessment was completed more than 60 days before the effective waiver or alternative care program eligibility start date, assessment and support plan information must be updated in a face‑to‑face visit and documented in the department's Medicaid Management Information System (MMIS). The effective date of program eligibility in this case cannot be prior to the date the updated assessment is completed.

 

Sec. 28. Minnesota Statutes 2006, section 256B.0911, subdivision 3b, is amended to read:

 

Subd. 3b. Transition assistance. (a) A long-term care consultation team shall provide assistance to persons residing in a nursing facility, hospital, regional treatment center, or intermediate care facility for persons with developmental disabilities who request or are referred for assistance. Transition assistance must include assessment, community support plan development, referrals to Minnesota health care programs, and referrals to programs that provide assistance with housing. Transition assistance must also include information about the Centers for Independent Living and about other organizations that can provide assistance with relocation efforts, and information about contacting these organizations to obtain their assistance and support.

 

(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. 29. Minnesota Statutes 2006, section 256B.0911, is amended by adding a subdivision to read:

 

Subd. 3c. Transition to housing with services. (a) Transitional consultation shall be offered to all prospective residents 65 years of age or older regardless of income, assets, or funding sources before housing with services establishments offering or providing assisted living execute a lease or contract with the prospective resident. The purpose of transitional long-term care consultation is to support persons with current or anticipated long-term care needs in making informed choices among options that include the most cost-effective and least restrictive settings, and to delay spenddown to eligibility for publicly funded programs by connecting people to alternative services in their homes before transition to housing with services.

 

(b) Transitional consultation services are provided as determined by the commissioner of human services in partnership with county long-term care consultation units, and the Area Agencies on Aging, and are a combination of telephone-based and in-person assistance provided under models developed by the commissioner. The consultation is to be performed in a manner which provides objective and complete information. Transitional consultation must be provided within five working days of the request of the prospective resident as follows:

 

(1) the consultation must be provided by a qualified professional as determined by the commissioner;


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(2) the consultation must include a review of the prospective resident's reasons for considering assisted living, the prospective resident's personal goals, a discussion of the prospective resident's immediate and projected long-term care needs, and alternative community services or assisted living settings that may meet the prospective resident's needs; and

 

(3) the prospective resident will be informed of the availability of long-term care consultation services described in subdivision 3a that are available at no charge to the prospective resident to assist the prospective resident in assessment and planning to meet the prospective resident's long-term care needs. Regardless of the consultation, prospective residents maintain the right to choose housing with services or assisted living, if that is their choice.

 

EFFECTIVE DATE. This section is effective October 1, 2008.

 

Sec. 30. Minnesota Statutes 2006, section 256B.0911, subdivision 4b, is amended to read:

 

Subd. 4b. Exemptions and emergency admissions. (a) Exemptions from the federal screening requirements outlined in subdivision 4a, paragraphs (b) and (c), are limited to:

 

(1) a person who, having entered an acute care facility from a certified nursing facility, is returning to a certified nursing facility;

 

(2) a person transferring from one certified nursing facility in Minnesota to another certified nursing facility in Minnesota; and

 

(3) a person, 21 years of age or older, who satisfies the following criteria, as specified in Code of Federal Regulations, title 42, section 483.106(b)(2):

 

(i) the person is admitted to a nursing facility directly from a hospital after receiving acute inpatient care at the hospital;

 

(ii) the person requires nursing facility services for the same condition for which care was provided in the hospital; and

 

(iii) the attending physician has certified before the nursing facility admission that the person is likely to receive less than 30 days of nursing facility services.

 

(b) Persons who are exempt from preadmission screening for purposes of level of care determination include:

 

(1) persons described in paragraph (a);

 

(2) an individual who has a contractual right to have nursing facility care paid for indefinitely by the veterans' administration;

 

(3) an individual enrolled in a demonstration project under section 256B.69, subdivision 8, at the time of application to a nursing facility; and

 

(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-


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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.