STATE OF MINNESOTA
EIGHTY-SIXTH SESSION - 2009
_____________________
FORTIETH DAY
Saint Paul, Minnesota, Friday, April 24, 2009
The House of Representatives convened at
10:30 a.m. and was called to order by Al Juhnke, Speaker pro tempore.
Prayer was offered by Minister R'Gina
Sellers, Celebrate New Life Ministries International, Eagan, Minnesota.
The members of the House gave the pledge
of allegiance to the flag of the United States of America.
The roll was called and the following
members were present:
Abeler
Anderson, B.
Anderson, P.
Anderson, S.
Anzelc
Beard
Benson
Bigham
Bly
Brod
Brown
Brynaert
Buesgens
Bunn
Carlson
Champion
Clark
Cornish
Davids
Davnie
Dean
Demmer
Dettmer
Dill
Dittrich
Doepke
Doty
Downey
Drazkowski
Eastlund
Eken
Emmer
Falk
Faust
Fritz
Gardner
Garofalo
Gottwalt
Greiling
Gunther
Hackbarth
Hamilton
Hansen
Hausman
Haws
Hayden
Hilstrom
Hilty
Holberg
Hoppe
Hornstein
Hortman
Hosch
Howes
Huntley
Jackson
Johnson
Juhnke
Kahn
Kalin
Kath
Kelly
Kiffmeyer
Knuth
Koenen
Kohls
Laine
Lanning
Lenczewski
Liebling
Lieder
Lillie
Loeffler
Loon
Mack
Magnus
Mahoney
Marquart
Masin
McFarlane
McNamara
Morgan
Morrow
Mullery
Murdock
Murphy, E.
Murphy, M.
Nelson
Newton
Nornes
Norton
Obermueller
Olin
Otremba
Paymar
Pelowski
Peppin
Persell
Peterson
Poppe
Reinert
Rosenthal
Rukavina
Ruud
Sailer
Sanders
Scalze
Scott
Seifert
Sertich
Severson
Shimanski
Simon
Slawik
Slocum
Smith
Solberg
Sterner
Swails
Thao
Thissen
Tillberry
Torkelson
Urdahl
Ward
Welti
Westrom
Winkler
Zellers
Spk.
Kelliher
A quorum was present.
Atkins, Lesch and Wagenius were excused.
Mariani was excused until 12:50 p.m.
The Chief Clerk proceeded to read the
Journal of the preceding day. Demmer
moved that further reading of the Journal be dispensed with and that the
Journal be approved as corrected by the Chief Clerk. The motion prevailed.
REPORTS OF
CHIEF CLERK
S. F. No. 1288 and
H. F. No. 1532, which had been referred to the Chief Clerk for
comparison, were examined and found to be identical with certain exceptions.
SUSPENSION OF RULES
Kalin moved that the rules be so far
suspended that S. F. No. 1288 be substituted for
H. F. No. 1532 and that the House File be indefinitely
postponed. The motion prevailed.
S. F. No. 1539 and
H. F. No. 1719, which had been referred to the Chief Clerk for
comparison, were examined and found to be identical with certain exceptions.
SUSPENSION OF RULES
Atkins moved that the rules be so far
suspended that S. F. No. 1539 be substituted for
H. F. No. 1719 and that the House File be indefinitely
postponed. The motion prevailed.
S. F. No. 1711 and
H. F. No. 1717, which had been referred to the Chief Clerk for
comparison, were examined and found to be identical with certain exceptions.
SUSPENSION OF RULES
Atkins moved that the rules be so far
suspended that S. F. No. 1711 be substituted for
H. F. No. 1717 and that the House File be indefinitely
postponed. The motion prevailed.
PETITIONS
AND COMMUNICATIONS
The following
communication was received:
STATE OF MINNESOTA
OFFICE OF THE SECRETARY OF STATE
ST. PAUL 55155
The
Honorable Margaret Anderson Kelliher
Speaker of
the House of Representatives
The
Honorable James P. Metzen
President of
the Senate
I have the honor to
inform you that the following enrolled Act of the 2009 Session of the State
Legislature has been received from the Office of the Governor and is deposited
in the Office of the Secretary of State for preservation, pursuant to the State
Constitution, Article IV, Section 23:
|
S. F. No. |
H. F. No. |
Session
Laws Chapter
No. |
Time and Date
Approved 2009 |
Date Filed 2009 |
` 33 24 1:10 p.m.
April 23 April
23
Sincerely,
Mark
Ritchie
Secretary
of State
REPORTS OF STANDING
COMMITTEES AND DIVISIONS
Carlson
from the Committee on Finance to which was referred:
H. F. No.
1362, A bill for an act relating to human services; requiring the commissioner
to apply for federal funds; amending Minnesota Statutes 2008, section 256D.051,
subdivision 2a.
Reported
the same back with the following amendments:
Delete
everything after the enacting clause and insert:
"ARTICLE
1
LICENSING
Section
1. Minnesota Statutes 2008, 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 not to exceed $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.
(e) For
purposes of adult foster care and child foster care licensing under this
chapter, a county agency may charge a fee to a corporate applicant or corporate
license holder to recover the actual cost of background studies. A county agency may also charge a fee to a
corporate applicant or corporate license holder to recover the actual cost
of licensing inspections, not to exceed $500 annually.
(f)
Counties may elect to reduce or waive the fees in paragraph (e) under the
following circumstances:
(1) in
cases of financial hardship;
(2) if the
county has a shortage of providers in the county's area; or
(3) for new
providers.
Sec.
2. Minnesota Statutes 2008, section
245A.10, subdivision 3, is amended to read:
Subd.
3. Application
fee for initial license or certification.
(a) For fees required under subdivision 1, an applicant for an initial
license or certification issued by the commissioner shall submit a $500
$750 application fee with each new application required under this
subdivision. The application fee shall
not be prorated, is nonrefundable, and is in lieu of the annual license or
certification fee that expires on December 31.
The commissioner shall not process an application until the application
fee is paid.
(b) Except
as provided in clauses (1) to (3), an applicant shall apply for a license to
provide services at a specific location.
(1) For a
license to provide waivered residential-based habilitation
services to persons with developmental disabilities or related conditions
under chapter 245B, an applicant shall submit an application for each
county in which the waivered services will be provided. Upon licensure, the license holder may
provide services to persons in that county plus no more than three persons at
any one time in each of up to ten additional counties. A license holder in one county may not provide
services under the home and community-based waiver for persons with
developmental disabilities to more than three people in a second county without
holding a separate license for that second county. Applicants or licensees providing services
under this clause to not more than three persons remain subject to the
inspection fees established in section 245A.10, subdivision 2, for each
location.
(2) For a
license to provide supported employment, crisis respite, or semi-independent
living services to persons with developmental disabilities or related
conditions under chapter 245B, an applicant shall submit a single
application to provide services statewide.
(3) For a
license to provide independent living assistance for youth under section
245A.22, an applicant shall submit a single application to provide services
statewide.
Sec.
3. Minnesota Statutes 2008, section
245A.10, subdivision 4, is amended to read:
Subd.
4. License
or certification fee for certain programs a child care center. (a) A child care centers and
programs with a licensed capacity center shall pay an annual
nonrefundable license or certification fee based on the following
schedule:
Child
Care Center Other
Program License
License
Fee Fiscal Fee
Fiscal Year 2011
Licensed
Capacity Year
2010 and
thereafter
1 to 24
persons $225
$295 $400
$360
25 to 49
persons $340
$410 $600
$475
50 to 74
persons $450
$520 $800
$585
75 to 99
persons $565
$635 $1,000
$700
100 to
124 persons $675
$745 $1,200
$810
125 to
149 persons $900
$970 $1,400
$1,035
150 to 174
persons $1,050
$1,120 $1,600
$1,185
175 to
199 persons $1,200
$1,270 $1,800
$1,335
200 to
224 persons $1,350
$1,420 $2,000
$1,485
225 or
more persons $1,500
$1,570 $2,500
$1,635
(b) A day training and habilitation
program serving persons with developmental disabilities or related conditions
shall be assessed a license fee based on the schedule in paragraph (a) unless
the license holder serves more than 50 percent of the same persons at two or
more locations in the community. Except
as provided in paragraph (c), when a day training and habilitation program
serves more than 50 percent of the same persons in two or more locations in a
community, the day training and habilitation program shall pay a license fee
based on the licensed capacity of the largest facility and the other facility
or facilities shall be charged a license fee based on a licensed capacity of a
residential program serving one to 24 persons.
(c) When a day training and
habilitation program serving persons with developmental disabilities or related
conditions seeks a single license allowed under section 245B.07, subdivision
12, clause (2) or (3), the licensing fee must be based on the combined licensed
capacity for each location.
Sec. 4. Minnesota Statutes 2008, section 245A.10, is
amended by adding a subdivision to read:
Subd. 4a.
License fee for an adult day
care center. An adult day
care center licensed under Minnesota Rules, parts 9555.9600 to 9555.9730, shall
pay an annual nonrefundable license fee based on the following schedule:
License
Fee Fiscal
License
Fee Fiscal Year
2011 and
Licensed
Capacity Year
2010 thereafter
1 to
24 persons $930 $1,460
25
to 49 persons $1,130 $1,660
50
to 74 persons $1,330 $1,860
75
to 99 persons $1,530 $2,060
100
or more persons $1,730 $2,260
Sec. 5. Minnesota Statutes 2008, section 245A.10, is
amended by adding a subdivision to read:
Subd. 4b.
License fee for day training
and habilitation program. (a)
A day training and habilitation program licensed under chapter 245B to provide
services to persons with developmental disabilities shall pay an annual
nonrefundable license fee based on the following schedule:
License
Fee Fiscal
License
Fee Fiscal Year
2011 and
Licensed
Capacity Year
2010 thereafter
1 to
24 persons $925 $1,430
25
to 49 persons $1,125 $1,630
50
to 74 persons $1,325 $1,830
75
to 99 persons $1,525 $2,030
100
to 124 persons $1,725 $2,230
125
to 149 persons $1,925 $2,430
150
to 174 persons $2,125 $2,630
175
to 199 persons $2,325 $2,830
200
to 224 persons $2,525 $3,030
225
or more persons $3,025 $3,530
(b) A day training and habilitation
program licensed under chapter 245B must be assessed a license fee based on the
schedule in paragraph (a) unless the license holder serves more than 50 percent
of the same persons at two or more locations in the community. Except as provided in paragraph (c), when a
day training and habilitation program serves more than 50 percent of the same
persons in two or more locations in a community, the day training and
habilitation program shall pay a license fee based on the licensed capacity of
the largest facility and the other facility or facilities must be charged a
license fee based on a licensed capacity of a residential program serving one
to 24 persons.
(c) When a day training and
habilitation program serving persons with developmental disabilities seeks a
single license allowed under section 245B.07, subdivision 12, clause (2) or
(3), the licensing fee must be based on the combined licensed capacity for each
location.
Sec. 6. Minnesota Statutes 2008, section 245A.10, is
amended by adding a subdivision to read:
Subd. 4c.
License fee for residential
program serving persons with developmental disabilities. A residential program licensed under
chapter 245B whether certified as an intermediate care facility for persons
with developmental disabilities or not shall pay an annual nonrefundable
license fee based on the following schedule:
License
Fee Fiscal
License
Fee Fiscal Year
2011 and
Licensed
Capacity Year
2010 thereafter
1 to
24 persons $1,000 $1,600
25 to
49 persons $1,200 $1,800
50 to
74 persons $1,400 $2,000
75 or
more persons $1,600 $2,200
Sec. 7. Minnesota Statutes 2008, section 245A.10, is
amended by adding a subdivision to read:
Subd. 4d.
License fee for program
providing crisis respite. (a)
In fiscal year 2010, a program licensed to provide crisis respite services for
persons with developmental disabilities under chapter 245B shall pay an annual
nonrefundable license fee of $1,600.
(b) In fiscal year 2011 and
thereafter, a program licensed to provide crisis respite services for persons
with developmental disabilities under chapter 245B shall pay an annual
nonrefundable license fee of $2,000.
Sec. 8. Minnesota Statutes 2008, section 245A.10, is
amended by adding a subdivision to read:
Subd. 4e.
License fee for program
providing residential-based habilitation services. (a) In fiscal year 2010, a program
licensed to provide residential-based habilitation services for persons with
developmental disabilities under chapter 245B shall pay an annual nonrefundable
license fee that is based on a base rate of $715 plus $50 times the number of
clients served on the first day of August of the current license year. State-operated programs are exempt from the
license fee under this paragraph and paragraph (b).
(b) In fiscal year 2011 and
thereafter, a program licensed to provide residential-based habilitation
services for persons with developmental disabilities under chapter 245B shall
pay an annual nonrefundable license fee that is based on a base rate of $1,000
plus $70 times the number of clients served on the first day of August of the
current license year.
Sec. 9. Minnesota Statutes 2008, section 245A.10, is
amended by adding a subdivision to read:
Subd. 4f.
License fee for program
providing semi-independent living services or supported employment services. (a) In fiscal year 2010, a program
licensed to provide semi-independent living services for persons with
developmental disabilities under chapter 245B or supported employment services
for persons with developmental disabilities under chapter 245B shall pay an
annual nonrefundable license fee of $1,250.
(b) In fiscal year 2011 and
thereafter, a program licensed to provide semi-independent living services for
persons with developmental disabilities under chapter 245B or supported
employment services for persons with developmental disabilities under chapter
245B shall pay an annual nonrefundable license fee of $2,000.
Sec. 10. Minnesota Statutes 2008, section 245A.10, is
amended by adding a subdivision to read:
Subd. 4g.
License fee for residential
program serving persons with physical disabilities. A residential program licensed under
Minnesota Rules, parts 9570.2000 to 9570.3400, to serve persons with physical
disabilities shall pay an annual nonrefundable license fee based on the
following schedule:
License
Fee Fiscal
License
Fee Fiscal Year
2011 and
Licensed
Capacity Year
2010 thereafter
1 to
24 persons $713 $1,025
25
to 49 persons $913 $1,225
50
to 74 persons $1,113 $1,425
75
to 99 persons $1,313 $1,625
100
to 124 persons $1,513 $1,825
125
or more persons $1,713 $2,025
Sec. 11. Minnesota Statutes 2008, section 245A.10, is
amended by adding a subdivision to read:
Subd. 4h.
License fee for residential
programs serving adults with mental illness. (a) In fiscal year 2010, a residential
program licensed under Minnesota Rules, parts 9520.0500 to 9520.0670, to serve
adults with mental illness shall pay an annual nonrefundable license fee of
$2,450.
(b) In fiscal year 2011 and
thereafter, a residential program licensed under Minnesota Rules, parts
9520.0500 to 9520.0670, to serve adults with mental illness shall pay an annual
nonrefundable license fee of $4,400.
Sec. 12. Minnesota Statutes 2008, section 245A.10, is
amended by adding a subdivision to read:
Subd. 4i.
License fee for a children's
residential program. (a) In
fiscal year 2010, a children's residential program licensed under Minnesota
Rules, chapter 2960, shall pay an annual nonrefundable license fee of $2,450.
(b) In fiscal year 2011 and
thereafter, a children's residential program licensed under Minnesota Rules,
chapter 2960, shall pay an annual nonrefundable license fee of $4,400.
Sec. 13. Minnesota Statutes 2008, section 245A.10, is
amended by adding a subdivision to read:
Subd. 4j.
License fee for programs
licensed to provide drug or chemical dependency treatment. (a) A program licensed under Minnesota
Rules, parts 9530.6405 to 9530.6505 or 9530.6510 to 9530.6590, to provide drug
or chemical dependency treatment shall pay an annual nonrefundable license fee
based on the following schedule:
License
Fee Fiscal
License
Fee Fiscal Year
2011 and
Licensed
Capacity Year
2010 thereafter
1 to
24 persons $755 $1,035
25
to 49 persons $955 $1,235
50
to 74 persons $1,155 $1,435
75
to 99 persons $1,355 $1,635
100
to 124 persons $1,555 $1,835
125
or more persons $1,755 $2,035
(b) In fiscal year 2010, if a license
issued to a program under Minnesota Rules, parts 9530.6405 to 9530.6505, does
not have a stated licensed capacity, the drug or chemical dependency treatment
program shall pay an annual nonrefundable license fee based on a licensed
capacity of one to 24 persons for fiscal year 2010.
(c) In fiscal year 2011 and
thereafter, if a license issued to a program under Minnesota Rules, parts
9530.6405 to 9530.6505, does not have a stated licensed capacity, the drug or
chemical dependency treatment program shall pay an annual nonrefundable license
fee based on a licensed capacity of one to 24 persons for fiscal year 2011 and
thereafter.
Sec. 14. Minnesota Statutes 2008, section 245A.10, is
amended by adding a subdivision to read:
Subd. 4k.
License fee for independent
living assistance for youth. A
program licensed to provide independent living assistance for youth under
section 245A.22, shall pay an annual nonrefundable license fee of $2,000.
Sec. 15. Minnesota Statutes 2008, section 245A.10, is
amended by adding a subdivision to read:
Subd. 4l.
License fee for private
agencies that provide child foster care or adoption services. A private agency licensed under Minnesota
Rules, parts 9545.0755 to 9545.0845, to provide child foster care or adoption
services shall pay an annual nonrefundable license fee of $400.
Sec. 16. Minnesota Statutes 2008, section 245A.10,
subdivision 5, is amended to read:
Subd. 5. License
or Mental health center or mental health clinic certification fee for
other programs. (a) Except as
provided in paragraphs (b) and (c), a program without a stated licensed
capacity shall pay a license or certification fee of $400.
(b) A mental health center or mental health clinic
requesting certification for purposes of insurance and subscriber contract
reimbursement under Minnesota Rules, parts 9520.0750 to 9520.0870, shall pay a
certification fee of $1,000 per year. If
the mental health center or mental health clinic provides services at a primary
location with satellite facilities, the satellite facilities shall be certified
with the primary location without an additional charge.
(c) A program licensed to provide
residential-based habilitation services under the home and community-based
waiver for persons with developmental disabilities shall pay an annual license
fee that includes a base rate of $250 plus $38 times the number of clients
served on the first day of August of the current license year. State-operated programs are exempt from the
license fee under this paragraph.
Sec. 17. Minnesota Statutes 2008, section 245A.10, is
amended by adding a subdivision to read:
Subd. 7.
Human services licensing
revenue and appropriations. Effective
July 1, 2011:
(1) departmental earnings collected
under subdivisions 3, 4 to 4l, and 5 shall be deposited in the state government
special revenue fund; and
(2) the direct appropriation to the
department for licensing activities in subdivisions 3, 4 to 4l, and 5 shall be
transferred from the general fund to the state government special revenue fund.
Sec. 18. Minnesota Statutes 2008, section 245A.11,
subdivision 2a, is amended to read:
Subd. 2a. Adult
foster care license capacity. The
commissioner shall issue adult foster care licenses with a maximum licensed
capacity of four beds, including nonstaff roomers and boarders, except that the
commissioner may issue a license with a capacity of five beds, including
roomers and boarders, according to paragraphs (a) to (e).
(a) An adult foster care license
holder may have a maximum license capacity of five if all persons in care are
age 55 or over and do not have a serious and persistent mental illness or a
developmental disability.
(b) The commissioner may grant
variances to paragraph (a) to allow a foster care provider with a licensed
capacity of five persons to admit an individual under the age of 55 if the
variance complies with section 245A.04, subdivision 9, and approval of the
variance is recommended by the county in which the licensed foster care
provider is located.
(c) The commissioner may grant
variances to paragraph (a) to allow the use of a fifth bed for emergency crisis
services for a person with serious and persistent mental illness or a
developmental disability, regardless of age, if the variance complies with
section 245A.04, subdivision 9, and approval of the variance is recommended by
the county in which the licensed foster care provider is located.
(d) Notwithstanding paragraph (a),
If the 2009 legislature adopts a rate reduction that impacts providers of
adult foster care services, the commissioner may issue an adult foster care
license with a capacity of five adults if the fifth bed does not increase
the overall statewide capacity of licensed adult foster care beds in homes that
are not the primary residence of the license holder, over the licensed capacity
in such homes on July 1, 2009, as identified in a plan submitted to the
commissioner by the county, when the capacity is recommended by the county
licensing agency of the county in which the facility is located and if the
recommendation verifies that:
(1) the facility meets the physical
environment requirements in the adult foster care licensing rule;
(2) the five-bed living arrangement
is specified for each resident in the resident's:
(i) individualized plan of care;
(ii) individual service plan under
section 256B.092, subdivision 1b, if required; or
(iii) individual resident placement
agreement under Minnesota Rules, part 9555.5105, subpart 19, if required;
(3) the license holder obtains
written and signed informed consent from each resident or resident's legal
representative documenting the resident's informed choice to living in the home
and that the resident's refusal to consent would not have resulted in service
termination; and
(4) the facility was licensed for
adult foster care before March 1, 2003 2009.
(e) The commissioner shall not issue
a new adult foster care license under paragraph (d) after June 30, 2005
2011. The commissioner shall allow a
facility with an adult foster care license issued under paragraph (d) before
June 30, 2005 2011, to continue with a capacity of five adults if
the license holder continues to comply with the requirements in paragraph (d).
EFFECTIVE DATE. This section is
effective July 1, 2009.
Sec. 19. Minnesota Statutes 2008, section 245A.11, is
amended by adding a subdivision to read:
Subd. 8.
Alternate overnight
supervision technology; adult foster care license. (a) The commissioner may grant an
applicant or license holder an adult foster care license for a residence that
does not have a caregiver in the residence during normal sleeping hours as
required under Minnesota Rules, part 9555.5105, subpart 37, item B, but uses
monitoring technology to alert the license holder when an incident occurs that
may jeopardize the health, safety, or rights of a foster care recipient. The applicant or license holder must comply
with all other requirements under Minnesota Rules, parts 9555.5105 to
9555.6265, and the requirements under this subdivision. The license printed by the commissioner must
state in bold and large font:
(1) that staff are not present
on-site overnight; and
(2) the telephone number of the
county's common entry point for making reports of suspected maltreatment of
vulnerable adults under section 626.557, subdivision 9.
(b) Applications for a license under
this section must be submitted directly to the Department of Human Services
licensing division. The licensing
division must immediately notify the host county and lead county contract
agency and the host county licensing agency.
The licensing division must collaborate with the county licensing agency
in the review of the application and the licensing of the program.
(c) Before a license is issued by the
commissioner, and for the duration of the license, the applicant or license
holder must establish, maintain, and document the implementation of written
policies and procedures addressing the requirements in paragraphs (d) to (f).
(d) The applicant or license holder
must have policies and procedures that:
(1) establish characteristics of
target populations that will be admitted into the home and characteristics of
populations that will not be accepted into the home;
(2) explain the discharge process
when a foster care recipient requires overnight supervision or other services
that cannot be provided by the license holder due to the limited hours that the
license holder is on-site;
(3) describe the types of events to
which the program will respond with a physical presence when those events occur
in the home during time when staff are not on-site, and how the license
holder's response plan meets the requirements in paragraph (e), clause (1) or
(2);
(4) establish a process for
documenting a review of the implementation and effectiveness of the response
protocol for the response required under paragraph (e), clause (1) or (2). The documentation must include:
(i) a description of the triggering
incident;
(ii) the date and time of the
triggering incident;
(iii) the time of the response or
responses under paragraph (e), clause (1) or (2);
(iv) whether the response met the
resident's needs;
(v) whether the existing policies and
response protocols were followed; and
(vi) whether the existing policies and
protocols are adequate or need modification.
When no physical presence response is
completed for a three-month period, the license holder's written policies and
procedures must require a physical presence response drill be to conducted for
which the effectiveness of the response protocol under paragraph (e), clause
(1) or (2), will be reviewed and documented as required under this clause; and
(5) establish that emergency and
nonemergency phone numbers are posted in a prominent location in a common area
of the home where they can be easily observed by a person responding to an
incident who is not otherwise affiliated with the home.
(e) The license holder must document
and include in the license application which response alternative under clause
(1) or (2) is in place for responding to situations that present a serious risk
to the health, safety, or rights of people receiving foster care services in
the home:
(1) response alternative (1) requires
only the technology to provide an electronic notification or alert to the
license holder that an event is underway that requires a response. Under this alternative, no more than ten
minutes will pass before the license holder will be physically present on-site
to respond to the situation; or
(2) response alternative (2) requires
the electronic notification and alert system under alternative (1), but more
than ten minutes may pass before the license holder is present on-site to
respond to the situation. Under
alternative (2), all of the following conditions are met:
(i) the license holder has a written
description of the interactive technological applications that will assist the
licenser holder in communicating with and assessing the needs related to care,
health, and safety of the foster care recipients. This interactive technology must permit the
license holder to remotely assess the well being of the foster care recipient
without requiring the initiation or participation by the foster care recipient. Requiring the foster care recipient to
initiate a telephone call or answer a telephone call does not meet this
requirement;
(ii) the license holder documents how
the remote license holder is qualified and capable of meeting the needs of the
foster care recipients and assessing foster care recipients' needs under item
(i), during the absence of the license holder on-site;
(iii) the license holder maintains
written procedures to dispatch emergency response personnel to the site in the
event of an identified emergency; and
(iv) each foster care recipient's
individualized plan of care, individual service plan under section 256B.092,
subdivision 1b, if required, or individual resident placement agreement under
Minnesota Rules, part 9555.5105, subpart 19, if required, identifies the maximum
response time, which may be greater than ten minutes, for the license holder to
be on-site for that foster care recipient.
(f) All placement agreements,
individual service agreements, and plans applicable to the foster care
recipient must clearly state that the adult foster care license category is a
program without the presence of a caregiver in the residence during normal
sleeping hours; the protocols in place for responding to situations that
present a serious risk to health, safety, or rights of foster care recipients
under paragraph (e), clause (1) or (2); and a signed informed consent from each
foster care recipient or the person's legal representative documenting the
person's or legal representative's agreement with placement in the program. If electronic monitoring technology is used
in the home, the informed consent form must also explain the following:
(1) how any electronic monitoring is
incorporated into the alternative supervision system;
(2) the backup system for any
electronic monitoring in times of electrical outages or other equipment
malfunctions;
(3) how the license holder is trained
on the use of the technology;
(4) the event types and license holder
response times established under paragraph (e);
(5) how the license holder protects the
foster care recipient's privacy related to electronic monitoring and related to
any electronically recorded data generated by the monitoring system. The consent form must explain where and how
the electronically recorded data is stored, with whom it will be shared, and
how long it is retained; and
(6) the risks and benefits of the
alternative overnight supervision system.
The written explanations under clauses
(1) to (6) may be accomplished through cross-references to other policies and
procedures as long as they are explained to the person giving consent, and the
person giving consent is offered a copy.
(g) Nothing in this section requires
the applicant or license holder to develop or maintain separate or duplicative
policies, procedures, documentation, consent forms, or individual plans that
may be required for other licensing standards, if the requirements of this
section are incorporated into those documents.
(h) The commissioner may grant
variances to the requirements of this section according to section 245A.04,
subdivision 9.
(i) For the purposes of paragraphs (c)
to (h), "license holder" has the meaning under section 245A.02,
subdivision 9, and additionally includes all staff, volunteers, and contractors
affiliated with the license holder.
Sec. 20. Minnesota Statutes 2008, 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, and family child 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;
(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
information about disqualification reconsiderations under sections 245C.25 and
245C.27, subdivision 2, 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.
(c) For family day care programs, the
commissioner may authorize licensing reviews every two years after a licensee
has had at least one annual review.
(d) For family adult day services
programs, the commissioner may authorize licensing reviews every two years after
a licensee has had at least one annual review.
(e) A license issued under this
section may be issued for up to two years.
Sec. 21. Minnesota Statutes 2008, section 245A.16,
subdivision 3, is amended to read:
Subd. 3. Recommendations
to 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, and family child care, a background study of
the applicant 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.
Sec. 22. Minnesota Statutes 2008, 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 adult foster care,
family adult day services, and family child 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 July 1, 2007, to June 30,
2009, the commissioner of human services shall conduct a study of an individual
required to be studied under section 245C.03, at the time of reapplication for
a child foster care license. The county
or private agency shall collect and forward to the commissioner the information
required under section 245C.05, subdivisions 1, paragraphs (a) and (b), and 5,
paragraphs (a) and (b). The background
study conducted by the commissioner of human services under this paragraph must
include a review of the information required under section 245C.08,
subdivisions 1, paragraph (a), clauses (1) to (5), 3, and 4.
(e) The commissioner of human
services shall conduct a background study of an individual specified under
section 245C.03, subdivision 1, paragraph (a), clauses (2) to (6), who is newly
affiliated with a child foster care license holder. The county or private agency shall collect
and forward to the commissioner the information required under section 245C.05,
subdivisions 1 and 5. The background
study conducted by the commissioner of human services under this paragraph must
include a review of the information required under section 245C.08,
subdivisions 1, 3, and 4.
(f) From January 1, 2010, to
December 31, 2012, unless otherwise specified in paragraph (c), the
commissioner shall conduct a study of an individual required to be studied
under section 245C.03 at the time of reapplication for an adult foster care
license. The county shall collect and
forward to the commissioner the information required under section 245C.05,
subdivision 1, paragraphs (a) and (b), and subdivision 5, paragraphs (a) and
(b). The background study conducted by
the commissioner under this paragraph must include a review of the information
required under section 245C.08, subdivision 1, paragraph (a), clauses (1) to
(5), and subdivisions 3 and 4.
(g) 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 an adult
foster care license holder. The county
shall collect and forward to the commissioner the information required under
section 245C.05, subdivision 1, paragraphs (a) and (b), and subdivision 5,
paragraphs (a) and (b). The background
study conducted by the commissioner under this paragraph must include a review
of the information required under section 245C.08, subdivision 1, paragraph
(a), and subdivisions 3 and 4.
(h) 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.
(g) (i) For purposes of this section, a
physician licensed under chapter 147 is considered to be continuously
affiliated upon the license holder's receipt from the commissioner of health or
human services of the physician's background study results.
Sec. 23. Minnesota Statutes 2008, 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;
(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 child foster care; and
(4) background study results to
county agencies for background studies conducted by the commissioner for adult
foster care.
Sec. 24. Minnesota Statutes 2008, section 245C.08,
subdivision 2, is amended to read:
Subd. 2. Background
studies conducted by a county agency.
(a) For a background study conducted by a county agency for adult
foster care, family adult day services, and family child care
services, 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); and
(3) information from the Bureau of
Criminal Apprehension.
(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 agency may consider information obtained under paragraph (a),
clause (3), unless the commissioner received notice of the petition for
expungement and the court order for expungement is directed specifically to the
commissioner.
Sec. 25. Minnesota Statutes 2008, section 245C.10, is
amended by adding a subdivision to read:
Subd. 5.
Adult foster care services. The commissioner shall recover the cost of
background studies required under section 245C.03, subdivision 1, for the
purposes of adult foster care licensing, through a fee of no more than $20 per
study charged to the license holder. The
fees collected under this subdivision are appropriated to the commissioner for
the purpose of conducting background studies.
Sec. 26. Minnesota Statutes 2008, section 245C.10, is
amended by adding a subdivision to read:
Subd. 8.
Private agencies. The commissioner shall recover the cost of
conducting background studies under section 245C.33 for studies initiated by
private agencies for the purpose of adoption through a fee of no more than $70
per study charged to the private agency.
The fees collected under this subdivision are appropriated to the
commissioner for the purpose of conducting background studies.
Sec. 27. Minnesota Statutes 2008, section 245C.17, is
amended by adding a subdivision to read:
Subd. 6.
Notice to county agency. For studies on individuals related to a
license to provide adult foster care, the commissioner shall also provide a
notice of the background study results to the county agency that initiated the
background study.
Sec. 28. Minnesota Statutes 2008, section 245C.20, is
amended to read:
245C.20 LICENSE HOLDER RECORD KEEPING.
A licensed program shall document the
date the program initiates a background study under this chapter in the
program's personnel files. When a
background study is completed under this chapter, a licensed program shall
maintain a notice that the study was undertaken and completed in the program's
personnel files. Except when
background studies are initiated through the commissioner's online system, if
a licensed program has not received a response from the commissioner under
section 245C.17 within 45 days of initiation of the background study request,
the licensed program must contact the commissioner human services
licensing division to inquire about the status of
the study. If a license holder initiates a background
study under the commissioner's online system, but the background study
subject's name does not appear in the list of active or recent studies
initiated by that license holder, the license holder must either contact the
human services licensing division or resubmit the background study information
online for that individual.
Sec. 29. Minnesota Statutes 2008, section 245C.21,
subdivision 1a, is amended to read:
Subd. 1a. Submission
of reconsideration request to county or private agency. (a) For disqualifications related to studies
conducted by county agencies for family child care and family adult day
services, and for disqualifications related to studies conducted by the
commissioner for child foster care and adult foster care, the individual
shall submit the request for reconsideration to the county or private
agency that initiated the background study.
(b) For disqualifications related
to studies conducted by the commissioner for child foster care, the individual
shall submit the request for reconsideration to the private agency that
initiated the background study.
(c) A reconsideration request shall be
submitted within 30 days of the individual's receipt of the disqualification notice
or the time frames specified in subdivision 2, whichever time frame is shorter.
(c) (d) 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. 30. Minnesota Statutes 2008, 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
child foster care, the commissioner shall also notify the county or private
agency that initiated the study of the results of the reconsideration.
(d) For background studies related to
adult foster care, the commissioner shall also notify the county that initiated
the study of the results of the reconsideration.
Sec. 31. Minnesota Statutes 2008, section 256B.092, is
amended by adding a subdivision to read:
Subd. 5b.
Revised per diem based on
legislated rate reduction. Notwithstanding
section 252.28, subdivision 3, paragraph (d), if the 2009 legislature adopts a
rate reduction that impacts payment to providers of adult foster care services,
the commissioner may issue adult foster care licenses that permit a capacity of
five adults. The application for a
five-bed license must meet the requirements of section 245A.11, subdivision
2a. Prior to admission of the fifth
recipient of adult foster care services, the county must negotiate a revised
per diem rate for room and board and waiver services that reflects the
legislated rate reduction and results in an overall average per diem reduction
for all foster care recipients in that home.
The revised per diem must allow the provider to maintain, as much as
possible, the level of services or enhanced services provided in the residence,
while mitigating the losses of the legislated rate reduction.
EFFECTIVE DATE. This section is
effective July 1, 2009.
Sec. 32. Minnesota Statutes 2008, section 256B.49,
subdivision 17, is amended to read:
Subd. 17. Cost
of services and supports. (a) The
commissioner shall ensure that the average per capita expenditures estimated in
any fiscal year for home and community-based waiver recipients does not exceed
the average per capita expenditures that would have been made to provide
institutional services for recipients in the absence of the waiver.
(b) The commissioner shall implement
on January 1, 2002, one or more aggregate, need-based methods for allocating to
local agencies the home and community-based waivered service resources
available to support recipients with disabilities in need of the level of care
provided in a nursing facility or a hospital.
The commissioner shall allocate resources to single counties and county
partnerships in a manner that reflects consideration of:
(1) an incentive-based payment process
for achieving outcomes;
(2) the need for a state-level risk
pool;
(3) the need for retention of
management responsibility at the state agency level; and
(4) a phase-in strategy as
appropriate.
(c) Until the allocation methods
described in paragraph (b) are implemented, the annual allowable reimbursement
level of home and community-based waiver services shall be the greater of:
(1) the statewide average payment
amount which the recipient is assigned under the waiver reimbursement system in
place on June 30, 2001, modified by the percentage of any provider rate
increase appropriated for home and community-based services; or
(2) an amount approved by the
commissioner based on the recipient's extraordinary needs that cannot be met
within the current allowable reimbursement level. The increased reimbursement level must be
necessary to allow the recipient to be discharged from an institution or to
prevent imminent placement in an institution.
The additional reimbursement may be used to secure environmental
modifications; assistive technology and equipment; and increased costs for
supervision, training, and support services necessary to address the
recipient's extraordinary needs. The
commissioner may approve an increased reimbursement level for up to one year of
the recipient's relocation from an institution or up to six months of a
determination that a current waiver recipient is at imminent risk of being
placed in an institution.
(d) Beginning July 1, 2001, medically
necessary private duty nursing services will be authorized under this section
as complex and regular care according to sections 256B.0651 and 256B.0653 to
256B.0656. The rate established by the
commissioner for registered nurse or licensed practical nurse services under
any home and community-based waiver as of January 1, 2001, shall not be
reduced.
(e) Notwithstanding section 252.28,
subdivision 3, paragraph (d), if the 2009 legislature adopts a rate reduction
that impacts payment to providers of adult foster care services, the
commissioner may issue adult foster care licenses that permit a capacity of
five adults. The application for a
five-bed license must meet the requirements of section 245A.11, subdivision
2a. Prior to admission of the fifth
recipient of adult foster care services, the county must negotiate a revised
per diem rate for room and board and waiver services that reflects the
legislated rate reduction and results in an overall average per diem reduction
for all foster care recipients in that home.
The revised per diem must allow the provider to maintain, as much as
possible, the level of services or enhanced services provided in the residence,
while mitigating the losses of the legislated rate reduction.
EFFECTIVE DATE. This section is
effective July 1, 2009.
Sec. 33. WAIVER.
By December 1, 2009, the commissioner
shall request all federal approvals and waiver amendments to the disability
home and community-based waivers to allow properly licensed adult foster care
homes to provide residential services for up to five individuals.
EFFECTIVE DATE. This section is
effective July 1, 2009.
Sec. 34. REPEALER.
(a) Minnesota Statutes 2008, section
256B.092, subdivision 5a, is repealed effective July 1, 2009.
(b) Minnesota Rules, part 9555.6125,
subpart 4, item B, is repealed.
ARTICLE 2
MFIP, CHILDREN, AND ADULT SUPPORTS
Section 1. Minnesota Statutes 2008, section 256D.051,
subdivision 2a, is amended to read:
Subd. 2a. Duties
of commissioner. In addition to any
other duties imposed by law, the commissioner shall:
(1) based on this section and section
256D.052 and Code of Federal Regulations, title 7, section 273.7, supervise the
administration of food stamp employment and training services to county
agencies;
(2) disburse money appropriated for
food stamp employment and training services to county agencies based upon the
county's costs as specified in section 256D.051, subdivision 6c;
(3) accept and supervise the
disbursement of any funds that may be provided by the federal government or
from other sources for use in this state for food stamp employment and training
services;
(4) apply for the maximum allowable
federal matching funds under United States Code, title 7, section 2025,
paragraph (h), for state expenditures made on behalf of family stabilization
services participants voluntarily engaged in food stamp employment and training
activities, where appropriate;
(5) cooperate with other agencies including any agency of
the United States or of another state in all matters concerning the powers and
duties of the commissioner under this section and section 256D.052; and
(5) (6) in cooperation with the commissioner of employment and
economic development, ensure that each component of an employment and training
program carried out under this section is delivered through a statewide
workforce development system, unless the component is not available locally
through such a system.
Sec. 2. Minnesota Statutes 2008, section 256D.0515,
is amended to read:
256D.0515 ASSET LIMITATIONS FOR FOOD STAMP HOUSEHOLDS.
All food stamp households must be
determined eligible for the benefit discussed under section 256.029. Food stamp households must demonstrate that:
(1) their gross income meets the federal Food Stamp
requirements under United States Code, title 7, section 2014(c); and
(2) they have financial resources,
excluding vehicles, of less than $7,000.
Sec. 3. Minnesota Statutes 2008, section 256D.06,
subdivision 2, is amended to read:
Subd. 2. Emergency
need. (a) Notwithstanding the
provisions of subdivision 1, a grant of emergency general assistance shall, to
the extent funds are available, be made to an eligible single adult, married
couple, or family for an emergency need, as defined in rules promulgated by
the commissioner, where the recipient requests temporary assistance not
exceeding 30 days if an emergency situation appears to exist under criteria
adopted by the county agency and the individual or family is ineligible for
MFIP or DWP or is not a participant of MFIP or DWP and whose annual net
income is no greater than 200 percent of the federal poverty level for the
previous calendar year. If an
applicant or recipient relates facts to the county agency which may be
sufficient to constitute an emergency situation, the county agency shall, to
the extent funds are available, advise the person of the procedure for applying
for assistance according to this subdivision.
An emergency general assistance grant is available to a recipient not
more than once in any 12-month period.
(b) Funding for an emergency general
assistance program is limited to the appropriation. Each fiscal year, the commissioner shall
allocate to counties the money appropriated for emergency general assistance
grants based on each county agency's average share of state's emergency general
expenditures for the immediate past three fiscal years as determined by the
commissioner, and may reallocate any unspent amounts to other counties.
(c) No county shall be allocated less
than $1,000 for the fiscal year.
(d) Should an emergency be declared
as provided in section 12.31, the commissioner may immediately reallocate
unspent funds without regard to the other provisions of this section to meet
the emergency needs. The emergency
reallocation must be excluded from calculations for subsequent allocations as
provided in paragraphs (b) and (c).
(e) Any emergency general assistance expenditures by a
county above the amount of the commissioner's allocation to the county must be
made from county funds.
Sec. 4. Minnesota Statutes 2008, section 256D.09,
subdivision 6, is amended to read:
Subd. 6. Recovery
of overpayments. (a) If an amount of
general assistance or family general assistance is paid to a recipient in
excess of the payment due, it shall be recoverable by the county agency. The agency shall give written notice to the
recipient of its intention to recover the overpayment.
(b) Except as provided for interim
assistance in section 256D.06, subdivision 5, when an overpayment occurs,
the county agency shall recover the overpayment from a current recipient by
reducing the amount of aid payable to the assistance unit of which the
recipient is a member, for one or more monthly assistance payments, until the
overpayment is repaid. All county
agencies in the state shall reduce the assistance payment by three percent of
the assistance unit's standard of need in nonfraud cases and ten percent where
fraud has occurred, or the amount of the monthly payment, whichever is less,
for all overpayments.
(c) In cases when there is both an
overpayment and underpayment, the county agency shall offset one against the
other in correcting the payment.
(d) Overpayments may also be
voluntarily repaid, in part or in full, by the individual, in addition to the
aid reductions provided in this subdivision, to include further voluntary
reductions in the grant level agreed to in writing by the individual, until the
total amount of the overpayment is repaid.
(e) The county agency shall make
reasonable efforts to recover overpayments to persons no longer on assistance
under standards adopted in rule by the commissioner of human services. The county agency need not attempt to recover
overpayments of less than $35 paid to an individual no longer on assistance if
the individual does not receive assistance again within three years, unless the
individual has been convicted of violating section 256.98.
(f) Establishment of an overpayment is
limited to 12 months prior to the month of discovery due to an agency error and
six years prior to the month of discovery due to a client error or an
intentional program violation determined under section 256.046.
Sec. 5. Minnesota Statutes 2008, section 256D.49,
subdivision 3, is amended to read:
Subd. 3. Overpayment
of monthly grants and recovery of ATM errors. (a) When the county agency determines
that an overpayment of the recipient's monthly payment of Minnesota
supplemental aid has occurred, it shall issue a notice of overpayment to the
recipient. If the person is no longer
receiving Minnesota supplemental aid, the county agency may request voluntary
repayment or pursue civil recovery. If
the person is receiving Minnesota supplemental aid, the county agency shall
recover the overpayment by withholding an amount equal to three percent of the
standard of assistance for the recipient or the total amount of the monthly
grant, whichever is less.
(b) Establishment of an overpayment is
limited to 12 months prior to the month of discovery due to an agency error and
six years prior to the month of discovery due to a client error or an
intentional program violation determined under section 256.046.
(c) For recipients receiving benefits via electronic
benefit transfer, if the overpayment is a result of an automated teller machine
(ATM) dispensing funds in error to the recipient, the agency may recover the
ATM error by immediately withdrawing funds from the recipient's electronic
benefit transfer account, up to the amount of the error.
(d) Residents of nursing homes, regional treatment
centers, and licensed residential facilities with negotiated
rates shall not have overpayments recovered from their personal needs
allowance.
Sec. 6. Minnesota Statutes 2008, section 256I.03, subdivision
7, is amended to read:
Subd. 7. Countable
income. "Countable income"
means all income received by an applicant or recipient less any applicable
exclusions or disregards. For a
recipient of any cash benefit from the SSI program, countable income means the
SSI benefit limit in effect at the time the person is in a GRH setting less
$20, less the medical assistance personal needs allowance. If the SSI limit has been reduced for a
person due to events occurring prior to the persons entering the GRH setting,
countable income means actual income less any applicable exclusions and
disregards.
EFFECTIVE DATE. This section is
effective April 1, 2010.
Sec. 7. Minnesota Statutes 2008, section 256I.05,
subdivision 7c, is amended to read:
Subd. 7c. Demonstration
project. The commissioner is
authorized to pursue the expansion of a demonstration project under
federal food stamp regulation for the purpose of gaining additional
federal reimbursement of food and nutritional costs currently paid by the state
group residential housing program. The
commissioner shall seek approval no later than January 1, 2004
October 1, 2009. Any reimbursement
received is nondedicated revenue to the general fund.
Sec. 8. Minnesota Statutes 2008, section 256J.20,
subdivision 3, is amended to read:
Subd. 3. Other
property limitations. To be eligible
for MFIP, the equity value of all nonexcluded real and personal property of the
assistance unit must not exceed $2,000 for applicants and $5,000 for ongoing
participants. The value of assets in
clauses (1) to (19) must be excluded when determining the equity value of real
and personal property:
(1) a licensed vehicle up to a loan
value of less than or equal to $15,000 $7,500. If the assistance unit owns more than one
licensed vehicle, the county agency shall determine the loan value of all
additional vehicles and exclude the combined loan value of less than or equal
to $7,500. The county agency shall
apply any excess loan value as if it were equity value to the asset limit described
in this section,. If the
assistance unit owns more than one licensed vehicle, the county agency shall
determine the vehicle with the highest loan value and count only the loan value
over $7,500, excluding: (i) the value of one vehicle per physically
disabled person when the vehicle is needed to transport the disabled
unit member; this exclusion does not apply to mentally disabled people; (ii)
the value of special equipment for a disabled member of the assistance unit;
and (iii) any vehicle used for long-distance travel, other than daily
commuting, for the employment of a unit member.
The county agency shall count the loan
value of all other vehicles and apply this amount as if it were equity value to
the asset limit described in this section.
To establish
the loan value of vehicles, a county agency must use the N.A.D.A. Official Used
Car Guide, Midwest Edition, for newer model cars. When a vehicle is not listed in the
guidebook, or when the applicant or participant disputes the loan value listed
in the guidebook as unreasonable given the condition of the particular vehicle,
the county agency may require the applicant or participant document the loan
value by securing a written statement from a motor vehicle dealer licensed
under section 168.27, stating the amount that the dealer would pay to purchase
the vehicle. The county agency shall
reimburse the applicant or participant for the cost of a written statement that
documents a lower loan value;
(2) the value of life insurance
policies for members of the assistance unit;
(3) one burial plot per member of an
assistance unit;
(4) the value of personal property
needed to produce earned income, including tools, implements, farm animals,
inventory, business loans, business checking and savings accounts used at least
annually and used exclusively for the operation of a self-employment business,
and any motor vehicles if at least 50 percent of the vehicle's use is to
produce income and if the vehicles are essential for the self-employment business;
(5) the value of personal property not
otherwise specified which is commonly used by household members in day-to-day
living such as clothing, necessary household furniture, equipment, and other
basic maintenance items essential for daily living;
(6) the value of real and personal
property owned by a recipient of Supplemental Security Income or Minnesota
supplemental aid;
(7) the value of corrective payments,
but only for the month in which the payment is received and for the following
month;
(8) a mobile home or other vehicle
used by an applicant or participant as the applicant's or participant's home;
(9) money in a separate escrow account
that is needed to pay real estate taxes or insurance and that is used for this
purpose;
(10) money held in escrow to cover
employee FICA, employee tax withholding, sales tax withholding, employee worker
compensation, business insurance, property rental, property taxes, and other
costs that are paid at least annually, but less often than monthly;
(11) monthly assistance payments for
the current month's or short-term emergency needs under section 256J.626,
subdivision 2;
(12) the value of school loans,
grants, or scholarships for the period they are intended to cover;
(13) payments listed in section
256J.21, subdivision 2, clause (9), which are held in escrow for a period not
to exceed three months to replace or repair personal or real property;
(14) income received in a budget month
through the end of the payment month;
(15) savings from earned income of a
minor child or a minor parent that are set aside in a separate account
designated specifically for future education or employment costs;
(16) the federal earned income credit,
Minnesota working family credit, state and federal income tax refunds, state
homeowners and renters credits under chapter 290A, property tax rebates and
other federal or state tax rebates in the month received and the following
month;
(17) payments excluded under federal
law as long as those payments are held in a separate account from any
nonexcluded funds;
(18) the assets of children ineligible
to receive MFIP benefits because foster care or adoption assistance payments
are made on their behalf; and
(19) the assets of persons whose
income is excluded under section 256J.21, subdivision 2, clause (43).
EFFECTIVE DATE. This section is
effective March 1, 2010.
Sec. 9. Minnesota Statutes 2008, section 256J.24,
subdivision 5a, is amended to read:
Subd. 5a. Food
portion of MFIP transitional standard.
The commissioner shall adjust the food portion of the MFIP transitional
standard by October 1 each year beginning October 1998 as needed
to reflect the cost-of-living adjustments to the food Stamp
support program. The commissioner
shall annually publish in the State Register the transitional
standard for an assistance unit of sizes one to ten in the State Register
whenever an adjustment is made.
EFFECTIVE DATE. This section is
effective October 1, 2009.
Sec. 10. Minnesota Statutes 2008, section 256J.24,
subdivision 10, is amended to read:
Subd. 10. MFIP
exit level. The commissioner shall
adjust the MFIP earned income disregard to ensure that most participants do not
lose eligibility for MFIP until their income reaches at least 115 110
percent of the federal poverty guidelines in effect in October of each
fiscal year at the time of the adjustment. The adjustment to the disregard shall be
based on a household size of three, and the resulting earned income disregard
percentage must be applied to all household sizes. The adjustment under this subdivision must be
implemented at the same time as the October food stamp or whenever
there is a food support cost-of-living adjustment is
reflected in the food portion of MFIP transitional standard as required under
subdivision 5a.
EFFECTIVE DATE. This section is
effective October 1, 2010.
Sec. 11. Minnesota Statutes 2008, section 256J.37,
subdivision 3a, is amended to read:
Subd. 3a. Rental
subsidies; unearned income. (a) Effective
July 1, 2003, The county agency shall count $50 $100 of the
value of public and assisted rental subsidies provided through the Department
of Housing and Urban Development (HUD) as unearned income to the cash portion
of the MFIP grant. The full amount of
the subsidy must be counted as unearned income when the subsidy is less than $50
$100. The income from this subsidy
shall be budgeted according to section 256J.34.
(b) The provisions of this
subdivision shall not apply to an MFIP assistance unit which includes a
participant who is:
(1) age 60 or older;
(2) a caregiver who is suffering from
an illness, injury, or incapacity that has been certified by a qualified
professional when the illness, injury, or incapacity is expected to continue
for more than 30 days and prevents the person from obtaining or retaining
employment; or
(3) a caregiver whose presence in the
home is required due to the illness or incapacity of another member in the
assistance unit, a relative in the household, or a foster child in the
household when the illness or incapacity and the need for the participant's
presence in the home has been certified by a qualified professional and is
expected to continue for more than 30 days.
(c) The provisions of this
subdivision shall not apply to an MFIP assistance unit where the parental
caregiver is an SSI recipient.
(d) Prior to implementing this
provision, the commissioner must identify the MFIP participants subject to this
provision and provide written notice to these participants at least 30 days
before the first grant reduction. The
notice must inform the participant of the basis for the potential grant
reduction, the exceptions to the provision, if any, and inform the participant
of the steps necessary to claim an exception.
A person who is found not to meet one of the exceptions to the provision
must be notified and informed of the right to a fair hearing under section
256J.40. The notice must also inform the
participant that the participant may be eligible for a rent reduction resulting
from a reduction in the MFIP grant and encourage the participant to contact the
local housing authority.
EFFECTIVE DATE. This section is
effective October 1, 2010.
Sec. 12. Minnesota Statutes 2008, section 256J.37, is
amended by adding a subdivision to read:
Subd. 11.
Treatment of Supplemental Security
Income. Effective March 1,
2010, the county shall reduce the cash portion of the MFIP grant by up to $125
for an MFIP assistance unit that includes one or more Supplemental Security
Income (SSI) recipients who reside in the household, and who would otherwise be
included in the MFIP assistance unit under section 256J.24, subdivision 2, but
are excluded solely due to the SSI recipient status under section 256J.24,
subdivision 3, paragraph (a), clause (1).
If the SSI recipient or recipients receive less than $125 of SSI, only
the amount received must be used in calculating the MFIP cash assistance
payment. This provision does not apply
to relative caregivers who could elect to be included in the MFIP assistance
unit under section 256J.24, subdivision 4, unless the caregiver's children or
stepchildren are included in the MFIP assistance unit.
EFFECTIVE DATE. This section is
effective October 1, 2010.
Sec. 13. Minnesota Statutes 2008, section 256J.38,
subdivision 1, is amended to read:
Subdivision 1. Scope
of overpayment. (a) When a
participant or former participant receives an overpayment due to agency,
client, or ATM error, or due to assistance received while an appeal is pending
and the participant or former participant is determined ineligible for
assistance or for less assistance than was received, the county agency must
recoup or recover the overpayment using the following methods:
(1) reconstruct each affected budget
month and corresponding payment month;
(2) use the policies and procedures
that were in effect for the payment month; and
(3) do not allow employment disregards
in section 256J.21, subdivision 3 or 4, in the calculation of the overpayment
when the unit has not reported within two calendar months following the end of
the month in which the income was received.
(b) Establishment of an overpayment is
limited to 12 months prior to the month of discovery due to agency error and
six years prior to the month of discovery due to client error or an intentional
program violation determined under section 256.046.
Sec. 14. Minnesota Statutes 2008, section 256J.575,
subdivision 3, is amended to read:
Subd. 3. Eligibility. (a) The following MFIP or diversionary
work program (DWP) participants are eligible for the services under this section:
(1) a participant who meets the
requirements for or has been granted a hardship extension under section
256J.425, subdivision 2 or 3, except that it is not necessary for the
participant to have reached or be approaching 60 months of eligibility for this
section to apply;
(2) a participant who is applying for
Supplemental Security Income or Social Security disability insurance; and
(3) a participant who is a noncitizen
who has been in the United States for 12 or fewer months.
(b) Families must meet all other
eligibility requirements for MFIP established in this chapter. Families are eligible for financial
assistance to the same extent as if they were participating in MFIP.
(c) A participant under paragraph (a),
clause (3), must be provided with English as a second language opportunities
and skills training for up to 12 months.
After 12 months, the case manager and participant must determine whether
the participant should continue with English as a second language classes or
skills training, or both, and continue to receive family stabilization
services.
EFFECTIVE DATE. This section is
effective March 1, 2010.
Sec. 15. Minnesota Statutes 2008, section 256J.575,
subdivision 6, is amended to read:
Subd. 6. Cooperation
with services requirements. (a) To
be eligible, A participant who is eligible for family stabilization
services under this section shall comply with paragraphs (b) to (d).
(b) Participants shall engage in
family stabilization plan services for the appropriate number of hours per week
that the activities are scheduled and available, unless good cause exists for
not doing so, as defined in section 256J.57, subdivision 1. The appropriate number of hours must be based
on the participant's plan.
(c) The case manager shall review the
participant's progress toward the goals in the family stabilization plan every
six months to determine whether conditions have changed, including whether
revisions to the plan are needed.
(d) A participant's requirement to
comply with any or all family stabilization plan requirements under this
subdivision is excused when the case management services, training and
educational services, or family support services identified in the
participant's family stabilization plan are unavailable for reasons beyond the
control of the participant, including when money appropriated is not sufficient
to provide the services.
Sec. 16. Minnesota Statutes 2008, section 256J.575,
subdivision 7, is amended to read:
Subd. 7. Sanctions. (a) The county agency or employment
services provider must follow the requirements of this subdivision at the time
the county agency or employment services provider has information that an MFIP
recipient may meet the eligibility criteria in subdivision 3.
(b) The financial assistance grant of a participating
family is reduced according to section 256J.46, if a participating adult fails
without good cause to comply or continue to comply with the family
stabilization plan requirements in this subdivision, unless compliance has been
excused under subdivision 6, paragraph (d).
(b) (c) Given the purpose of the family stabilization services
in this section and the nature of the underlying family circumstances that act
as barriers to both employment and full compliance with program requirements,
there must be a review by the county agency prior to imposing a sanction to
determine whether the plan was appropriated to the needs of the participant and
family, and. There must be a
current assessment by a behavioral health or medical professional confirming
that the participant in all ways had the ability to comply with the plan, as
confirmed by a behavioral health or medical professional.
(c) (d) Prior to the imposition of a sanction, the county
agency or employment services provider shall review the participant's case to
determine if the family stabilization plan is still appropriate and meet with
the participant face-to-face. The
participant may bring an advocate The county agency or employment
services provider must inform the participant of the right to bring an advocate
to the face-to-face meeting.
During the face-to-face meeting, the
county agency shall:
(1) determine whether the continued
noncompliance can be explained and mitigated by providing a needed family
stabilization service, as defined in subdivision 2, paragraph (d);
(2) determine whether the participant
qualifies for a good cause exception under section 256J.57, or if the sanction
is for noncooperation with child support requirements, determine if the
participant qualifies for a good cause exemption under section 256.741,
subdivision 10;
(3) determine whether activities in
the family stabilization plan are appropriate based on the family's
circumstances;
(4) explain the consequences of
continuing noncompliance;
(5) identify other resources that may
be available to the participant to meet the needs of the family; and
(6) inform the participant of the
right to appeal under section 256J.40.
If the lack of an identified activity
or service can explain the noncompliance, the county shall work with the
participant to provide the identified activity.
(d) If the participant fails to come
to the face-to-face meeting, the case manager or a designee shall attempt at
least one home visit. If a face-to-face
meeting is not conducted, the county agency shall send the participant a
written notice that includes the information under paragraph (c).
(e) After the requirements of
paragraphs (c) and (d) are met and prior to imposition of a sanction, the
county agency shall provide a notice of intent to sanction under section
256J.57, subdivision 2, and, when applicable, a notice of adverse action under
section 256J.31.
(f) Section 256J.57 applies to this
section except to the extent that it is modified by this subdivision.
Sec. 17. Minnesota Statutes 2008, section 256J.621, is
amended to read:
256J.621 WORK PARTICIPATION CASH BENEFITS.
(a) Effective October 1, 2009, upon
exiting the diversionary work program (DWP) or upon terminating the Minnesota
family investment program with earnings, a participant who is employed may be
eligible for work participation cash benefits of $75 $50 per
month to assist in meeting the family's basic needs as the participant
continues to move toward self-sufficiency.
(b) To be eligible for work
participation cash benefits, the participant shall not receive MFIP or
diversionary work program assistance during the month and the participant or
participants must meet the following work requirements:
(1) if the participant is a single
caregiver and has a child under six years of age, the participant must be
employed at least 87 hours per month;
(2) if the participant is a single
caregiver and does not have a child under six years of age, the participant
must be employed at least 130 hours per month; or
(3) if the household is a two-parent
family, at least one of the parents must be employed an average of at least 130
hours per month.
Whenever a participant exits the
diversionary work program or is terminated from MFIP and meets the other
criteria in this section, work participation cash benefits are available for up
to 24 consecutive months.
(c) Expenditures on the program are
maintenance of effort state funds under a separate state program for
participants under paragraph (b), clauses (1) and (2). Expenditures for participants under paragraph
(b), clause (3), are nonmaintenance of effort funds. Months in which a participant receives work
participation cash benefits under this section do not count toward the
participant's MFIP 60-month time limit.
Sec. 18. Minnesota Statutes 2008, section 256J.626,
subdivision 6, is amended to read:
Subd. 6. Base
allocation to counties and tribes; definitions. (a) For purposes of this section, the
following terms have the meanings given.
(1) "2002 historic spending
base" means the commissioner's determination of the sum of the
reimbursement related to fiscal year 2002 of county or tribal agency
expenditures for the base programs listed in clause (6) (5),
items (i) through (iv), and earnings related to calendar year 2002 in the base
program listed in clause (6) (5), item (v), and the amount of
spending in fiscal year 2002 in the base program listed in clause (6)
(5), item (vi), issued to or on behalf of persons residing in the county or
tribal service delivery area.
(2) "Adjusted caseload
factor" means a factor weighted:
(i) 47 percent on the MFIP cases in
each county at four points in time in the most recent 12-month period for which
data is available multiplied by the county's caseload difficulty factor; and
(ii) 53 percent on the count of adults
on MFIP in each county and tribe at four points in time in the most recent
12-month period for which data is available multiplied by the county or tribe's
caseload difficulty factor.
(3) "Caseload difficulty
factor" means a factor determined by the commissioner for each county and
tribe based upon the self-support index described in section 256J.751,
subdivision 2, clause (6).
(4) "Initial allocation"
means the amount potentially available to each county or tribe based on the
formula in paragraphs (b) through (d).
(5) (4) "Final allocation" means the
amount available to each county or tribe based on the formula in paragraphs (b)
through (d), after adjustment by subdivision 7 and (c).
(6) (5) "Base programs" means the:
(i) MFIP employment and training
services under Minnesota Statutes 2002, section 256J.62, subdivision 1, in
effect June 30, 2002;
(ii) bilingual employment and training
services to refugees under Minnesota Statutes 2002, section 256J.62,
subdivision 6, in effect June 30, 2002;
(iii) work literacy language programs
under Minnesota Statutes 2002, section 256J.62, subdivision 7, in effect June
30, 2002;
(iv) supported work program authorized
in Laws 2001, First Special Session chapter 9, article 17, section 2, in effect
June 30, 2002;
(v) administrative aid program under
section 256J.76 in effect December 31, 2002; and
(vi) emergency assistance program
under Minnesota Statutes 2002, section 256J.48, in effect June 30, 2002.
(b) The commissioner shall:
(1) beginning July 1, 2003, determine
the initial allocation of funds available under this section according to
clause (2);
(2) allocate all of the funds
available for the period beginning July 1, 2003, and ending December 31, 2004,
to each county or tribe in proportion to the county's or tribe's share of the
statewide 2002 historic spending base;
(3) determine for calendar year 2005
the initial allocation of funds to be made available under this section in
proportion to the county or tribe's initial allocation for the period of July
1, 2003, to December 31, 2004;
(4) determine for calendar year 2006
the initial allocation of funds to be made available under this section based
90 percent on the proportion of the county or tribe's share of the statewide
2002 historic spending base and ten percent on the proportion of the county or
tribe's share of the adjusted caseload factor;
(5) determine for calendar year 2007
the initial allocation of funds to be made available under this section based
70 percent on the proportion of the county or tribe's share of the statewide
2002 historic spending base and 30 percent on the proportion of the county or
tribe's share of the adjusted caseload factor; and
(6) determine for calendar year 2008
and subsequent years the initial allocation of allocate funds to be made available under this
section based 50 percent on the proportion of the county or tribe's share of
the statewide 2002 historic spending base and 50 percent on the proportion of
the county or tribe's share of the adjusted caseload factor.
(c) With the commencement of a new or
expanded tribal TANF program or an agreement under section 256.01, subdivision
2, paragraph (g), in which some or all of the responsibilities of particular
counties under this section are transferred to a tribe, the commissioner shall:
(1) in the case where all
responsibilities under this section are transferred to a tribal program,
determine the percentage of the county's current caseload that is transferring
to a tribal program and adjust the affected county's allocation accordingly;
and
(2) in the case where a portion of the
responsibilities under this section are transferred to a tribal program, the
commissioner shall consult with the affected county or counties to determine an
appropriate adjustment to the allocation.
(d) Effective January 1, 2005,
counties and tribes will have their final allocations adjusted based on the
performance provisions of subdivision 7.
EFFECTIVE DATE. This section is
effective July 1, 2010.
Sec. 19. Minnesota Statutes 2008, section 256J.751, is
amended by adding a subdivision to read:
Subd. 2a.
County performance standards. (a) For the purpose of this section, the
following terms have the meanings given:
(1) "Caseload reduction
credit" (CRC) means the measure of how much the Minnesota TANF caseload,
including the separate state program caseload, has fallen relative to the
federal fiscal year 2005 caseload based on caseload data from October 1 to
September 30.
(2) "TANF participation rate
target" means a 50 percent participation rate reduced by the CRC as
calculated by the Department of Human Services.
(b) A county or tribe shall negotiate
a multiyear improvement plan with the commissioner if the county or tribe does
not:
(1) achieve the TANF participation
rate target or a five percentage point improvement over the county or tribe's
previous year's TANF participation rate under subdivision 2, clause (7), as
averaged across 12 consecutive months for the most recent year for which the
measurements are available; or
(2) perform within or above its range
of expected performance on the annualized three-year self-support index under
subdivision 2, clause (6).
(c) A county or tribe that has
successfully negotiated an improvement plan must provide a semiannual report
indicating that the plan has been implemented, the impact of the plan, and any
anticipated changes to the plan.
Sec. 20. Minnesota Statutes 2008, section 256J.95,
subdivision 12, is amended to read:
Subd. 12. Conversion
or referral to MFIP. (a) If at any
time during the DWP application process or during the four-month DWP
eligibility period, it is determined that a participant is unlikely to benefit
from the diversionary work program, the county shall convert or refer the
participant to MFIP as specified in paragraph (d). Participants who are determined to be
unlikely to benefit from the diversionary work program must develop and sign an
employment plan. Participants who
meet any one of the criteria in paragraph (b) shall be considered to be
unlikely to benefit from DWP, provided the necessary documentation is available
to support the determination.
(b) A participant who: meets
the eligibility requirements under section 256J.575, subdivision 3, must be
considered to be unlikely to benefit from DWP, provided the necessary
documentation is available to support the determination.
(1) has been determined by a qualified
professional as being unable to obtain or retain employment due to an illness,
injury, or incapacity that is expected to last at least 60 days;
(2) is required in the home as a
caregiver because of the illness, injury, or incapacity, of a family member, or
a relative in the household, or a foster child, and the illness, injury, or
incapacity and the need for a person to provide assistance in the home has been
certified by a qualified professional and is expected to continue more than 60
days;
(3) is determined by a qualified
professional as being needed in the home to care for a child or adult meeting
the special medical criteria in section 256J.561, subdivision 2, paragraph (d),
clause (3);
(4) is pregnant and is determined by a
qualified professional as being unable to obtain or retain employment due to
the pregnancy; or
(5) has applied for SSI or SSDI.
(c) In a two-parent family unit, both
parents must be if one parent is determined to be unlikely to
benefit from the diversionary work program before, the family
unit can must be converted or referred to MFIP.
(d) A participant who is determined to
be unlikely to benefit from the diversionary work program shall be converted to
MFIP and, if the determination was made within 30 days of the initial
application for benefits, no additional application form is required. A participant who is determined to be
unlikely to benefit from the diversionary work program shall be referred to
MFIP and, if the determination is made more than 30 days after the initial
application, the participant must submit a program change request form. The county agency shall process the program
change request form by the first of the following month to ensure that no gap
in benefits is due to delayed action by the county agency. In processing the program change request
form, the county must follow section 256J.32, subdivision 1, except that the
county agency shall not require additional verification of the information in
the case file from the DWP application unless the information in the case file
is inaccurate, questionable, or no longer current.
(e) The county shall not request a
combined application form for a participant who has exhausted the four months
of the diversionary work program, has continued need for cash and food
assistance, and has completed, signed, and submitted a program change request
form within 30 days of the fourth month of the diversionary work program. The county must process the program change
request according to section 256J.32, subdivision 1, except that the county
agency shall not require additional verification of information in the case
file unless the information is inaccurate, questionable, or no longer current. When a participant does not request MFIP
within 30 days of the diversionary work program benefits being exhausted, a new
combined application form must be completed for any subsequent request for
MFIP.
EFFECTIVE DATE. This section is
effective March 1, 2010.
Sec. 21. Minnesota Statutes 2008, section 393.07,
subdivision 10, is amended to read:
Subd. 10. Food
stamp program; Maternal and Child Nutrition Act. (a) The local social services agency shall
establish and administer the food stamp program according to rules of the
commissioner of human services, the supervision of the commissioner as
specified in section 256.01, and all federal laws and regulations. The commissioner of human services shall
monitor food stamp program delivery on an ongoing basis to ensure that each
county complies with federal laws and regulations. Program requirements to be monitored include,
but are not limited to, number of applications, number of approvals, number of
cases pending, length of time required to process each application and deliver
benefits, number of applicants eligible for expedited issuance, length of time
required to process and deliver expedited issuance, number of terminations and
reasons for terminations, client profiles by age, household composition and
income level and sources, and the use of phone certification and home
visits. The commissioner shall determine
the county-by-county and statewide participation rate.
(b) On July 1 of each year, the
commissioner of human services shall determine a statewide and county-by-county
food stamp program participation rate.
The commissioner may designate a different agency to administer the food
stamp program in a county if the agency administering the program fails to
increase the food stamp program participation rate among families or eligible
individuals, or comply with all federal laws and regulations governing the food
stamp program. The commissioner shall
review agency performance annually to determine compliance with this paragraph.
(c) A person who commits any of the
following acts has violated section 256.98 or 609.821, or both, and is subject
to both the criminal and civil penalties provided under those sections:
(1) obtains or attempts to obtain, or
aids or abets any person to obtain by means of a willful statement or
misrepresentation, or intentional concealment of a material fact, food stamps
or vouchers issued according to sections 145.891 to 145.897 to which the person
is not entitled or in an amount greater than that to which that person is
entitled or which specify nutritional supplements to which that person is not
entitled; or
(2) presents or causes to be
presented, coupons or vouchers issued according to sections 145.891 to 145.897
for payment or redemption knowing them to have been received, transferred or
used in a manner contrary to existing state or federal law; or
(3) willfully uses, possesses, or
transfers food stamp coupons, authorization to purchase cards or vouchers
issued according to sections 145.891 to 145.897 in any manner contrary to
existing state or federal law, rules, or regulations; or
(4) buys or sells food stamp coupons,
authorization to purchase cards, other assistance transaction devices, vouchers
issued according to sections 145.891 to 145.897, or any food obtained through
the redemption of vouchers issued according to sections 145.891 to 145.897 for cash
or consideration other than eligible food.
(d) A peace officer or welfare fraud
investigator may confiscate food stamps, authorization to purchase cards, or
other assistance transaction devices found in the possession of any person who
is neither a recipient of the food stamp program nor otherwise authorized to
possess and use such materials.
Confiscated property shall be disposed of as the commissioner may direct
and consistent with state and federal food stamp law. The confiscated property must be retained for
a period of not less than 30 days to allow any affected person to appeal the
confiscation under section 256.045.
(e) Food stamp overpayment claims
which are due in whole or in part to client error shall be established by the
county agency for a period of six years from the date of any resultant
overpayment. Establishment of a food stamp overpayment is limited to 12
months prior to the month of discovery due to an agency error and six years
prior to the month of discovery due to a client error or an intentional program
violation determined under section 256.046.
(f) With regard to the federal tax
revenue offset program only, recovery incentives authorized by the federal food
and consumer service shall be retained at the rate of 50 percent by the state
agency and 50 percent by the certifying county agency.
(g) A peace officer, welfare fraud
investigator, federal law enforcement official, or the commissioner of health
may confiscate vouchers found in the possession of any person who is neither issued
vouchers under sections 145.891 to 145.897, nor otherwise authorized to possess
and use such vouchers. Confiscated
property shall be disposed of as the commissioner of health may direct and
consistent with state and federal law.
The confiscated property must be retained for a period of not less than
30 days.
(h) The commissioner of human services
may seek a waiver from the United States Department of Agriculture to allow the
state to specify foods that may and may not be purchased in Minnesota with
benefits funded by the federal Food Stamp Program. The commissioner shall consult with the
members of the house of representatives and senate policy committees having
jurisdiction over food support issues in developing the waiver. The commissioner, in consultation with the
commissioners of health and education, shall develop a broad public health
policy related to improved nutrition and health status. The commissioner must seek legislative
approval prior to implementing the waiver.
Sec. 22. AMERICAN
INDIAN CHILD WELFARE PROJECTS.
Notwithstanding Minnesota Statutes,
section 16A.28, the commissioner of human services shall extend payment of
state fiscal year 2009 funds in state fiscal year 2010 to tribes participating
in the American Indian child welfare projects under Minnesota Statutes, section
256.01, subdivision 14b. Future
extensions of payment for a tribe participating in the Indian child welfare
projects under Minnesota Statutes, section 256.01, subdivision 14b, must be
granted according to the commissioner's authority under Minnesota Statutes,
section 16A.28.
Sec. 23. REPEALER.
(a) Minnesota Statutes 2008, sections
256D.46; 256I.06, subdivision 9; and 256J.626, subdivision 7, are repealed.
(b) Minnesota Rules, parts 9500.1243,
subpart 3; and 9500.1261, subparts 3, 4, 5, and 6, are repealed.
ARTICLE 3
CHILD SUPPORT
Section 1. Minnesota Statutes 2008, section 518A.53,
subdivision 1, is amended to read:
Subdivision 1. Definitions. (a) For the purpose of this section, the
following terms have the meanings provided in this subdivision unless otherwise
stated.
(b) "Payor of funds" means
any person or entity that provides funds to an obligor, including an employer
as defined under chapter 24 of the Internal Revenue Code, section 3401(d), an
independent contractor, payor of worker's compensation benefits or unemployment
benefits, or a financial institution as defined in section 13B.06.
(c) "Business day" means a
day on which state offices are open for regular business.
(d) The term "arrears"
means amounts owed under a support order that are past due as used in
this section has the meaning provided in section 518A.26.
EFFECTIVE DATE. This section is
effective April 1, 2010.
Sec. 2. Minnesota Statutes 2008, section 518A.53,
subdivision 4, is amended to read:
Subd. 4. Collection
services. (a) The commissioner of
human services shall prepare and make available to the courts a notice of
services that explains child support and maintenance collection services
available through the public authority, including income withholding, and the
fees for such services. Upon receiving a
petition for dissolution of marriage or legal separation, the court administrator
shall promptly send the notice of services to the petitioner and respondent at
the addresses stated in the petition.
(b) Either the obligee or obligor may
at any time apply to the public authority for either full IV-D services or for
income withholding only services.
(c) For those persons applying for
income withholding only services, a monthly service fee of $15 must be charged
to the obligor. This fee is in addition
to the amount of the support order and shall be withheld through income withholding. The public authority shall explain the
service options in this section to the affected parties and encourage the
application for full child support collection services.
(d) If the obligee is not a current
recipient of public assistance as defined in section 256.741, the person who
applied for services may at any time choose to terminate either full IV-D
services or income withholding only services regardless of whether income
withholding is currently in place. The
obligee or obligor may reapply for either full IV-D services or income
withholding only services at any time.
Unless the applicant is a recipient of public assistance as defined in
section 256.741, a $25 application fee shall be charged at the time of each
application.
(e) When a person terminates IV-D
services, if an arrearage for public assistance as defined in section 256.741
exists, the public authority may continue income withholding, as well as use
any other enforcement remedy for the collection of child support, until all
public assistance arrears are paid in full.
Income withholding shall be in an amount equal to 20 percent of the
support order in effect at the time the services terminated., unless
the support order includes a specific monthly payback amount. If the support order includes a specific
monthly payback amount, income withholding shall be in the specific amount
ordered. The provisions of this
paragraph apply to all support orders in effect on or before April 1, 2010, and
to all support orders in effect after April 1, 2010.
EFFECTIVE DATE. This section is
effective April 1, 2010.
Sec. 3. Minnesota Statutes 2008, section 518A.53,
subdivision 10, is amended to read:
Subd. 10. Arrearage
order. (a) This section does not
prevent the court from ordering the payor of funds to withhold amounts to
satisfy the obligor's previous arrearage in support order payments. This remedy shall not operate to exclude
availability of other remedies to enforce judgments. The employer or payor of funds shall withhold
from the obligor's income an additional amount equal to 20 percent of the
monthly child support or maintenance obligation until the arrearage is paid.,
unless the support order includes a specific monthly payback amount. If the support order includes a specific
monthly payback amount, income withholding shall be in the specific amount
ordered. The provisions of this paragraph
apply to all support orders in effect on or before April 1, 2010, and to all
support orders in effect after April 1, 2010.
(b) Notwithstanding any law to the
contrary, funds from income sources included in section 518A.26, subdivision 8,
whether periodic or lump sum, are not exempt from attachment or execution upon
a judgment for child support arrearage.
(c) Absent an order to the contrary,
if an arrearage exists at the time a support order would otherwise terminate,
income withholding shall continue in effect or may be implemented in an amount
equal to the support order plus an additional 20 percent of the monthly child
support obligation, until all arrears have been paid in full.
EFFECTIVE DATE. This section is
effective April 1, 2010.
ARTICLE 4
STATE-OPERATED SERVICES
Section 1. Minnesota Statutes 2008, section 246.50,
subdivision 5, is amended to read:
Subd. 5. Cost
of care. "Cost of care"
means the commissioner's charge for services provided to any person admitted to
a state facility.
For purposes of this subdivision,
"charge for services" means the cost of services, treatment,
maintenance, bonds issued for capital improvements, depreciation of buildings
and equipment, and indirect costs related to the operation of state
facilities. The commissioner may
determine the charge for services on an anticipated average per diem basis as
an all inclusive charge per facility, per disability group, or per treatment
program. The commissioner may determine
a charge per service, using a method that includes direct and indirect costs.
usual and customary fee charged for services provided to clients. The usual and customary fee shall be
established in a manner required to appropriately bill services to all payers
and shall include the costs related to the operations of any program offered by
the state.
Sec. 2. Minnesota Statutes 2008, section 246.50, is
amended by adding a subdivision to read:
Subd. 10.
State-operated community-based
program. "State-operated
community-based program" means any program operated in the community
including community behavioral health hospitals, crisis centers, residential
facilities, outpatient services, and other community-based services developed
and operated by the state and under the commissioner's control.
Sec. 3. Minnesota Statutes 2008, section 246.50, is
amended by adding a subdivision to read:
Subd. 11.
Health plan company. "Health plan company" has the
meaning given it in section 62Q.01, subdivision 4, and also includes a
demonstration provider as defined in section 256B.69, subdivision 2, paragraph
(b), a county or group of counties participating in county-based purchasing
according to section 256B.692, and a children's mental health collaborative
under contract to provide medical assistance for individuals enrolled in the
prepaid medical assistance and MinnesotaCare programs under sections 245.493 to
245.495.
Sec. 4. Minnesota Statutes 2008, section 246.51, is
amended by adding a subdivision to read:
Subd. 1a.
Clients in state-operated
community-based programs; determination. For clients admitted to a state-operated community-based
program, the commissioner shall make an investigation to determine the
available health plan coverage for services being provided. If the health plan coverage requires a co-pay
or deductible, or if there is no available health plan coverage, the commission
shall make an investigation as necessary to determine, and as circumstances
require redetermine, what part of the noncovered cost of care, if any, the
client is able to pay. If the client is
unable to pay the uncovered cost of care, the commissioner shall make a
determination as to the ability of the client's relatives to pay. The client and relatives shall provide the
commissioner documents and proof necessary to determine their ability to pay. Failure to provide the commissioner with sufficient
information to determine ability to pay may make the client or relatives liable
for the full cost of care until the time when sufficient information is
provided. If it is determined that the
responsible party does not have the ability to pay, the commissioner shall
waive payment of the portion that exceeds ability to pay under the
determination.
Sec. 5. Minnesota Statutes 2008, section 246.51, is
amended by adding a subdivision to read:
Subd. 1b.
Clients served by regional
treatment centers or nursing homes; determination. For clients served in regional treatment
centers or nursing homes operated by state-operated services, the commissioner
shall make investigation as necessary to determine, and as circumstances
require redetermine, what part of the cost of care, if any, the client is able
to pay. If the client is unable to pay
the full cost of care, the commissioner shall determine whether the client's
relatives have the ability to pay. The
client and relatives shall provide the commissioner documents and proof
necessary to determine their ability to pay.
Failure to provide the commissioner with sufficient information to
determine ability to pay may make the client or relatives liable for the full
cost of care until the time when sufficient information is provided. No parent shall be liable for the cost of
care given a client at a regional treatment center after the client has reached
the age of 18 years.
Sec. 6. Minnesota Statutes 2008, section 246.511, is
amended to read:
246.511 RELATIVE RESPONSIBILITY.
Except for chemical dependency
services paid for with funds provided under chapter 254B, a client's relatives
shall not, pursuant to the commissioner's authority under section 246.51, be
ordered to pay more than ten percent of the cost of the following: (1) for services provided in a community-based
service, the noncovered cost of care as determined under the ability to pay
determination; and (2) for services provided at a regional treatment center
operated by state-operated services, 20 percent of the cost of care, unless
they reside outside the state. Parents
of children in state facilities shall have their responsibility to pay
determined according to section 252.27, subdivision 2, or in rules adopted
under chapter 254B if the cost of care is paid under chapter 254B. The commissioner may accept voluntary
payments in excess of ten 20 percent. The commissioner may require full payment of
the full per capita cost of care in state facilities for clients whose parent,
parents, spouse, guardian, or conservator do not reside in Minnesota.
Sec. 7. Minnesota Statutes 2008, section 246.52, is
amended to read:
246.52 PAYMENT FOR CARE; ORDER; ACTION.
The commissioner shall issue an order
to the client or the guardian of the estate, if there be one, and relatives
determined able to pay requiring them to pay monthly to the state of
Minnesota the amounts so determined the total of which shall not exceed the
full cost of care. Such order shall
specifically state the commissioner's determination and shall be conclusive
unless appealed from as herein provided.
When a client or relative fails to pay the amount due hereunder the
attorney general, upon request of the commissioner, may institute, or direct
the appropriate county attorney to institute, civil action to recover such
amount.
Sec. 8. Minnesota Statutes 2008, section 246B.01, is
amended by adding a subdivision to read:
Subd. 1a. Client. "Client" means a person who is
admitted to the Minnesota sex offender program or subject to a court hold order
under section 253B.185 for the purpose of assessment, diagnosis, care,
treatment, supervision, or other services provided by the Minnesota sex
offender program.
Sec. 9. Minnesota Statutes 2008, section 246B.01, is
amended by adding a subdivision to read:
Subd. 1b.
Client's county. "Client's county" means the
county of the client's legal settlement for poor relief purposes at the time of
commitment. If the client has no legal
settlement for poor relief in this state, it means the county of commitment,
except that when a client with no legal settlement for poor relief is committed
while serving a sentence at a penal institution, it means the county from which
the client was sentenced.
Sec. 10. Minnesota Statutes 2008, section 246B.01, is
amended by adding a subdivision to read:
Subd. 2a.
Cost of care. "Cost of care" means the
commissioner's charge for housing and treatment services provided to any person
admitted to the Minnesota sex offender program.
For purposes of this subdivision,
"charge for housing and treatment services" means the cost of
services, treatment, maintenance, bonds issued for capital improvements,
depreciation of buildings and equipment, and indirect costs related to the
operation of state facilities. The
commissioner may determine the charge for services on an anticipated average
per diem basis as an all-inclusive charge per facility.
Sec. 11. Minnesota Statutes 2008, section 246B.01, is
amended by adding a subdivision to read:
Subd. 2b.
Local social services agency. "Local social services agency"
means the local social services agency of the client's county as defined in
subdivision 1b and of the county of commitment, and any other local social
services agency possessing information regarding, or requested by the
commissioner to investigate, the financial circumstances of a client.
Sec. 12. [246B.07]
PAYMENT FOR CARE AND TREATMENT: DETERMINATION.
Subdivision 1.
Procedures. The commissioner shall make investigation
as necessary to determine, and as circumstances require redetermine, what part
of the cost of care, if any, the client is able to pay. The client shall provide the commissioner
documents and proof necessary to determine the ability to pay. Failure to provide the commissioner with sufficient
information to determine ability to pay may make the client liable for the full
cost of care until the time when sufficient information is provided.
Subd. 2.
Rules. The commissioner shall adopt, pursuant to
the Administrative Procedure Act, rules establishing uniform standards for
determination of client liability for care provided by the Minnesota sex
offender program. These rules shall have
the force and effect of law.
Subd. 3.
Applicability. The commissioner may recover, under
sections 246B.07 to 246B.10, the cost of any care provided by the Minnesota sex
offender program.
Sec. 13. [246B.08]
PAYMENT FOR CARE; ORDER; ACTION.
The commissioner shall issue an order
to the client or the guardian of the estate, if there is one, requiring them to
pay to the state the amounts so determined, the total of which shall not exceed
the full cost of care. The order shall
specifically state the commissioner's determination and must be conclusive,
unless appealed. When a client fails to
pay the amount due, the attorney general, upon request of the commissioner, may
institute, or direct the appropriate county attorney to institute, civil action
to recover the amount.
Sec. 14. [246B.09]
CLAIM AGAINST ESTATE OF DECEASED CLIENT.
Subdivision 1.
Client's estate. Upon the death of a client, or a former
client, the total cost of care given the client, less the amount actually paid
toward the cost of care by the client, shall be filed by the commissioner as a
claim against the estate of the client with the court having jurisdiction to
probate the estate and all proceeds collected by the state in the case shall be
divided between the state and county in proportion to the cost of care each has
borne.
Subd. 2.
Preferred status. An estate claim in subdivision 1 shall be
considered an expense of the last illness for purposes of section 524.3-805.
If the commissioner of human services
determines that the property or estate of a client is not more than needed to
care for and maintain the spouse and minor or dependent children of a deceased
client, the commissioner has the power to compromise the claim of the state in
a manner deemed just and proper.
Subd. 3.
Exception from statute of
limitations. Any statute of
limitations that limits the commissioner in recovering the cost of care
obligation incurred by a client or former client must not apply to any claim
against an estate made under this section to recover cost of care.
Sec. 15. [246B.10]
LIABILITY OF COUNTY; REIMBURSEMENT.
The client's county shall pay to the
state a portion of the cost of care provided in the Minnesota sex offender
program to a client legally settled in that county. A county's payment shall be made from the
county's own sources of revenue and payments shall equal ten percent of the
cost of care, as determined by the commissioner, for each day or portion of a
day, that the client spends at the facility.
If payments received by the state under sections 246.50 to 246.53 exceed
90 percent of the cost of care, the county shall be responsible for paying the
state only the remaining amount. The
county shall not be entitled to reimbursement from the client, the client's
estate, or from the client's relatives, except as provided in section 246B.07.
Sec. 16. REPEALER.
Minnesota Statutes 2008, sections
246.51, subdivision 1; and 246.53, subdivision 3, are repealed.
ARTICLE 5
DEPARTMENT OF HEALTH AND HEALTH CARE
Section 1. Minnesota Statutes 2008, section 13.465,
subdivision 8, is amended to read:
Subd. 8. Adoption
records. Various adoption records
are classified under section 259.53, subdivision 1. Access to the original birth record of a
person who has been adopted is governed by section 259.89 144.2253.
EFFECTIVE DATE. This section is
effective August 1, 2010.
Sec. 2. Minnesota Statutes 2008, section 62J.495, is
amended to read:
62J.495 HEALTH INFORMATION TECHNOLOGY AND INFRASTRUCTURE.
Subdivision 1. Implementation. By January 1, 2015, all hospitals and health
care providers must have in place an interoperable electronic health records
system within their hospital system or clinical practice setting. The commissioner of health, in consultation
with the e-Health Information Technology and Infrastructure
Advisory Committee, shall develop a statewide plan to meet this goal, including
uniform standards to be used for the
interoperable system for sharing and
synchronizing patient data across systems.
The standards must be compatible with federal efforts. The uniform standards must be developed by
January 1, 2009, with a status report on the development of these standards
submitted to the legislature by January 15, 2008 and updated on an
ongoing basis. The commissioner shall
include an update on standards development as part of an annual report to the
legislature.
Subd. 1a.
Definitions. (a) "Certified electronic health
record technology" means an electronic health record that is certified
pursuant to section 3001(c)(5) of the HITECH Act to meet the standards and
implementation specifications adopted under section 3004 as applicable.
(b) "Commissioner" means the
commissioner of health.
(c) "Pharmaceutical electronic
data intermediary" means any entity that provides the infrastructure to
connect computer systems or other electronic devices utilized by prescribing
practitioners with those used by pharmacies, health plans, third party
administrators, and pharmacy benefit manager in order to facilitate the secure
transmission of electronic prescriptions, refill authorization requests,
communications, and other prescription-related information between such
entities.
(d) "HITECH Act" means the
Health Information Technology for Economic and Clinical Health Act in division
A, title XIII and division B, title IV of the American Recovery and
Reinvestment Act of 2009, including federal regulations adopted under that act.
(e) "Interoperable electronic
health record" means an electronic health record that securely exchanges
health information with another electronic health record system that meets
national requirements for certification under the HITECH Act.
(f) "Qualified electronic health
record" means an electronic record of health-related information on an
individual that includes patient demographic and clinical health information
and has the capacity to:
(1) provide clinical decision support;
(2) support physician order entry;
(3) capture and query information
relevant to health care quality; and
(4) exchange electronic health
information with, and integrate such information from, other sources.
Subd. 2. E-Health
Information Technology and Infrastructure Advisory Committee. (a) The commissioner shall establish a
an e-Health Information Technology and Infrastructure Advisory
Committee governed by section 15.059 to advise the commissioner on the
following matters:
(1) assessment of the adoption and
effective use of health information technology by the state, licensed
health care providers and facilities, and local public health agencies;
(2) recommendations for implementing a
statewide interoperable health information infrastructure, to include estimates
of necessary resources, and for determining standards for administrative
clinical data exchange, clinical support programs, patient privacy
requirements, and maintenance of the security and confidentiality of individual
patient data;
(3) recommendations for encouraging
use of innovative health care applications using information technology and
systems to improve patient care and reduce the cost of care, including
applications relating to disease management and personal health management that
enable remote monitoring of patients' conditions, especially those with chronic
conditions; and
(4) other related issues as requested
by the commissioner.
(b) The members of the e-Health
Information Technology and Infrastructure Advisory Committee shall
include the commissioners, or commissioners' designees, of health, human
services, administration, and commerce and additional members to be appointed
by the commissioner to include persons representing Minnesota's local public
health agencies, licensed hospitals and other licensed facilities and
providers, private purchasers, the medical and nursing professions, health
insurers and health plans, the state quality improvement organization, academic
and research institutions, consumer advisory organizations with an interest and
expertise in health information technology, and other stakeholders as
identified by the Health Information Technology and Infrastructure Advisory
Committee commissioner to fulfill the requirements of section 3013,
paragraph (g) of the HITECH Act.
(c) The commissioner shall prepare and
issue an annual report not later than January 30 of each year outlining
progress to date in implementing a statewide health information infrastructure
and recommending future projects action on policy and necessary
resources to continue the promotion of adoption and effective use of health
information technology.
(d) Notwithstanding section 15.059,
this subdivision expires June 30, 2015.
Subd. 3. Interoperable
electronic health record requirements.
(a) To meet the requirements of subdivision 1, hospitals and
health care providers must meet the following criteria when implementing an
interoperable electronic health records system within their hospital system or
clinical practice setting.
(a) The electronic health record must
be a qualified electronic health record.
(b) The electronic health record must
be certified by the Certification Commission for Healthcare Information
Technology, or its successor Office of the National Coordinator pursuant
to the HITECH Act. This criterion
only applies to hospitals and health care providers whose practice setting
is a practice setting covered by the Certification Commission for Healthcare
Information Technology certifications only if a certified electronic health
record product for the provider's particular practice setting is available. This criterion shall be considered met if a
hospital or health care provider is using an electronic health records system
that has been certified within the last three years, even if a more current
version of the system has been certified within the three-year period.
(c) The electronic health record must
meet the standards established according to section 3004 of the HITECH Act as
applicable.
(d) The electronic health record must
have the ability to generate information on clinical quality measures and other
measures reported under sections 4101, 4102, and 4201 of the HITECH Act.
(c) (e) A health care provider who is a prescriber or
dispenser of controlled substances legend drugs must have an
electronic health record system that meets the requirements of section 62J.497.
Subd. 4.
Coordination with national HIT
activities. (a) The
commissioner, in consultation with the e-Health Advisory Committee, shall
update the statewide implementation plan required under subdivision 2 and
released June 2008, to be consistent with the updated Federal HIT Strategic
Plan released by the Office of the National Coordinator in accordance with
section 3001 of the HITECH Act. The
statewide plan shall meet the requirements for a plan required under section
3013 of the HITECH Act.
(b) The commissioner, in consultation
with the e-Health Advisory Committee, shall work to ensure coordination between
state, regional, and national efforts to support and accelerate efforts to
effectively use health information technology to improve the quality and
coordination of health care and continuity of patient care among health care
providers, to reduce medical errors, to improve population health, to reduce health
disparities, and to reduce chronic disease.
The commissioner's coordination efforts shall include but not be limited
to:
(1) assisting in the development and
support of health information technology regional extension centers established
under section 3012(c) of the HITECH Act to provide technical assistance and
disseminate best practices; and
(2) providing supplemental information
to the best practices gathered by regional centers to ensure that the
information is relayed in a meaningful way to the Minnesota health care
community.
(c) The commissioner, in consultation
with the e-Health Advisory Committee, shall monitor national activity related
to health information technology and shall coordinate statewide input on policy
development. The commissioner shall
coordinate statewide responses to proposed federal health information
technology regulations in order to ensure that the needs of the Minnesota
health care community are adequately and efficiently addressed in the proposed
regulations. The commissioner's
responses may include, but are not limited to:
(1) reviewing and evaluating any
standard, implementation specification, or certification criteria proposed by
the national HIT standards committee;
(2) reviewing and evaluating policy
proposed by the national HIT policy committee relating to the implementation of
a nationwide health information technology infrastructure;
(3) monitoring and responding to
activity related to the development of quality measures and other measures as
required by section 4101 of the HITECH Act.
Any response related to quality measures shall consider and address the
quality efforts required under chapter 62U; and
(4) monitoring and responding to
national activity related to privacy, security, and data stewardship of
electronic health information and individually identifiable health information.
(d) To the extent that the state is
either required or allowed to apply, or designate an entity to apply for or
carry out activities and programs under section 3013 of the HITECH Act, the
commissioner of health, in consultation with the e-Health Advisory Committee
and the commissioner of human services, shall be the lead applicant or sole
designating authority. The commissioner
shall make such designations consistent with the goals and objectives of
sections 62J.495 to 62J.497, and sections 62J.50 to 62J.61.
(e) The commissioner of human services
shall apply for funding necessary to administer the incentive payments to
providers authorized under title IV of the American Recovery and Reinvestment
Act.
(f) The commissioner shall include in
the report to the legislature information on the activities of this subdivision
and provide recommendations on any relevant policy changes that should be
considered in Minnesota.
Subd. 5.
Collection of data for
assessment and eligibility determination. (a) The commissioner of health, in
consultation with the commissioner of human services, may require providers,
dispensers, group purchasers, and pharmaceutical electronic data intermediaries
to submit data in a form and manner specified by the commissioner to assess the
status of adoption, effective use, and interoperability of electronic health
records for the purpose of:
(1) demonstrating Minnesota's progress
on goals established by the Office of the National Coordinator to accelerate
the adoption and effective use of health information technology established
under the HITECH Act;
(2) assisting the Center for Medicare
and Medicaid Services and Department of Human Services in determining
eligibility of health care professionals and hospitals to receive federal
incentives for the adoption and effective use of health information technology
under the HITECH Act or other federal incentive programs;
(3) assisting the Office of the National
Coordinator in completing required assessments of the impact of the
implementation and effective use of health information technology in achieving
goals identified in the national strategic plan, and completing studies
required by the HITECH Act;
(4) providing the data necessary to
assist the Office of the National Coordinator in conducting evaluations of
regional extension centers as required by the HITECH Act; and
(5) other purposes as necessary to
support the implementation of the HITECH Act.
(b) The commissioner shall coordinate
with the commissioner of human services and other state agencies in the
collection of data required under this section to:
(1) avoid duplicative reporting
requirements;
(2) maximize efficiencies in the
development of reports on state activities as required by HITECH; and
(3) determine health professional and
hospital eligibility for incentives available under the HITECH Act.
Subd. 6.
Data classification. (a) Data collected on providers,
dispensers, group purchasers, and electronic data intermediaries under this
section are private data on individuals or nonpublic data, as defined in
section 13.02. Notwithstanding the
definition of summary data in section 13.02, subdivision 19, summary data
prepared under this subdivision may be derived from nonpublic data.
(b) Nothing in this section
authorizes the collection of individual patient data.
Sec. 3. Minnesota Statutes 2008, section 62J.496, is
amended to read:
62J.496 ELECTRONIC HEALTH RECORD SYSTEM REVOLVING ACCOUNT AND LOAN
PROGRAM.
Subdivision 1. Account
establishment. (a) An account
is established to: provide
loans to eligible borrowers to assist in financing the installation or support
of an interoperable health record system.
The system must provide for the interoperable exchange of health care
information between the applicant and, at a minimum, a hospital system,
pharmacy, and a health care clinic or other physician group.
(1) finance the purchase of certified
electronic health records or qualified electronic health records as defined in
section 62J.495, subdivision 1a;
(2) enhance the utilization of
electronic health record technology, which may include costs associated with
upgrading the technology to meet the criteria necessary to be a certified electronic
health record or a qualified electronic health record;
(3) train personnel in the use of
electronic health record technology; and
(4) improve the secure electronic
exchange of health information.
(b) Amounts deposited in the account,
including any grant funds obtained through federal or other sources, loan
repayments, and interest earned on the amounts shall be used only for awarding
loans or loan guarantees, as a source of reserve and security for leveraged
loans, or for the administration of the account.
(c) The commissioner may accept
contributions to the account from private sector entities subject to the
following provisions:
(1) the contributing entity may not
specify the recipient or recipients of any loan issued under this subdivision;
(2) the commissioner shall make public
the identity of any private contributor to the loan fund, as well as the amount
of the contribution provided; and
(3) the commissioner may issue letters
of commendation or make other awards that have no financial value to any such
entity.
A contributing entity may not specify
that the recipient or recipients of any loan use specific products or services,
nor may the contributing entity imply that a contribution is an endorsement of
any specific product or service.
(d) The commissioner may use the loan
funds to reimburse private sector entities for any contribution made to the
loan fund. Reimbursement to private
entities may not exceed the principle amount contributed to the loan fund.
(e) The commissioner may use funds
deposited in the account to guarantee, or purchase insurance for, a local
obligation if the guarantee or purchase would improve credit market access or
reduce the interest rate applicable to the obligation involved.
(f) The commissioner may use funds
deposited in the account as a source of revenue or security for the payment of
principal and interest on revenue or bonds issued by the state if the proceeds
of the sale of the bonds will be deposited into the loan fund.
Subd. 2. Eligibility. (a) "Eligible borrower" means one
of the following:
(1) federally qualified health
centers;
(1) (2) community clinics, as defined under section 145.9268;
(2) (3) nonprofit hospitals eligible for rural
hospital capital improvement grants, as defined in section 144.148
licensed under sections 144.50 to 144.56;
(3) physician clinics located in a
community with a population of less than 50,000 according to United States
Census Bureau statistics and outside the seven-county metropolitan area;
(4) individual or small group
physician practices that are focused primarily on primary care;
(4) (5) nursing facilities licensed under sections 144A.01 to
144A.27; and
(6) local public health departments as
defined in chapter 145A; and
(5) (7) other providers of health or health care services
approved by the commissioner for which interoperable electronic health record
capability would improve quality of care, patient safety, or community health.
(b) The commissioner shall administer
the loan fund to prioritize support and assistance to:
(1) critical access hospitals;
(2) federally qualified health
centers;
(3) entities that serve uninsured,
underinsured, and medically underserved individuals, regardless of whether such
area is urban or rural; and
(4) individual or small group
practices that are primarily focused on primary care.
(b) To be eligible for a loan under
this section, the
(c) An eligible
applicant must submit a loan application to the commissioner of health on forms
prescribed by the commissioner. The application
must include, at a minimum:
(1) the amount of the loan requested
and a description of the purpose or project for which the loan proceeds will be
used;
(2) a quote from a vendor;
(3) a description of the health care
entities and other groups participating in the project;
(4) evidence of financial stability
and a demonstrated ability to repay the loan; and
(5) a description of how the system
to be financed interconnects interoperates or plans in the future
to interconnect interoperate with other health care entities and
provider groups located in the same geographical area;
(6) a plan on how the certified
electronic health record technology will be maintained and supported over time;
and
(7) any other requirements for
applications included or developed pursuant to section 3014 of the HITECH Act.
Subd. 3. Loans and
grants. (a) The commissioner of
health may make a no interest grant, or a no interest loan or low
interest loan to a provider or provider group who is eligible under
subdivision 2 on a first-come, first-served basis provided that the
applicant is able to comply with this section consistent with the
priorities established in subdivision 2.
The total accumulative loan principal must not exceed $1,500,000
$3,000,000 per loan. The interest
rate for each loan, if imposed, shall not exceed the current market interest
rate. The commissioner of health has
discretion over the size, interest rate, and number of loans made. Nothing in this section shall require the
commissioner to make a loan to an eligible borrower under subdivision 2.
(b) The commissioner of health may
prescribe forms and establish an application process and, notwithstanding
section 16A.1283, may impose a reasonable nonrefundable application fee to
cover the cost of administering the loan program. Any application fees imposed and collected
under the electronic health records system revolving account and loan program
in this section are appropriated to the commissioner of health for the duration
of the loan program. The commissioner
may apply for and use all federal funds available through the HITECH Act to
administer the loan program.
(c) For loans approved prior to
July 1, 2009, the borrower must begin repaying the principal no later than
two years from the date of the loan.
Loans must be amortized no later than six years from the date of the
loan.
(d) For loans granted on January 1,
2010, or thereafter, the borrower must begin repaying the principle no later
than one year from the date of the loan.
Loans must be amortized no later than six years after the date of the
loan.
(d) Repayments (e) All repayments and interest paid
on each loan must be
credited to the account.
(f) The loan agreement shall include
the assurances that borrower meets requirements included or developed pursuant
to section 3014 of the HITECH Act. The
requirements shall include, but are not limited to:
(1) submitting reports on quality
measures in compliance with regulations adopted by the federal government;
(2) demonstrating that any certified
electronic health record technology purchased, improved, or otherwise
financially supported by this loan program is used to exchange health
information in a manner that, in accordance with law and standards applicable
to the exchange of information, improves the quality of health care;
(3) including a plan on how the
borrower intends to maintain and support the certified electronic health record
technology over time and the resources expected to be used to maintain and
support the technology purchased with the loan; and
(4) complying with other requirements
the secretary may require to use loans funds under the HITECH Act.
Subd. 4. Data
classification. Data collected by
the commissioner of health on the application to determine eligibility under
subdivision 2 and to monitor borrowers' default risk or collect payments owed
under subdivision 3 are (1) private data on individuals as defined in section
13.02, subdivision 12; and (2) nonpublic data as defined in section 13.02,
subdivision 9. The names of borrowers
and the amounts of the loans granted are public data.
Sec. 4. Minnesota Statutes 2008, section 62J.497,
subdivision 1, is amended to read:
Subdivision 1. Definitions. For the purposes of this section, the
following terms have the meanings given.
(a) "Backward compatible"
means that the newer version of a data transmission standard would retain, at a
minimum, the full functionality of the versions previously adopted, and would
permit the successful completion of the applicable transactions with entities
that continue to use the older versions.
(a) (b) "Dispense" or
"dispensing" has the meaning given in section 151.01, subdivision
30. Dispensing does not include the
direct administering of a controlled substance to a patient by a licensed
health care professional.
(b) (c) "Dispenser" means a person
authorized by law to dispense a controlled substance, pursuant to a valid
prescription.
(c) (d) "Electronic media" has the
meaning given under Code of Federal Regulations, title 45, part 160.103.
(d) (e) "E-prescribing" means the
transmission using electronic media of prescription or prescription-related
information between a prescriber, dispenser, pharmacy benefit manager, or group
purchaser, either directly or through an intermediary, including an
e-prescribing network. E-prescribing
includes, but is not limited to, two-way transmissions between the point of
care and the dispenser and two-way transmissions related to eligibility,
formulary, and medication history information.
(e) (f) "Electronic prescription drug
program" means a program that provides for e-prescribing.
(f) (g) "Group purchaser" has the
meaning given in section 62J.03, subdivision 6.
(g) (h) "HL7 messages" means a
standard approved by the standards development organization known as Health
Level Seven.
(h) (i) "National Provider
Identifier" or "NPI" means the identifier described under Code
of Federal Regulations, title 45, part 162.406.
(i) (j) "NCPDP" means the National
Council for Prescription Drug Programs, Inc.
(j) (k) "NCPDP Formulary and Benefits
Standard" means the National Council for Prescription Drug Programs
Formulary and Benefits Standard, Implementation Guide, Version 1, Release 0,
October 2005.
(k) (l) "NCPDP SCRIPT Standard"
means the National Council for Prescription Drug Programs Prescriber/Pharmacist
Interface SCRIPT Standard, Implementation Guide Version 8, Release 1 (Version
8.1), October 2005, or the most recent standard adopted by the Centers for
Medicare and Medicaid Services for
e‑prescribing under Medicare
Part D as required by section 1860D-4(e)(4)(D) of the Social Security Act, and
regulations adopted under it. The
standards shall be implemented according to the Centers for Medicare and
Medicaid Services schedule for compliance.
Subsequently released versions of the NCPDP SCRIPT Standard may be used,
provided that the new version of the standard is backward compatible to the
current version adopted by the Centers for Medicare and Medicaid Services.
(l) (m) "Pharmacy" has the meaning
given in section 151.01, subdivision 2.
(m) (n) "Prescriber" means a
licensed health care professional who is authorized to prescribe a
controlled substance under section 152.12, subdivision 1. practitioner,
other than a veterinarian, as defined in section 151.01, subdivision 23.
(n) (o) "Prescription-related
information" means information regarding eligibility for drug benefits,
medication history, or related health or drug information.
(o) (p) "Provider" or "health
care provider" has the meaning given in section 62J.03, subdivision 8.
Sec. 5. Minnesota Statutes 2008, section 62J.497,
subdivision 2, is amended to read:
Subd. 2. Requirements
for electronic prescribing. (a)
Effective January 1, 2011, all providers, group purchasers, prescribers, and
dispensers must establish and, maintain, and use an
electronic prescription drug program that complies. This program must comply with the
applicable standards in this section for transmitting, directly or through an
intermediary, prescriptions and prescription-related information using electronic
media.
(b) Nothing in this section
requires providers, group purchasers, prescribers, or dispensers to conduct the
transactions described in this section. If
transactions described in this section are conducted, they must be done
electronically using the standards described in this section. Nothing in this section requires providers,
group purchasers, prescribers, or dispensers to electronically conduct
transactions that are expressly prohibited by other sections or federal law.
(c) Providers, group purchasers,
prescribers, and dispensers must use either HL7 messages or the NCPDP SCRIPT
Standard to transmit prescriptions or prescription-related information
internally when the sender and the recipient are part of the same legal entity. If an entity sends prescriptions outside the
entity, it must use the NCPDP SCRIPT Standard or other applicable standards
required by this section. Any pharmacy
within an entity must be able to receive electronic prescription transmittals
from outside the entity using the adopted NCPDP SCRIPT Standard. This exemption does not supersede any Health
Insurance Portability and Accountability Act (HIPAA) requirement that may
require the use of a HIPAA transaction standard within an organization.
(d) Entities transmitting
prescriptions or prescription-related information where the prescriber is
required by law to issue a prescription for a patient to a nonprescribing
provider that in turn forwards the prescription to a dispenser are exempt from
the requirement to use the NCPDP SCRIPT Standard when transmitting
prescriptions or prescription-related information.
Sec. 6. Minnesota Statutes 2008, section 62J.497, is
amended by adding a subdivision to read:
Subd. 4.
Development and use of uniform
formulary exception form. (a)
The commissioner of health, in consultation with the Minnesota Administrative
Uniformity Committee, shall develop by July 1, 2009, or six weeks after
enactment of this subdivision, whichever is later, a uniform formulary
exception form that allows health care providers to request exceptions from
group purchaser formularies using a uniform form. Upon development of the form, all health care
providers must submit requests for formulary exceptions using the uniform form,
and all group purchasers must accept this form from health care providers.
(b) No later than January 1, 2011, the
uniform formulary exception form must be accessible and submitted by health
care providers, and accepted and processed by group purchasers, through secure
electronic transmissions. Facsimile
shall not be considered secure electronic transmissions.
Sec. 7. Minnesota Statutes 2008, section 62J.497, is
amended by adding a subdivision to read:
Subd. 5.
Electronic drug prior
authorization standardization and transmission. (a) The commissioner of health, in
consultation with the Minnesota e-Health Advisory Committee and the Minnesota
Administrative Uniformity Committee, shall, by February 15, 2010, identify an
outline on how best to standardize drug prior authorization request transactions
between providers and group purchasers with the goal of maximizing
administrative simplification and efficiency in preparation for electronic
transmissions.
(b) No later than January 1, 2011,
drug prior authorization requests must be accessible and submitted by health
care providers, and accepted and processed by group purchasers, electronically
through secure electronic transmissions.
Facsimile shall not be considered electronic transmission.
Sec. 8. [62Q.676]
MEDICATION THERAPY MANAGEMENT.
A pharmacy benefit manager that
provides prescription drug services must make available medication therapy
management services for enrollees taking four or more prescriptions to treat or
prevent two or more chronic medical conditions.
For purposes of this section, "medication therapy management"
means the provision of the following pharmaceutical care services by a licensed
pharmacist to optimize the therapeutic outcomes of the patient's medications:
(1) performing a comprehensive
medication review to identify, resolve, and prevent medication-related
problems, including adverse drug events;
(2) communicating essential
information to the patient's other primary care providers; and
(3) providing verbal education and
training designed to enhance patient understanding and appropriate use of the
patient's medications.
Nothing in this section shall be
construed to expand or modify the scope of practice of the pharmacist as
defined in section 151.01, subdivision 27.
Sec. 9. Minnesota Statutes 2008, section 144.122, is
amended to read:
144.122 LICENSE, PERMIT, AND SURVEY FEES.
(a) The state commissioner of health,
by rule, may prescribe procedures and fees for filing with the commissioner as
prescribed by statute and for the issuance of original and renewal permits,
licenses, registrations, and certifications issued under authority of the
commissioner. The expiration dates of
the various licenses, permits, registrations, and certifications as prescribed
by the rules shall be plainly marked thereon.
Fees may include application and examination fees and a penalty fee for
renewal applications submitted after the expiration date of the previously
issued permit, license, registration, and certification. The commissioner may also prescribe, by rule,
reduced fees for permits, licenses, registrations, and certifications when the
application therefor is submitted during the last three months of the permit,
license, registration, or certification period.
Fees proposed to be prescribed in the rules shall be first approved by
the Department of Finance. All fees
proposed to be prescribed in rules shall be reasonable. The fees shall be in an amount so that the
total fees collected by the commissioner will, where practical, approximate the
cost to the commissioner in administering the program. All fees collected shall be deposited in the
state treasury and credited to the state government special revenue fund unless
otherwise specifically appropriated by law for specific purposes.
(b) The commissioner may charge a fee
for voluntary certification of medical laboratories and environmental
laboratories, and for environmental and medical laboratory services provided by
the department, without complying with paragraph (a) or chapter 14. Fees charged for environment and medical
laboratory services provided by the department must be approximately equal to
the costs of providing the services.
(c) The commissioner may develop a
schedule of fees for diagnostic evaluations conducted at clinics held by the
services for children with disabilities program. All receipts generated by the program are
annually appropriated to the commissioner for use in the maternal and child
health program.
(d) The commissioner shall set license
fees for hospitals and nursing homes that are not boarding care homes at the
following levels:
Joint Commission on Accreditation of Healthcare $7,555 $7,655 plus $13
$16 per bed
Organizations (JCAHO) and American Osteopathic
Association (AOA) hospitals
Non-JCAHO and non-AOA hospitals $5,180
$5,280 plus $247 $250 per bed
Nursing home $183
plus $91 per bed
The commissioner shall set license fees for outpatient surgical centers,
boarding care homes, and supervised living facilities at the following levels:
Outpatient surgical centers $3,349
$3,712
Boarding care homes $183
plus $91 per bed
Supervised living facilities $183
plus $91 per bed.
(e) Unless prohibited by federal law, the commissioner of
health shall charge applicants the following fees to cover the cost of any
initial certification surveys required to determine a provider's eligibility to
participate in the Medicare or Medicaid program:
Prospective payment surveys for hospitals $900
Swing bed surveys for nursing homes $1,200
Psychiatric hospitals $1,400
Rural health facilities $1,100
Portable x-ray providers $500
Home health agencies $1,800
Outpatient therapy agencies $800
End stage renal dialysis providers $2,100
Independent therapists $800
Comprehensive rehabilitation outpatient facilities $1,200
Hospice providers $1,700
Ambulatory surgical providers $1,800
Hospitals $4,200
Other provider categories or additional resurveys Actual surveyor
costs: average surveyor cost
required to complete initial certification x
number of hours for the survey process.
These fees shall be submitted at the time of the application
for federal certification and shall not be refunded. All fees collected after the date that the
imposition of fees is not prohibited by federal law shall be deposited in the state
treasury and credited to the state government special revenue fund.
Sec. 10. Minnesota
Statutes 2008, section 144.218, subdivision 1, is amended to read:
Subdivision 1. Adoption. (a) Upon receipt of a certified copy
of an order, decree, or certificate of adoption, the state registrar shall
register a replacement vital record in the new name of the adopted person. Except as provided in paragraph (b), the
original record of birth is confidential pursuant to private data on
individuals, as defined in section 13.02, subdivision 3 12,
and shall not be disclosed except pursuant to court order or section 144.2252
or 144.2253.
(b)
The information contained on the original birth record, except for the
registration number, shall be provided on request to: (1) a parent who is named on the original
birth record; or (2) the adopted person who is the subject of the record if
the person is at least 19 years of age, unless there is an affidavit of
nondisclosure on file with the state registrar. Upon the receipt of a certified copy of a
court order of annulment of adoption the state registrar shall restore the
original vital record to its original place in the file.
EFFECTIVE DATE.
This section is effective August 1, 2010.
Sec. 11. Minnesota
Statutes 2008, section 144.225, subdivision 2, is amended to read:
Subd. 2. Data about births. (a) Except as otherwise provided in this
subdivision, data pertaining to the birth of a child to a woman who was not
married to the child's father when the child was conceived nor when the child
was born, including the original record of birth and the certified vital
record, are confidential data. At the
time of the birth of a child to a woman who was not married to the child's
father when the child was conceived nor when the child was born, the mother may
designate demographic data pertaining to the birth as public. Notwithstanding the designation of the data
as confidential, it may be disclosed:
(1) to a parent or guardian of the child;
(2) to the child when the child is 16 years of age or older;
(3) under paragraph (b) or (e); or
(4) pursuant to a court order.
For purposes of this section, a subpoena does not constitute a court
order.
(b) Unless the child is adopted, data pertaining to the birth
of a child that are not accessible to the public become public data if 100
years have elapsed since the birth of the child who is the subject of the data,
or as provided under section 13.10, whichever occurs first.
(c) If a child is adopted, data pertaining to the child's
birth are governed by the provisions relating to adoption records, including
sections 13.10, subdivision 5; 144.218, subdivision 1; 144.2252; 144.2253; and
259.89.
(d) The name and address of a mother under paragraph (a) and
the child's date of birth may be disclosed to the county social services or
public health member of a family services collaborative for purposes of
providing services under section 124D.23.
(e) The commissioner of human services shall have access to
birth records for:
(1) the purposes of administering medical assistance, general
assistance medical care, and the MinnesotaCare program;
(2) child support enforcement purposes; and
(3) other public health purposes as determined by the
commissioner of health.
EFFECTIVE DATE.
This section is effective August 1, 2010.
Sec. 12. Minnesota
Statutes 2008, section 144.2252, is amended to read:
144.2252 ACCESS TO ORIGINAL BIRTH
RECORD AFTER ADOPTION.
(a) Whenever an adopted person requests the state registrar to
disclose the information on the adopted person's original birth record, the
state registrar shall act according to section 259.89 144.2253.
(b) The state registrar shall provide a transcript of an
adopted person's original birth record to an authorized representative of a
federally recognized American Indian tribe for the sole purpose of determining
the adopted person's eligibility for enrollment or membership. Information contained in the birth record may
not be used to provide the adopted person information about the person's birth
parents, except as provided in this section or section 259.83
144.2253.
EFFECTIVE DATE.
This section is effective August 1, 2010.
Sec. 13. [144.2253] ACCESS TO ORIGINAL BIRTH
RECORDS BY ADOPTED PERSON; DEPARTMENT DUTIES.
Subdivision 1. Affidavits. The
department shall prepare affidavit of disclosure and nondisclosure forms under
which a birth parent may agree to or object to the release of the original
birth record to the adopted person. The
department shall make the forms readily accessible to birth parents on the
department's Web site.
Subd. 2. Disclosure. Upon
request, the state registrar shall provide a noncertified copy of the original birth
record to an adopted person age 19 or older, unless there is an affidavit of
nondisclosure on file. The state
registrar must comply with the terms of affidavits of disclosure or affidavits
of nondisclosure.
Subd. 3. Rescission of affidavit.
A birth parent may rescind an affidavit of disclosure or an affidavit
of nondisclosure at any time.
Subd. 4. Affidavit of nondisclosure; access to birth record. If an affidavit of nondisclosure is on file
with the registrar, an adopted person age 19 or older may petition the
appropriate court for disclosure of the original birth record pursuant to
section 259.61. The court shall grant
the petition if, after consideration of the interests of all known persons
affected by the petition, the court determines that the benefits of disclosure
of the information are greater than the benefits of nondisclosure.
Subd. 5. Information provided.
(a) The department shall, in consultation with adoption agencies and
adoption advocates, provide information and educational materials to adopted
persons and birth parents about the changes in the law under this act affecting
accessibility to birth records. For
purposes of this subdivision, an adoption advocate is a nonprofit organization that
works with adoption issues in Minnesota.
(b) The department shall include a notice on the department
Web site about the change in the law under this act and direct individuals to
private agencies and advocates for post-adoption resources.
(c) Adoption agencies may charge a fee for counseling and
support services provided to adopted persons and birth parents.
EFFECTIVE DATE.
This section is effective August 1, 2010.
Sec. 14. Minnesota
Statutes 2008, section 144.226, subdivision 1, is amended to read:
Subdivision 1. Which services are for fee. The fees for the following services shall be
the following or an amount prescribed by rule of the commissioner:
(a) The fee for the issuance of a certified vital record or a
certification that the vital record cannot be found is $9. No fee shall be charged for a certified
birth, stillbirth, or death record that is reissued within one year of the
original issue, if an amendment is made to the vital record and if the
previously issued vital record is surrendered.
The fee is nonrefundable.
(b) The fee for processing a request for the replacement of a
birth record for all events, except when filing a recognition of parentage
pursuant to section 257.73, subdivision 1, is $40. The fee is payable at the time of application
and is nonrefundable.
(c) The fee for processing a request for the filing of a
delayed registration of birth, stillbirth, or death is $40. The fee is payable at the time of application
and is nonrefundable. This fee includes
one subsequent review of the request if the request is not acceptable upon the
initial receipt.
(d) The fee for processing a request for the amendment of any
vital record when requested more than 45 days after the filing of the vital
record is $40. No fee shall be charged
for an amendment requested within 45 days after the filing of the vital
record. The fee is payable at the time
of application and is nonrefundable.
This fee includes one subsequent review of the request if the request is
not acceptable upon the initial receipt.
(e) The fee for processing a request for the verification of
information from vital records is $9 when the applicant furnishes the specific
information to locate the vital record.
When the applicant does not furnish specific information, the fee is $20
per hour for staff time expended.
Specific information includes the correct date of the event and the
correct name of the registrant. Fees
charged shall approximate the costs incurred in searching and copying the vital
records. The fee is payable at the time
of application and is nonrefundable.
(f) The fee for processing a request for the issuance of a
copy of any document on file pertaining to a vital record or statement that a
related document cannot be found is $9.
The fee is payable at the time of application and is nonrefundable.
(g) The department shall charge a fee of $18 for noncertified
copies of birth records provided to adopted persons age 19 or older to cover
the cost of providing the birth record and any costs associated with the
distribution of information to adopted persons and birth parents required under
section 144.2253, subdivision 5.
EFFECTIVE DATE.
This section is effective August 1, 2010.
Sec. 15. Minnesota
Statutes 2008, section 144.226, subdivision 4, is amended to read:
Subd. 4. Vital records surcharge. (a) In addition to any fee prescribed under
subdivision 1, there is a nonrefundable surcharge of $2 for each certified and
noncertified birth, stillbirth, or death record, and for a certification that
the record cannot be found. The local or
state registrar shall forward this amount to the commissioner of finance to be
deposited into the state government special revenue fund. This surcharge shall not be charged under
those circumstances in which no fee for a birth, stillbirth, or death record is
permitted under subdivision 1, paragraph (a).
(b) Effective August 1, 2005, to June 30, 2009, the
surcharge in paragraph (a) shall be is $4.
Sec. 16. Minnesota
Statutes 2008, section 148.6445, is amended by adding a subdivision to read:
Subd. 2a. Duplicate license fee.
The fee for a duplicate license is $25.
Sec. 17. Minnesota
Statutes 2008, section 259.89, subdivision 1, is amended to read:
Subdivision 1. Request. An adopted person who is 19 years of age or
over may request the commissioner of health to disclose the information on the
adopted person's original birth record. The
commissioner of health shall, within five days of receipt of the request,
notify the commissioner of human services' agent or licensed child-placing
agency when known, or the commissioner of human services when the agency is not
known in writing of the request by the adopted person.
EFFECTIVE DATE.
This section is effective August 1, 2010.
Sec. 18. Minnesota
Statutes 2008, section 260C.317, subdivision 4, is amended to read:
Subd. 4. Rights of terminated parent. Upon entry of an order terminating the
parental rights of any person who is identified as a parent on the original
birth record of the child as to whom the parental rights are terminated, the
court shall cause written notice to be made to that person setting forth:
(1) the right of the person to file at any time with the
state registrar of vital statistics a consent to disclosure, as defined in
section 144.212, subdivision 11; and
(2) the right of the person to file at any time with the
state registrar of vital statistics an affidavit stating that the information
on the original birth record shall not be disclosed as provided in section 144.2252
144.2253; and.
(3) the effect of a failure to file either a consent to
disclosure, as defined in section 144.212, subdivision 11, or an affidavit
stating that the information on the original birth record shall not be
disclosed.
EFFECTIVE DATE.
This section is effective August 1, 2010.
Sec. 19. REPEALER.
(a) Minnesota Statutes 2008, sections 259.83, subdivision 3;
and 259.89, subdivisions 2, 3, and 4, are repealed effective retroactively from
August 1, 2008.
(b) Minnesota Statutes 2008, section 62U.08, is repealed.
ARTICLE 6
HEALTH CARE PROGRAMS
Section 1. Minnesota
Statutes 2008, section 62J.692, subdivision 7, is amended to read:
Subd. 7. Transfers from the commissioner of human
services. (a) The amount
transferred according to section 256B.69, subdivision 5c, paragraph (a), clause
(1), shall be distributed by the commissioner annually to clinical medical
education programs that meet the qualifications of subdivision 3 based on the
formula in subdivision 4, paragraph (a). Of the amount transferred
according to section 256B.69, subdivision 5c, paragraph (a), clauses (1) to
(4), $21,714,000 must be distributed as follows:
(1) $2,157,000 by the commissioner to the University of
Minnesota Board of Regents for the purposes described in sections 137.38 to
137.40;
(2) $1,035,360 by the commissioner to the Hennepin County
Medical Center for clinical medical education;
(3) $17,400,000 by the commissioner to the University of
Minnesota Board of Regents for purposes of medical education;
(4) $1,121,640 by the commissioner to clinical medical
education dental innovation grants in accordance with subdivision 7a; and
(5) the remainder of the amount transferred according to
section 256B.69, subdivision 5c, paragraph (a), clauses (1) to (4), must be
distributed by the commissioner annually to clinical medical education programs
that meet the qualifications of subdivision 3 based on the formula in
subdivision 4, paragraph (a).
(b) Fifty percent of the amount transferred according to
section 256B.69, subdivision 5c, paragraph (a), clause (2), shall be
distributed by the commissioner to the University of Minnesota Board of Regents
for the purposes described in sections 137.38 to 137.40. Of the remaining amount transferred according
to section 256B.69, subdivision 5c, paragraph (a), clause (2), 24 percent of
the amount shall be distributed by the commissioner to the Hennepin County
Medical Center for clinical medical education.
The remaining 26 percent of the amount transferred shall be distributed
by the commissioner in accordance with subdivision 7a. If the federal approval is not obtained for
the matching funds under section 256B.69, subdivision 5c, paragraph (a), clause
(2), 100 percent of the amount transferred under this paragraph shall be distributed
by the commissioner to the University of Minnesota Board of Regents for the
purposes described in sections 137.38 to 137.40.
(c) The amount transferred according to section 256B.69,
subdivision 5c, paragraph (a), clauses (3) and (4), shall be distributed by the
commissioner upon receipt to the University of Minnesota Board of Regents for
the purposes of clinical graduate medical education.
Sec. 2. Minnesota
Statutes 2008, section 125A.744, subdivision 3, is amended to read:
Subd. 3. Implementation. Consistent with section 256B.0625, subdivision
26, school districts may enroll as medical assistance providers or
subcontractors and bill the Department of Human Services under the medical
assistance fee for service claims processing system for special education
services which are covered services under chapter 256B, which are provided in
the school setting for a medical assistance recipient, and for whom the
district has secured informed consent consistent with section 13.05,
subdivision 4, paragraph (d), and section 256B.77, subdivision 2, paragraph
(p), to bill for each type of covered service.
School districts shall be reimbursed by the commissioner of human
services for the federal share of individual education plan health-related
services that qualify for reimbursement by medical assistance, minus up to five
percent retained by the commissioner of human services for administrative costs,
not to exceed $350,000 per fiscal year.
The commissioner may withhold up to five percent of each payment to a
school district. Following the end of each
fiscal year, the commissioner shall settle up with each school district in
order to ensure that collections from each district for departmental
administrative costs are made on a pro rata basis according to federal earnings
for these services in each district. A
school district is not eligible to enroll as a home care provider or a personal
care provider organization for purposes of billing home care services under
sections 256B.0651 and 256B.0653 to 256B.0656 until the commissioner of human
services issues a bulletin instructing county public health nurses on how to
assess for the needs of eligible recipients during school hours. To use private duty nursing services or
personal care services at school, the recipient or responsible party must
provide written authorization in the care plan identifying the chosen provider
and the daily amount of services to be used at school.
Sec. 3. Minnesota
Statutes 2008, section 256.01, subdivision 2b, is amended to read:
Subd. 2b. Performance payments; performance
measurement. (a) The
commissioner shall develop and implement a pay-for-performance system to
provide performance payments to eligible medical groups and clinics that
demonstrate optimum care in serving individuals with chronic diseases who are
enrolled in health care programs administered by the commissioner under
chapters 256B, 256D, and 256L. The
commissioner may receive any federal matching money that is made available
through the medical assistance program for managed care oversight contracted
through vendors, including consumer surveys, studies, and external quality
reviews as required by the federal Balanced Budget Act of 1997, Code of Federal
Regulations, title 42, part 438-managed care, subpart E-external quality
review. Any federal money received for
managed care oversight is appropriated to the commissioner for this
purpose. The commissioner may expend the
federal money received in either year of the biennium.
(b) Effective July 1, 2008, or upon federal approval,
whichever is later, the commissioner shall develop and implement a patient
incentive health program to provide incentives and rewards to patients who are
enrolled in health care programs administered by the commissioner under
chapters 256B, 256D, and 256L, and who have agreed to and have met personal
health goals established with the patients' primary care providers to manage a
chronic disease or condition, including but not limited to diabetes, high blood
pressure, and coronary artery disease. The commissioner, in consultation
with the Health and Human Services Policy Committee, shall develop and provide
to the legislature by December 15, 2009, a methodology and any draft
legislation necessary to allow for the release, upon request, of summary data
as defined in section 13.02, subdivision 19, on claims and utilization for
medical assistance, general assistance medical care, and MinnesotaCare
enrollees at no charge to the University of Minnesota Medical School, the Mayo
Medical School, Northwestern Health Sciences University, the Institute for
Clinical Systems Improvement, and other research institutions, to conduct
analyses of health care outcomes and treatment effectiveness, provided the
research institutions do not release private or nonpublic data, or data for
which dissemination is prohibited by law.
Sec. 4. Minnesota
Statutes 2008, section 256.01, is amended by adding a subdivision to read:
Subd. 18a. Public Assistance Reporting Information System. (a) Effective October 1, 2009, the
commissioner shall comply with the federal requirements in Public Law 110-379
in implementing the Public Assistance Reporting Information System (PARIS) to
determine eligibility for all individuals applying for:
(1) health care benefits under chapters 256B, 256D, and 256L;
and
(2) public benefits under chapters 119B, 256D, 256I, and the
supplemental nutrition assistance program.
(b) The commissioner shall determine eligibility under
paragraph (a) by performing data matches, including matching with medical
assistance, cash, child care, and supplemental assistance programs operated by
other states.
EFFECTIVE DATE.
This section is effective October 1, 2009.
Sec. 5. Minnesota
Statutes 2008, section 256.962, subdivision 2, is amended to read:
Subd. 2. Outreach grants. (a) The commissioner shall award grants to
public and private organizations, regional collaboratives, and regional health
care outreach centers for outreach activities, including, but not limited to:
(1) providing information, applications, and assistance in
obtaining coverage through Minnesota public health care programs;
(2) collaborating with public and private entities such as
hospitals, providers, health plans, legal aid offices, pharmacies, insurance
agencies, and faith-based organizations to develop outreach activities and partnerships
to ensure the distribution of information and applications and provide
assistance in obtaining coverage through Minnesota health care programs; and
(3) providing or collaborating with public and private
entities to provide multilingual and culturally specific information and
assistance to applicants in areas of high uninsurance in the state or
populations with high rates of uninsurance; and
(4) targeting geographic areas with high rates of (i)
eligible but unenrolled children, including children who reside in rural areas,
or (ii) racial and ethnic minorities and health disparity populations.
(b) The commissioner shall ensure that all outreach materials
are available in languages other than English.
(c) The commissioner shall establish an outreach trainer
program to provide training to designated individuals from the community and
public and private entities on application assistance in order for these
individuals to provide training to others in the community on an as-needed
basis.
Sec. 6. Minnesota
Statutes 2008, section 256.962, subdivision 6, is amended to read:
Subd. 6. School districts and charter schools. (a) At the beginning of each school year, a
school district or charter school shall provide information to each
student on the availability of health care coverage through the Minnesota
health care programs and how to obtain an application for the Minnesota
health care programs.
(b) For each child who is determined to be eligible for
the free and reduced-price school lunch program, the district shall provide the
child's family with information on how to obtain an application for the
Minnesota health care programs and application assistance.
(c)
A school district or charter school shall also ensure that
applications and information on application assistance are available at early
childhood education sites and public schools located within the district's
jurisdiction.
(d) (c) Each
district shall designate an enrollment specialist to provide application
assistance and follow-up services with families who have indicated an interest
in receiving information or an application for the Minnesota health care
program. A district is eligible for the
application assistance bonus described in subdivision 5.
(e) Each (d) If a school district or charter school maintains a
district Web site, the school district or charter school shall provide on their
its Web site a link to information on how to obtain an application and
application assistance.
Sec. 7. Minnesota
Statutes 2008, section 256.963, is amended by adding a subdivision to read:
Subd. 3. Urgent dental care services.
The commissioner of human services shall authorize pilot projects to
reduce the total costs to the state for dental services provided to persons
enrolled in Minnesota health care programs by reducing hospital emergency room
costs for preventable and nonemergency dental services. The commissioner may provide start-up funding
and establish special payment rates for urgent dental care services provided as
an alternative to emergency room services and may change or waive existing
payment policies in order to adequately reimburse providers for providing
cost-effective alternative services in outpatient or urgent care settings. The commissioner may establish a project in
conjunction with the initiative authorized under subdivisions 1 and 2, or
establish new initiatives, or may implement both approaches.
Sec. 8. Minnesota
Statutes 2008, 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 are
excluded from this paragraph.
(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 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.
(e) In addition to the reductions in paragraphs (b), (c), and
(d), the total payment for fee-for-service admissions occurring on or after
July 1, 2008, through June 30, 2009, made to hospitals for inpatient services
before third-party liability and spenddown, is reduced 3.46 percent from the
current statutory rates. Mental health
services with diagnosis related groups 424 to 432 and facilities defined under
subdivision 16 are excluded from this paragraph. Payments made to managed care plans shall be
reduced for services provided on or after January 1, 2009, through June 30,
2009, to reflect this reduction.
(f) In addition to the reductions in paragraphs (b), (c), and
(d), the total payment for fee-for-service admissions occurring on or after
July 1, 2009, through June 30, 2010, made to hospitals for inpatient services
before third-party liability and spenddown, is reduced 1.9 percent from the
current statutory rates. Mental health
services with diagnosis related groups 424 to 432 and facilities defined under
subdivision 16 are excluded from this paragraph. Payments made to managed care plans shall be
reduced for services provided on or after July 1, 2009, through June 30, 2010,
to reflect this reduction.
(g) In addition to the reductions in paragraphs (b), (c), and
(d), the total payment for fee-for-service admissions occurring on or after July
1, 2010, made to hospitals for inpatient services before third-party liability
and spenddown, is reduced 1.79 percent from the current statutory rates. Mental health services with diagnosis related
groups 424 to 432 and facilities defined under subdivision 16 are excluded from
this paragraph. Payments made to managed
care plans shall be reduced for services provided on or after July 1, 2010, to
reflect this reduction.
(h) In addition to the reductions in paragraphs (b), (c), (d),
(f), and (g), the total payment for fee-for-service admissions occurring on or
after July 1, 2009, made to hospitals for inpatient services before third-party
liability and spenddown, is reduced 3.0 percent from the current statutory
rates. Facilities defined under
subdivision 16 are excluded from this paragraph. Payments made to managed care plans shall be
reduced for services provided on or after January 1, 2010, to reflect this
reduction.
(i) In addition to the reductions in paragraphs (b) and (h),
the total payment for fee-for-service admissions occurring on or after July 1,
2009, made to hospitals for mental health services within diagnosis-related
groups 424 to 432 before third-party liability and spenddown, is reduced 5.2
percent from the current statutory rates.
Facilities defined under subdivision 16 are excluded from this
paragraph. Payments made to managed care
plans shall be reduced for services provided on or after January 1, 2010, to
reflect this reduction.
Sec. 9. Minnesota
Statutes 2008, section 256B.056, subdivision 3, is amended to read:
Subd. 3. Asset limitations for individuals and
families. To be eligible for medical
assistance, a person must not individually own more than $3,000 in assets, or
if a member of a household with two family members, husband and wife, or parent
and child, the household must not own more than $6,000 in assets, plus $200 for
each additional legal dependent. In
addition to these maximum amounts, an eligible individual or family may accrue
interest on these amounts, but they must be reduced to the maximum at the time
of an eligibility redetermination. The
accumulation of the clothing and personal needs allowance according to section
256B.35 must also be reduced to the maximum at the time of the eligibility
redetermination. The value of assets
that are not considered in determining eligibility for medical assistance is
the value of those assets excluded under the supplemental security income
program for aged, blind, and disabled persons, with the following exceptions:
(1) household goods and personal effects are not considered;
(2) 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. A bank
account that contains personal income or assets, or is used to pay personal
expenses, is not considered a capital or operating asset of a trade or business;
(3) motor vehicles are excluded to the same extent excluded by
the supplemental security income program;
(4) 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; and
(5) 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 (c).
The
assets specified in clause (2) must be disclosed to the local agency at the
time of application and at the time of an eligibility redetermination, and must
be verified upon request of the local agency.
EFFECTIVE DATE.
This section is effective January 1, 2011, or upon federal approval,
whichever is later.
Sec. 10. Minnesota
Statutes 2008, section 256B.056, subdivision 3b, is amended to read:
Subd. 3b. Treatment of trusts. (a) A "medical assistance qualifying
trust" is a revocable or irrevocable trust, or similar legal device,
established on or before August 10, 1993, by a person or the person's spouse
under the terms of which the person receives or could receive payments from the
trust principal or income and the trustee has discretion in making payments to
the person from the trust principal or income.
Notwithstanding that definition, a medical
assistance qualifying trust does not
include: (1) a trust set up by will; (2)
a trust set up before April 7, 1986, solely to benefit a person with a developmental disability
living in an intermediate care facility for persons with developmental
disabilities; or (3) a trust set up by a person with payments made by the
Social Security Administration pursuant to the United States Supreme Court
decision in Sullivan v. Zebley, 110 S. Ct. 885 (1990). The maximum amount of payments that a trustee
of a medical assistance qualifying trust may make to a person under the terms
of the trust is considered to be available assets to the person, without regard
to whether the trustee actually makes the maximum payments to the person and
without regard to the purpose for which the medical assistance qualifying trust
was established.
(b) Except as
provided in paragraphs (c) and (d), trusts established after August 10,
1993, are treated according to section 13611(b) of the Omnibus Budget
Reconciliation Act of 1993 (OBRA), Public Law 103-66.
(c) For purposes
of paragraph (d), a pooled trust means a trust established under United States
Code, title 42, section 1396p(d)(4)(C).
(d) A
beneficiary's interest in a pooled trust is considered an available asset
unless the trust provides that upon the death of the beneficiary or termination
of the trust during the beneficiary's lifetime, whichever is sooner, the
department receives any amount in excess of reasonable administrative fees
remaining in the beneficiary's trust account up to the amount of medical
assistance benefits paid on behalf of the beneficiary under the state medical
assistance plan. The trust may provide
the nonprofit trustee, prior to payment to the state:
(1) reimbursement
of reasonable expenses incurred by the trustee on behalf of the beneficiary
which are subject to reimbursement under the terms of the trust; and
(2) reimbursement
of reasonable administrative costs and fees.
A remainder
interest may be retained by the nonprofit trustee that does not exceed five
percent of the remaining balance in the trust account upon the death of the
beneficiary or the termination of the trust, and must only be used for the
benefit of disabled individuals who have a beneficial interest in the pooled
trust.
EFFECTIVE DATE. This section is effective
for pooled trust accounts established on or after January 1, 2011.
Sec. 11. Minnesota Statutes 2008, section 256B.056,
subdivision 3c, is amended to read:
Subd. 3c. Asset
limitations for families and children.
A household of two or more persons must not own more than $20,000 in
total net assets, and a household of one person must not own more than $10,000
in total net assets. 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 value
of assets that are not considered in determining eligibility for medical
assistance for families and children is the value of those assets excluded
under the AFDC state plan as of July 16, 1996, as required by the Personal
Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), Public
Law 104-193, with the following exceptions:
(1) household goods
and personal effects are not considered;
(2) capital and
operating assets of a trade or business up to $200,000 are not considered,
except that a bank account that contains personal income or assets, or is used
to pay personal expenses, is not considered a capital or operating asset of a
trade or business;
(3) one motor vehicle
is excluded for each person of legal driving age who is employed or seeking
employment;
(4) one burial plot
and all other burial expenses equal to the supplemental security income program
asset limit are not considered for each individual;
(5) court-ordered settlements up to $10,000 are not
considered;
(6) individual retirement accounts and funds are not
considered; and
(7) assets owned by children are not considered.
The
assets specified in clause (2) must be disclosed to the local agency at the
time of application and at the time of an eligibility redetermination, and must
be verified upon request of the local agency.
EFFECTIVE DATE.
This section is effective January 1, 2011, or upon federal approval,
whichever is later.
Sec. 12. Minnesota
Statutes 2008, section 256B.056, is amended by adding a subdivision to read:
Subd. 10a. Presumptive eligibility.
Medical assistance is available during a presumptive period of
eligibility that meets the requirements of United States Code, title 42,
section 1396r-1a. Presumptive
eligibility shall be determined by the state or local agency for children under
age 19 who appear to meet income requirements of section 256B.057, subdivisions
1, 2, and 8, on the basis of preliminary information. The presumptive period begins on the first
day of the month in which presumptive eligibility is determined. The agency must provide notice of presumptive
eligibility and information on the procedures for completing the eligibility
process. The presumptive period ends on
the earlier of the date of the determination for medical assistance
eligibility, or the last day of the month following the presumptive eligibility
determination if a complete application with requested verifications is not
submitted by that date. Enrollees who
are terminated for failure to complete an application or provide verifications
cannot be granted presumptive eligibility again for 12 months.
EFFECTIVE DATE.
This section is effective January 1, 2010, or upon federal approval,
whichever is later.
Sec. 13. Minnesota
Statutes 2008, section 256B.057, subdivision 3, is amended to read:
Subd. 3. Qualified Medicare beneficiaries. A person who is entitled to Part A Medicare
benefits, whose income is equal to or less than 100 percent of the federal
poverty guidelines, and whose assets are no more than $10,000 for a single
individual and $18,000 for a married couple or family of two or more the
maximum resource level applied for the year for an individual or an individual
and the individual's spouse according to United States Code, title 42, section
1396d(p)(1)(C), is eligible for medical assistance reimbursement of Part A
and Part B premiums, Part A and Part B coinsurance and deductibles, and
cost-effective premiums for enrollment with a health maintenance organization
or a competitive medical plan under section 1876 of the Social Security
Act. Reimbursement of the Medicare
coinsurance and deductibles, when added to the amount paid by Medicare, must
not exceed the total rate the provider would have received for the same service
or services if the person were a medical assistance recipient with Medicare
coverage. 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 DATE.
This section is effective January 1, 2012.
Sec. 14. Minnesota
Statutes 2008, section 256B.057, subdivision 9, is amended to read:
Subd. 9. Employed persons with disabilities. (a) Medical assistance may be paid for a
person who is employed and who:
(1) meets the definition of disabled under the supplemental
security income program;
(2) is at least 16 but less than 65 years of age;
(3) meets the asset limits in paragraph (c); and
(4) effective November 1, 2003, pays a premium and other
obligations under paragraph (e).
Any
spousal income or assets shall be disregarded for purposes of eligibility and
premium determinations.
(b) After the month of enrollment, a person enrolled in
medical assistance under this subdivision who:
(1) is temporarily unable to work and without receipt of earned
income due to a medical condition, as verified by a physician, may retain
eligibility for up to four calendar months; or
(2) effective January 1, 2004, loses employment for reasons
not attributable to the enrollee, may retain eligibility for up to four
consecutive months after the month of job loss.
To receive a four-month extension, enrollees must verify the medical
condition or provide notification of job loss.
All other eligibility requirements must be met and the enrollee must pay
all calculated premium costs for continued eligibility.
(c) For purposes of determining eligibility under this
subdivision, a person's assets must not exceed $20,000, excluding:
(1) all assets excluded under section 256B.056;
(2) retirement accounts, including individual accounts,
401(k) plans, 403(b) plans, Keogh plans, and pension plans; and
(3) medical expense accounts set up through the person's
employer.
(d)(1) Effective January 1, 2004, for purposes of
eligibility, there will be a $65 earned income disregard. To be eligible, a person applying for medical
assistance under this subdivision must have earned income above the disregard
level.
(2) Effective January 1, 2004, to be considered earned
income, Medicare, Social Security, and applicable state and federal income
taxes must be withheld. To be eligible,
a person must document earned income tax withholding.
(e)(1) A person whose earned and unearned income is equal to
or greater than 100 percent of federal poverty guidelines for the applicable
family size must pay a premium to be eligible for medical assistance under this
subdivision. The premium shall be based
on the person's gross earned and unearned income and the applicable family size
using a sliding fee scale established by the commissioner, which begins at one
percent of income at 100 percent of the federal poverty guidelines and
increases to 7.5 percent of income for those with incomes at or above 300
percent of the federal poverty guidelines.
Annual adjustments in the premium schedule based upon changes in the
federal poverty guidelines shall be effective for premiums due in July of each
year.
(2) Effective January 1, 2004, all enrollees must pay a
premium to be eligible for medical assistance under this subdivision. An enrollee shall pay the greater of a $35
$50 premium or the premium calculated in clause (1).
(3) Effective November 1, 2003, all enrollees who receive
unearned income must pay one-half of one 2.5 percent of unearned
income in addition to the premium amount.
(4) Effective November 1, 2003, for enrollees whose income
does not exceed 200 percent of the federal poverty guidelines and who are also
enrolled in Medicare, the commissioner must reimburse the enrollee for Medicare
Part B premiums under section 256B.0625, subdivision 15, paragraph (a).
(5) 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.
(f) A person's eligibility and premium shall be determined by
the local county agency. Premiums must
be paid to the commissioner. All
premiums are dedicated to the commissioner.
(g) Any required premium shall be determined at application
and redetermined at the enrollee's six-month income review or when a change in
income or household size is reported.
Enrollees must report any change in income or household size within ten
days of when the change occurs. A
decreased premium resulting from a reported change in income or household size
shall be effective the first day of the next available billing month after the
change is reported. Except for changes
occurring from annual cost-of-living increases, a change resulting in an
increased premium shall not affect the premium amount until the next six-month
review.
(h) Premium payment is due upon notification from the
commissioner of the premium amount required.
Premiums may be paid in installments at the discretion of the
commissioner.
(i) Nonpayment of the premium shall result in denial or
termination of medical assistance unless the person demonstrates good cause for
nonpayment. Good cause exists if the
requirements specified in Minnesota Rules, part 9506.0040, subpart 7, items B
to D, are met. Except when an installment
agreement is accepted by the commissioner, all persons disenrolled for
nonpayment of a premium must pay any past due premiums as well as current
premiums due prior to being reenrolled.
Nonpayment shall include payment with a returned, refused, or dishonored
instrument. The commissioner may require
a guaranteed form of payment as the only means to replace a returned, refused,
or dishonored instrument.
EFFECTIVE DATE.
This section is effective January 1, 2011.
Sec. 15. Minnesota
Statutes 2008, section 256B.057, is amended by adding a subdivision to read:
Subd. 11. Treatment for colorectal cancer. (a) State-only funded medical assistance
may be paid for an individual who:
(1) has been screened for colorectal cancer by the colorectal
cancer prevention demonstration project;
(2) according to the individual's treating health
professional, needs treatment for colorectal cancer;
(3) meets income eligibility guidelines for the colorectal
cancer prevention demonstration project;
(4) is under the age of 65; and
(5) is not otherwise eligible for federally funded medical assistance
or covered under creditable coverage as defined under United States Code, title
42, section 1396a(aa).
(b) Medical assistance provided under this subdivision shall
be limited to services provided during the period that the individual receives
treatment for colorectal cancer.
(c) An individual meeting the criteria in paragraph (a) is
eligible for state-only funded medical assistance without meeting the
eligibility criteria relating to income and assets in section 256B.056,
subdivisions 1a to 5b.
Sec. 16. Minnesota
Statutes 2008, section 256B.0575, is amended to read:
256B.0575 AVAILABILITY OF INCOME FOR
INSTITUTIONALIZED PERSONS.
Subdivision 1. Income deductions.
When an institutionalized person is determined eligible for medical
assistance, the income that exceeds the deductions in paragraphs (a) and (b)
must be applied to the cost of institutional care.
(a) The following amounts must be deducted from the institutionalized
person's income in the following order:
(1) the personal needs allowance under section 256B.35 or, for
a veteran who does not have a spouse or child, or a surviving spouse of a
veteran having no child, the amount of an improved pension received from the
veteran's administration not exceeding $90 per month;
(2) the personal allowance for disabled individuals under
section 256B.36;
(3) if the institutionalized person has a legally appointed
guardian or conservator, five percent of the recipient's gross monthly income
up to $100 as reimbursement for guardianship or conservatorship services;
(4) a monthly income allowance determined under section
256B.058, subdivision 2, but only to the extent income of the institutionalized
spouse is made available to the community spouse;
(5) a monthly allowance for children under age 18 which,
together with the net income of the children, would provide income equal to the
medical assistance standard for families and children according to section
256B.056, subdivision 4, for a family size that includes only the minor
children. This deduction applies only if
the children do not live with the community spouse and only to the extent that
the deduction is not included in the personal needs allowance under section 256B.35,
subdivision 1, as child support garnished under a court order;
(6) a monthly family allowance for other family members, equal
to one-third of the difference between 122 percent of the federal poverty
guidelines and the monthly income for that family member;
(7) reparations payments made by the Federal Republic of
Germany and reparations payments made by the Netherlands for victims of Nazi
persecution between 1940 and 1945;
(8) all other exclusions from income for institutionalized
persons as mandated by federal law; and
(9) amounts for reasonable expenses, as specified in
subdivision 2, incurred for necessary medical or remedial care for the
institutionalized person that are recognized under state law, not
medical assistance covered expenses, and that are not subject to
payment by a third party.
Reasonable expenses are limited to expenses that have not been
previously used as a deduction from income and are incurred during the
enrollee's current period of eligibility, including retroactive months
associated with the current period of eligibility, for medical assistance
payment of long-term care services.
For purposes of clause (6), "other family member"
means a person who resides with the community spouse and who is a minor or
dependent child, dependent parent, or dependent sibling of either spouse.
"Dependent" means a person who could be claimed as a dependent for
federal income tax purposes under the Internal Revenue Code.
(b) Income shall be allocated to an institutionalized person
for a period of up to three calendar months, in an amount equal to the medical
assistance standard for a family size of one if:
(1) a physician certifies that the person is expected to
reside in the long-term care facility for three calendar months or less;
(2) if the person has expenses of maintaining a residence in
the community; and
(3) if one of the following circumstances apply:
(i) the person was not living together with a spouse or a
family member as defined in paragraph (a) when the person entered a long-term
care facility; or
(ii) the person and the person's spouse become
institutionalized on the same date, in which case the allocation shall be
applied to the income of one of the spouses.
For
purposes of this paragraph, a person is determined to be residing in a licensed
nursing home, regional treatment center, or medical institution if the person
is expected to remain for a period of one full calendar month or more.
Subd. 2. Reasonable expenses. (a)
For the purposes of subdivision 1, paragraph (a), clause (9), reasonable
expenses are limited to expenses that have not been previously used as a
deduction from income and were not:
(1) for long-term care expenses incurred during a period of
ineligibility as defined in section 256B.0595, subdivision 2;
(2) incurred more than three months before the month of
application associated with the current period of eligibility;
(3) for expenses incurred by a recipient that are duplicative
of services that are covered under chapter 256B; or
(4) nursing facility expenses incurred without a timely
assessment as required under section 256B.0911.
Sec. 17. Minnesota
Statutes 2008, section 256B.0595, subdivision 1, is amended to read:
Subdivision 1. Prohibited transfers. (a) For transfers of assets made on or before
August 10, 1993, if an institutionalized person or the institutionalized
person's spouse has given away, sold, or disposed of, for less than fair market
value, any asset or interest therein, except assets other than the homestead
that are excluded under the supplemental security program, within 30 months
before or any time after the date of institutionalization if the person has
been determined eligible for medical assistance, or within 30 months before or
any time after the date of the first approved application for medical
assistance if the person has not yet been determined eligible for medical
assistance, the person is ineligible for long-term care services for the period
of time determined under subdivision 2.
(b) Effective for transfers made after August 10, 1993, an
institutionalized person, an institutionalized person's spouse, or any person,
court, or administrative body with legal authority to act in place of, on
behalf of, at the direction of, or upon the request of the institutionalized person
or institutionalized person's spouse, may not give away, sell, or dispose of,
for less than fair market value, any asset or interest therein, except assets
other than the homestead that are excluded under the Supplemental Security
Income program, for the purpose of establishing or maintaining medical
assistance eligibility. This applies to
all transfers, including those made by a community spouse after the month in
which the institutionalized spouse is determined eligible for medical
assistance. For purposes of determining
eligibility for long-term care services, any transfer of such assets within 36
months before or any time after an institutionalized person requests medical
assistance payment of long-term care services, or 36 months before or any time
after a medical assistance recipient becomes an institutionalized person, for
less than fair market value may be considered.
Any such transfer is presumed to have been made for the purpose of
establishing or maintaining medical assistance eligibility and the
institutionalized person is ineligible for long-term care services for the
period of time determined under subdivision 2, unless the institutionalized
person furnishes convincing evidence to establish that the transaction was
exclusively for another purpose, or unless the transfer is permitted under
subdivision 3 or 4. In the case of
payments from a trust or portions of a trust that are considered transfers of
assets under federal law, or in the case of any other disposal of assets made
on or after February 8, 2006, any transfers made within 60 months before or any
time after an institutionalized person requests medical assistance payment of
long-term care services and within 60 months before or any time after a medical
assistance recipient becomes an institutionalized person, may be considered.
(c) This section applies to transfers, for less than fair
market value, of income or assets, including assets that are considered income
in the month received, such as inheritances, court settlements, and retroactive
benefit payments or income to which the institutionalized person or the
institutionalized person's spouse is entitled but does not
receive due to action by the institutionalized person, the
institutionalized person's spouse, or any person, court, or administrative body
with legal authority to act in place of, on behalf of, at the direction of, or
upon the request of the institutionalized person or the institutionalized
person's spouse.
(d) This section applies to payments for care or personal
services provided by a relative, unless the compensation was stipulated in a
notarized, written agreement which was in existence when the service was
performed, the care or services directly benefited the person, and the payments
made represented reasonable compensation for the care or services
provided. A notarized written agreement
is not required if payment for the services was made within 60 days after the
service was provided.
(e) This section applies to the portion of any asset or
interest that an institutionalized person, an institutionalized person's
spouse, or any person, court, or administrative body with legal authority to
act in place of, on behalf of, at the direction of, or upon the request of the
institutionalized person or the institutionalized person's spouse, transfers to
any annuity that exceeds the value of the benefit likely to be returned to the
institutionalized person or institutionalized person's spouse while alive,
based on estimated life expectancy as determined according to the current
actuarial tables published by the Office of the Chief Actuary of the Social
Security Administration. The
commissioner may adopt rules reducing life expectancies based on the need for
long-term care. This section applies to
an annuity purchased on or after March 1, 2002, that:
(1) is not purchased from an insurance company or financial
institution that is subject to licensing or regulation by the Minnesota
Department of Commerce or a similar regulatory agency of another state;
(2) does not pay out principal and interest in equal monthly
installments; or
(3) does not begin payment at the earliest possible date
after annuitization.
(f) Effective for transactions, including the purchase of an
annuity, occurring on or after February 8, 2006, by or on behalf of an
institutionalized person who has applied for or is receiving long-term care
services or the institutionalized person's spouse shall be treated as the
disposal of an asset for less than fair market value unless the department is
named a preferred remainder beneficiary as described in section 256B.056,
subdivision 11. Any subsequent change to
the designation of the department as a preferred remainder beneficiary shall
result in the annuity being treated as a disposal of assets for less than fair
market value. The amount of such
transfer shall be the maximum amount the institutionalized person or the
institutionalized person's spouse could receive from the annuity or similar
financial instrument. Any change in the
amount of the income or principal being withdrawn from the annuity or other
similar financial instrument at the time of the most recent disclosure shall be
deemed to be a transfer of assets for less than fair market value unless the
institutionalized person or the institutionalized person's spouse demonstrates
that the transaction was for fair market value.
In the event a distribution of income or principal has been improperly
distributed or disbursed from an annuity or other retirement planning
instrument of an institutionalized person or the institutionalized person's
spouse, a cause of action exists against the individual receiving the improper
distribution for the cost of medical assistance services provided or the amount
of the improper distribution, whichever is less.
(g) Effective for transactions, including the purchase of an
annuity, occurring on or after February 8, 2006, by or on behalf of an
institutionalized person applying for or receiving long-term care services
shall be treated as a disposal of assets for less than fair market value unless
it is:
(i) an annuity described in subsection (b) or (q) of section
408 of the Internal Revenue Code of 1986; or
(ii) purchased with proceeds from:
(A) an account or trust described in subsection (a), (c), or
(p) of section 408 of the Internal Revenue Code;
(B) a simplified employee pension within the meaning of
section 408(k) of the Internal Revenue Code; or
(C) a Roth IRA described in section 408A of the Internal
Revenue Code; or
(iii) an annuity that is irrevocable and nonassignable; is
actuarially sound as determined in accordance with actuarial publications of
the Office of the Chief Actuary of the Social Security Administration; and
provides for payments in equal amounts during the term of the annuity, with no
deferral and no balloon payments made.
(h) For purposes of this section, long-term care services
include services in a nursing facility, services that are eligible for payment
according to section 256B.0625, subdivision 2, because they are provided in a
swing bed, intermediate care facility for persons with developmental
disabilities, and home and community-based services provided pursuant to sections
256B.0915, 256B.092, and 256B.49. For
purposes of this subdivision and subdivisions 2, 3, and 4,
"institutionalized person" includes a person who is an inpatient in a
nursing facility or in a swing bed, or intermediate care facility for persons
with developmental disabilities or who is receiving home and community-based
services under sections 256B.0915, 256B.092, and 256B.49.
(i) This section applies to funds used to purchase a
promissory note, loan, or mortgage unless the note, loan, or mortgage:
(1) has a repayment term that is actuarially sound;
(2) provides for payments to be made in equal amounts during
the term of the loan, with no deferral and no balloon payments made; and
(3) prohibits the cancellation of the balance upon the death
of the lender.
In the case of a promissory note, loan, or mortgage that does
not meet an exception in clauses (1) to (3), the value of such note, loan, or
mortgage shall be the outstanding balance due as of the date of the
institutionalized person's request for medical assistance payment of long-term
care services.
(j) This section applies to the purchase of a life estate
interest in another person's home unless the purchaser resides in the home for
a period of at least one year after the date of purchase.
(k) This section applies to transfers into a pooled trust
that qualifies under United States Code, title 42, section 1396p(d)(4)(C), by:
(1) a person age 65 or older or the person's spouse; or
(2) any person, court, or administrative body with legal
authority to act in place of, on behalf of, at the direction of, or upon the
request of a person age 65 or older or the person's spouse.
Sec. 18. Minnesota
Statutes 2008, section 256B.0595, subdivision 2, is amended to read:
Subd. 2. Period of ineligibility for long-term
care services. (a) For any
uncompensated transfer occurring on or before August 10, 1993, the number of
months of ineligibility for long-term care services shall be the lesser of 30
months, or the uncompensated transfer amount divided by the average medical
assistance rate for nursing facility services in the state in effect on the
date of application. The amount used to
calculate the average medical assistance payment rate shall be adjusted each
July 1 to reflect payment rates for the previous calendar year. The period of ineligibility begins with the
month in which the assets were transferred.
If the transfer was not reported to the local agency at the time of
application, and the applicant received long-term care services during what
would have been the period of ineligibility if the transfer had been reported,
a cause of action exists against the transferee for the cost
of long-term care services provided during the period of
ineligibility, or for the uncompensated amount of the transfer, whichever is
less. The uncompensated transfer amount
is the fair market value of the asset at the time it was given away, sold, or
disposed of, less the amount of compensation received.
(b) For uncompensated transfers made after August 10, 1993,
the number of months of ineligibility for long-term care services shall be the
total uncompensated value of the resources transferred divided by the average
medical assistance rate for nursing facility services in the state in effect on
the date of application. The amount used
to calculate the average medical assistance payment rate shall be adjusted each
July 1 to reflect payment rates for the previous calendar year. The period of ineligibility begins with the
first day of the month after the month in which the assets were transferred
except that if one or more uncompensated transfers are made during a period of
ineligibility, the total assets transferred during the ineligibility period
shall be combined and a penalty period calculated to begin on the first day of
the month after the month in which the first uncompensated transfer was
made. If the transfer was reported to
the local agency after the date that advance notice of a period of
ineligibility that affects the next month could be provided to the recipient
and the recipient received medical assistance services or the transfer was not
reported to the local agency, and the applicant or recipient received medical
assistance services during what would have been the period of ineligibility if
the transfer had been reported, a cause of action exists against the transferee
for that portion of long-term care services provided during the period of
ineligibility, or for the uncompensated amount of the transfer, whichever is
less. The uncompensated transfer amount
is the fair market value of the asset at the time it was given away, sold, or
disposed of, less the amount of compensation received. Effective for transfers made on or after
March 1, 1996, involving persons who apply for medical assistance on or after
April 13, 1996, no cause of action exists for a transfer unless:
(1) the transferee knew or should have known that the
transfer was being made by a person who was a resident of a long-term care
facility or was receiving that level of care in the community at the time of
the transfer;
(2) the transferee knew or should have known that the
transfer was being made to assist the person to qualify for or retain medical
assistance eligibility; or
(3) the transferee actively solicited the transfer with
intent to assist the person to qualify for or retain eligibility for medical
assistance.
(c) For uncompensated transfers made on or after February 8,
2006, the period of ineligibility:
(1) for uncompensated transfers by or on behalf of
individuals receiving medical assistance payment of long-term care services,
begins the first day of the month following advance notice of the penalty
period of ineligibility, but no later than the first day of the month
that follows three full calendar months from the date of the report or
discovery of the transfer; or
(2) for uncompensated transfers by individuals requesting
medical assistance payment of long-term care services, begins the date on which
the individual is eligible for medical assistance under the Medicaid state plan
and would otherwise be receiving long-term care services based on an approved
application for such care but for the application of the penalty period
of ineligibility resulting from the uncompensated transfer; and
(3) cannot begin during any other period of ineligibility.
(d) If a calculation of a penalty period of
ineligibility results in a partial month, payments for long-term care
services shall be reduced in an amount equal to the fraction.
(e) In the case of multiple fractional transfers of assets in
more than one month for less than fair market value on or after February 8,
2006, the period of ineligibility is calculated by treating the total,
cumulative, uncompensated value of all assets transferred during all months on
or after February 8, 2006, as one transfer.
(f) A period of ineligibility established under paragraph (c)
may be eliminated if all of the assets transferred for less than fair market
value used to calculate the period of ineligibility, or cash equal to the value
of the assets at the time of the transfer, are returned within 12 months after
the date the period of ineligibility began.
A period of ineligibility must not be adjusted if less than the full amount
of the transferred assets or the full cash value of the transferred assets are
returned.
EFFECTIVE DATE.
This section is effective for periods of ineligibility established on
or after January 1, 2011.
Sec. 19. Minnesota
Statutes 2008, section 256B.06, subdivision 4, is amended to read:
Subd. 4. Citizenship requirements. (a) Eligibility for medical assistance is
limited to citizens of the United States, qualified noncitizens as defined in
this subdivision, and other persons residing lawfully in the United States. Citizens or nationals of the United States
must cooperate in obtaining satisfactory documentary evidence of citizenship or
nationality according to the requirements of the federal Deficit Reduction Act
of 2005, Public Law 109-171.
(b) "Qualified noncitizen" means a person who meets
one of the following immigration criteria:
(1) admitted for lawful permanent residence according to
United States Code, title 8;
(2) admitted to the United States as a refugee according to
United States Code, title 8, section 1157;
(3) granted asylum according to United States Code, title 8,
section 1158;
(4) granted withholding of deportation according to United
States Code, title 8, section 1253(h);
(5) paroled for a period of at least one year according to
United States Code, title 8, section 1182(d)(5);
(6) granted conditional entrant status according to United
States Code, title 8, section 1153(a)(7);
(7) determined to be a battered noncitizen by the United
States Attorney General according to the Illegal Immigration Reform and
Immigrant Responsibility Act of 1996, title V of the Omnibus Consolidated
Appropriations Bill, Public Law 104-200;
(8) is a child of a noncitizen determined to be a battered
noncitizen by the United States Attorney General according to the Illegal
Immigration Reform and Immigrant Responsibility Act of 1996, title V, of the
Omnibus Consolidated Appropriations Bill, Public Law 104-200; or
(9) determined to be a Cuban or Haitian entrant as defined in
section 501(e) of Public Law 96-422, the Refugee Education Assistance Act of
1980.
(c) All qualified noncitizens who were residing in the United
States before August 22, 1996, who otherwise meet the eligibility requirements of
this chapter, are eligible for medical assistance with federal financial
participation.
(d) All qualified noncitizens who entered the United States on
or after August 22, 1996, and who otherwise meet the eligibility requirements
of this chapter, are eligible for medical assistance with federal financial
participation through November 30, 1996.
Beginning December 1, 1996, qualified noncitizens who entered
the United States on or after August 22, 1996, and who otherwise meet the
eligibility requirements of this chapter are eligible for medical assistance
with federal participation for five years if they meet one of the following
criteria:
(i) refugees admitted to the United States according to
United States Code, title 8, section 1157;
(ii) persons granted asylum according to United States Code,
title 8, section 1158;
(iii) persons granted withholding of deportation according to
United States Code, title 8, section 1253(h);
(iv) veterans of the United States armed forces with an
honorable discharge for a reason other than noncitizen status, their spouses
and unmarried minor dependent children; or
(v) persons on active duty in the United States armed forces,
other than for training, their spouses and unmarried minor dependent children.
Beginning December 1, 1996, qualified noncitizens who do not
meet one of the criteria in items (i) to (v) are eligible for medical
assistance without federal financial participation as described in paragraph
(j).
Notwithstanding paragraph (j), beginning July 1, 2010,
children and pregnant women who are qualified noncitizens, as described in
paragraph (b), are eligible for medical assistance with federal financial
participation as provided by the federal Children's Health Insurance Program
Reauthorization Act of 2009, Public Law 111-3.
(e) Noncitizens who are not qualified noncitizens as defined
in paragraph (b), who are lawfully present in the United States, as defined in
Code of Federal Regulations, title 8, section 103.12, and who otherwise meet
the eligibility requirements of this chapter, are eligible for medical
assistance under clauses (1) to (3).
These individuals must cooperate with the United States Citizenship and
Immigration Services to pursue any applicable immigration status, including
citizenship, that would qualify them for medical assistance with federal
financial participation.
(1) Persons who were medical assistance recipients on August
22, 1996, are eligible for medical assistance with federal financial
participation through December 31, 1996.
(2) Beginning January 1, 1997, persons described in clause
(1) are eligible for medical assistance without federal financial participation
as described in paragraph (j).
(3) Beginning December 1, 1996, persons residing in the
United States prior to August 22, 1996, who were not receiving medical
assistance and persons who arrived on or after August 22, 1996, are eligible
for medical assistance without federal financial participation as described in
paragraph (j).
(f) Nonimmigrants who otherwise meet the eligibility
requirements of this chapter are eligible for the benefits as provided in
paragraphs (g) to (i). For purposes of
this subdivision, a "nonimmigrant" is a person in one of the classes
listed in United States Code, title 8, section 1101(a)(15).
(g) Payment shall also be made for care and services that are
furnished to noncitizens, regardless of immigration status, who otherwise meet
the eligibility requirements of this chapter, if such care and services are
necessary for the treatment of an emergency medical condition, except for organ
transplants and related care and services and routine prenatal care.
(h) For purposes of this subdivision, the term
"emergency medical condition" means a medical condition that meets
the requirements of United States Code, title 42, section 1396b(v).
(i) Beginning July 1, 2009, pregnant noncitizens who
are undocumented, nonimmigrants, or eligible for medical assistance as
described in paragraph (j), lawfully present as designated in paragraph
(e) and who are not covered by a group health plan or health insurance
coverage according to Code of Federal Regulations, title 42, section 457.310,
and who otherwise meet the eligibility requirements of this chapter, are
eligible for medical assistance through the
period of pregnancy, including labor and delivery, and 60
days postpartum, to the extent federal funds are available under title XXI
of the Social Security Act, and the state children's health insurance program,
followed by 60 days postpartum without federal financial participation.
(j) Qualified noncitizens as described in paragraph (d), and
all other noncitizens lawfully residing in the United States as described in
paragraph (e), who are ineligible for medical assistance with federal financial
participation and who otherwise meet the eligibility requirements of chapter
256B and of this paragraph, are eligible for medical assistance without federal
financial participation. Qualified
noncitizens as described in paragraph (d) are only eligible for medical
assistance without federal financial participation for five years from their
date of entry into the United States.
(k) Beginning October 1, 2003, persons who are receiving care
and rehabilitation services from a nonprofit center established to serve victims
of torture and are otherwise ineligible for medical assistance under this
chapter are eligible for medical assistance without federal financial
participation. These individuals are
eligible only for the period during which they are receiving services from the
center. Individuals eligible under this
paragraph shall not be required to participate in prepaid medical assistance.
EFFECTIVE DATE.
This section is effective July 1, 2009.
Sec. 20. Minnesota
Statutes 2008, section 256B.06, subdivision 5, is amended to read:
Subd. 5. Deeming of sponsor income and resources. When determining eligibility for any federal
or state funded medical assistance under this section, the income and resources
of all noncitizens shall be deemed to include their sponsors' income and
resources as required under the Personal Responsibility and Work Opportunity
Reconciliation Act of 1996, title IV, Public Law 104-193, sections 421 and 422,
and subsequently set out in federal rules.
This section is effective May 1, 1997.
Beginning July 1, 2010, sponsor deeming does not apply to pregnant
women and children who are qualified noncitizens, as described in section
256B.06, subdivision 4, paragraph (b).
EFFECTIVE DATE.
This section is effective July 1, 2010.
Sec. 21. Minnesota
Statutes 2008, section 256B.0625, subdivision 3c, is amended to read:
Subd. 3c. Health Services Policy Committee. (a) The commissioner, after receiving
recommendations from professional physician associations, professional
associations representing licensed nonphysician health care professionals, and
consumer groups, shall establish a 13-member Health Services Policy Committee,
which consists of 12 voting members and one nonvoting member. The Health Services Policy Committee shall
advise the commissioner regarding health services pertaining to the
administration of health care benefits covered under the medical assistance,
general assistance medical care, and MinnesotaCare programs. The Health Services Policy Committee shall
meet at least quarterly. The Health
Services Policy Committee shall annually elect a physician chair from among its
members, who shall work directly with the commissioner's medical director, to
establish the agenda for each meeting.
The Health Services Policy Committee shall also recommend criteria for
verifying centers of excellence for specific aspects of medical care where a
specific set of combined services, a volume of patients necessary to maintain a
high level of competency, or a specific level of technical capacity is
associated with improved health outcomes.
(b) The commissioner shall establish a dental subcommittee to
operate under the Health Services Policy Committee. The dental subcommittee consists of general
dentists, dental specialists, safety net providers, dental hygienists, health
plan company and county and public health representatives, health researchers,
consumers, and the Minnesota Department of Health oral health director. The dental subcommittee shall advise the
commissioner regarding:
(1) the critical access dental program under section 256B.76,
subdivision 4;
(2) any changes to the critical access dental provider
program necessary to comply with program expenditure limits;
(3) dental coverage policy based on evidence, quality,
continuity of care, and best practices;
(4) the development of dental delivery models; and
(5) dental services to be added or eliminated from
subdivision 9, paragraph (b).
(c) The Health Services Policy Committee shall study
approaches to making provider reimbursement under the medical assistance,
MinnesotaCare, and general assistance medical care programs contingent on
patient participation in a patient-centered decision-making process, and shall
evaluate the impact of these approaches on health care quality, patient satisfaction,
and health care costs. The committee
shall present findings and recommendations to the commissioner and the
legislative committees with jurisdiction over health care by January 15, 2010.
Sec. 22. Minnesota
Statutes 2008, section 256B.0625, subdivision 9, is amended to read:
Subd. 9. Dental services. (a) Medical assistance covers dental
services. Dental services include,
with prior authorization, fixed bridges that are cost-effective for persons who
cannot use removable dentures because of their medical condition.
(b) Medical assistance dental coverage for nonpregnant adults
is limited to the following services:
(1) comprehensive exams, limited to once every five years;
(2) periodic exams, limited to one per year;
(3) limited exams;
(4) bitewing x-rays, limited to one per year;
(5) periapical x-rays;
(6) panoramic x-rays, limited to one every five years, and
only if provided in conjunction with a posterior extraction or scheduled
outpatient facility procedure, or as medically necessary for the diagnosis and
follow-up of oral and maxillofacial pathology and trauma. Panoramic x-rays may be taken once every two
years for patients who cannot cooperate for intraoral film due to a
developmental disability or medical condition that does not allow for intraoral
film placement;
(7) prophylaxis, limited to one per year;
(8) application of fluoride varnish, limited to one per year;
(9) posterior fillings, all at the amalgam rate;
(10) anterior fillings;
(11) endodontics, limited to root canals on the anterior and
premolars only;
(12) removable prostheses, each dental arch limited to one
every six years;
(13) oral surgery, limited to extractions, biopsies, and
incision and drainage of abscesses;
(14) palliative treatment and sedative fillings for relief of
pain; and
(15) full-mouth debridement, limited to one every five years.
(c) In addition to the services specified in paragraph (b),
medical assistance covers the following services for adults, if provided in an
outpatient hospital setting or freestanding ambulatory surgical center as part
of outpatient dental surgery:
(1) periodontics, limited to periodontal scaling and root
planing once every two years;
(2) general anesthesia; and
(3) full-mouth survey once every five years.
(d) Medical assistance covers dental services for children
that are medically necessary. The
following guidelines apply:
(1) posterior fillings are paid at the amalgam rate;
(2) application of sealants once every five years per
permanent molar; and
(3) application of fluoride varnish once every six months.
EFFECTIVE DATE.
This section is effective January 1, 2010.
Sec. 23. Minnesota
Statutes 2008, section 256B.0625, subdivision 13e, is amended to read:
Subd. 13e. Payment rates. (a) The basis for determining the amount of
payment shall be the lower of the actual acquisition costs of the drugs plus a
fixed dispensing fee; the maximum allowable cost set by the federal government
or by the commissioner plus the fixed dispensing fee; or the usual and
customary price charged to the public.
The amount of payment basis must be reduced to reflect all discount
amounts applied to the charge by any provider/insurer agreement or contract for
submitted charges to medical assistance programs. The net submitted charge may not be greater
than the patient liability for the service.
The pharmacy dispensing fee shall be $3.65, except that the dispensing
fee for intravenous solutions which must be compounded by the pharmacist shall
be $8 per bag, $14 per bag for cancer chemotherapy products, and $30 per bag
for total parenteral nutritional products dispensed in one liter quantities, or
$44 per bag for total parenteral nutritional products dispensed in quantities
greater than one liter. Actual acquisition
cost includes quantity and other special discounts except time and cash
discounts. Effective July 1, 2008, the
actual acquisition cost of a drug shall be estimated by the commissioner, at
average wholesale price minus 14 15 percent. The actual acquisition cost of antihemophilic
factor drugs shall be estimated at the average wholesale price minus 30
percent. The maximum allowable cost of a
multisource drug may be set by the commissioner and it shall be comparable to,
but no higher than, the maximum amount paid by other third-party payors in this
state who have maximum allowable cost programs.
Establishment of the amount of payment for drugs shall not be subject to
the requirements of the Administrative Procedure Act.
(b) An additional dispensing fee of $.30 may be added to the
dispensing fee paid to pharmacists for legend drug prescriptions dispensed to
residents of long-term care facilities when a unit dose blister card system,
approved by the department, is used.
Under this type of dispensing system, the pharmacist must dispense a
30-day supply of drug. The National Drug
Code (NDC) from the drug container used to fill the blister card must be
identified on the claim to the department.
The unit dose blister card containing the drug must meet the packaging
standards set forth in
Minnesota Rules, part 6800.2700, that govern the return of
unused drugs to the pharmacy for reuse.
The pharmacy provider will be required to credit the department for the
actual acquisition cost of all unused drugs that are eligible for reuse. Over-the-counter medications must be
dispensed in the manufacturer's unopened package. The commissioner may permit the drug
clozapine to be dispensed in a quantity that is less than a 30-day supply.
(c) Whenever a generically equivalent product is available,
payment shall be on the basis of the actual acquisition cost of the generic
drug, or on the maximum allowable cost established by the commissioner.
(d) The basis for determining the amount of payment for drugs
administered in an outpatient setting shall be the lower of the usual and
customary cost submitted by the provider or the amount established for Medicare
by the United States Department of Health and Human Services pursuant to title
XVIII, section 1847a of the federal Social Security Act.
(e) The commissioner may negotiate lower reimbursement rates
for specialty pharmacy products than the rates specified in paragraph (a). The commissioner may require individuals
enrolled in the health care programs administered by the department to obtain
specialty pharmacy products from providers with whom the commissioner has
negotiated lower reimbursement rates.
Specialty pharmacy products are defined as those used by a small number
of recipients or recipients with complex and chronic diseases that require
expensive and challenging drug regimens.
Examples of these conditions include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation,
hepatitis C, growth hormone deficiency, Crohn's Disease, rheumatoid arthritis,
and certain forms of cancer. Specialty
pharmaceutical products include injectable and infusion therapies,
biotechnology drugs, high-cost therapies, and therapies that require complex
care. The commissioner shall consult
with the formulary committee to develop a list of specialty pharmacy products
subject to this paragraph. In consulting
with the formulary committee in developing this list, the commissioner shall
take into consideration the population served by specialty pharmacy products,
the current delivery system and standard of care in the state, and access to
care issues. The commissioner shall have
the discretion to adjust the reimbursement rate to prevent access to care
issues.
EFFECTIVE DATE.
This section is effective July 1, 2009.
Sec. 24. Minnesota
Statutes 2008, 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 route available. The maximum
medical assistance reimbursement rates for special transportation services are:
(1) $17 for the base rate and $1.35 $1.65 per
mile for services to eligible persons who need a wheelchair-accessible van;
(2) $11.50 $8.50 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. 25. Minnesota
Statutes 2008, section 256B.0625, subdivision 26, is amended to read:
Subd. 26. Special education services. (a) Medical assistance covers medical
services identified in a recipient's individualized education plan and covered
under the medical assistance state plan.
Covered services include occupational therapy, physical therapy,
speech-language therapy, clinical psychological services, nursing services,
school psychological services, school social work services, personal care
assistants serving as management aides, assistive technology devices,
transportation services, health assessments, and other services covered under
the medical assistance state plan.
Mental health services eligible for medical assistance reimbursement
must be provided or coordinated through a children's mental health
collaborative where a collaborative exists if the child is included in the
collaborative operational target population.
The provision or coordination of services does not require that the
individual education plan be developed by the collaborative.
The services may be provided by a Minnesota school district
that is enrolled as a medical assistance provider or its subcontractor, and
only if the services meet all the requirements otherwise applicable if the
service had been provided by a provider other than a school district, in the
following areas: medical necessity,
physician's orders, documentation, personnel qualifications, and prior
authorization requirements. The
nonfederal share of costs for services provided under this subdivision is the responsibility
of the local school district as provided in section 125A.74. Services listed in a child's individual
education plan are eligible for medical assistance reimbursement only if those
services meet criteria for federal financial participation under the Medicaid
program.
(b) Approval of health-related services for inclusion in the
individual education plan does not require prior authorization for purposes of
reimbursement under this chapter. The
commissioner may require physician review and approval of the plan not more
than once annually or upon any modification of the individual education plan
that reflects a change in health-related services.
(c) Services of a speech-language pathologist provided under
this section are covered notwithstanding Minnesota Rules, part 9505.0390,
subpart 1, item L, if the person:
(1) holds a masters degree in speech-language pathology;
(2) is licensed by the Minnesota Board of Teaching as an
educational speech-language pathologist; and
(3) either has a certificate of clinical competence from the
American Speech and Hearing Association, has completed the equivalent
educational requirements and work experience necessary for the certificate or
has completed the academic program and is acquiring supervised work experience
to qualify for the certificate.
(d) Medical assistance coverage for medically necessary
services provided under other subdivisions in this section may not be denied
solely on the basis that the same or similar services are covered under this
subdivision.
(e) The commissioner shall develop and implement package
rates, bundled rates, or per diem rates for special education services under
which separately covered services are grouped together and billed as a unit in
order to reduce administrative complexity.
(f) The commissioner shall develop a cost-based payment
structure for payment of these services.
The commissioner shall reimburse claims submitted based on an interim
rate, and shall settle at a final rate once the department has determined it. The commissioner shall notify the school
district of the final rate. The school
district has 60 days to appeal the final rate.
To appeal the final rate, the school district shall file a written
appeal request to the commissioner within 60 days of the date the final rate
determination was mailed. The appeal
request shall specify (1) the disputed items and (2) the name and address of
the person to contact regarding the appeal.
(g) Effective July 1, 2000, medical assistance services
provided under an individual education plan or an individual family service
plan by local school districts shall not count against medical assistance
authorization thresholds for that child.
(h) Nursing services as defined in section 148.171,
subdivision 15, and provided as an individual education plan health-related
service, are eligible for medical assistance payment if they are otherwise a
covered service under the medical assistance program. Medical assistance covers the administration
of prescription medications by a licensed nurse who is employed by or under
contract with a school district when the administration of medications is
identified in the child's individualized education plan. The simple administration of medications alone
is not covered under medical assistance when administered by a provider other
than a school district or when it is not identified in the child's
individualized education plan.
Sec. 26. Minnesota
Statutes 2008, section 256B.0631, subdivision 1, is amended to read:
Subdivision 1. Co-payments. (a) Except as provided in subdivision 2, the
medical assistance benefit plan shall include the following co-payments for all
recipients, effective for services provided on or after October 1, 2003, and
before January 1, 2009 July 1, 2009:
(1) $3 per nonpreventive visit. For purposes of this subdivision, a visit
means an episode of service which is required because of a recipient's
symptoms, diagnosis, or established illness, and which is delivered in an
ambulatory setting by a physician or physician ancillary, chiropractor,
podiatrist, nurse midwife, advanced practice nurse, audiologist, optician, or
optometrist;
(2) $3 for eyeglasses;
(3) $6 for nonemergency visits to a hospital-based emergency
room; and
(4) $3 per brand-name drug prescription and $1 per generic
drug prescription, subject to a $12 per month maximum for prescription drug
co-payments. No co-payments shall apply
to antipsychotic drugs when used for the treatment of mental illness.
(b) Except as provided in subdivision 2, the medical
assistance benefit plan shall include the following co-payments for all
recipients, effective for services provided on or after January 1, 2009:
(1) $6 for nonemergency visits to a hospital-based emergency
room;
(2) (4) $3 per
brand-name drug prescription and $1 per generic drug prescription, subject to a
$7 per month maximum for prescription drug co-payments. No co-payments shall apply to antipsychotic
drugs when used for the treatment of mental illness; and
(3) (5) for
individuals identified by the commissioner with income at or below 100 percent
of the federal poverty guidelines, total monthly co-payments must not exceed
five percent of family income. For
purposes of this paragraph, family income is the total earned and unearned
income of the individual and the individual's spouse, if the spouse is enrolled
in medical assistance and also subject to the five percent limit on
co-payments.
(c) (b)
Recipients of medical assistance are responsible for all co-payments in
this subdivision.
Sec. 27. [256B.0755] PAYMENT REFORM DEMONSTRATION
PROJECT FOR SPECIAL PATIENT POPULATIONS.
Subdivision 1. Demonstration project.
(a) The commissioner of human services, in consultation with the
commissioner of health, shall establish a payment reform demonstration project
implementing an alternative payment system for health care providers serving an
identified group of patients who are enrolled in a state health care program,
and are either high utilizers of high-cost health care services or have
characteristics that put them at high risk of becoming high utilizers. The purpose of the demonstration project is
to implement and evaluate methods of reducing hospitalizations, emergency room
use, high-cost medications and specialty services, admissions to nursing
facilities, or use of long-term home and community-based services, in order to
reduce the total cost of care and services for the patients.
(b) The commissioner shall give the highest priority to
projects that will serve patients who have chronic medical conditions or
complex medical needs that are complicated by a physical disability, serious
mental illness, or serious socioeconomic factors such as poverty, homelessness,
or language or cultural barriers. The
commissioner shall also give the highest priority to providers or groups of
providers who have the highest concentrations of patients with these
characteristics.
(c) The commissioner must implement this payment reform
demonstration project in a manner consistent with the payment reform initiative
provided in sections 62U.02 to 62U.04.
(d) For purposes of this section, "state health care
program" means the medical assistance, MinnesotaCare, and general
assistance medical care programs.
Subd. 2. Participation. (a)
The commissioner shall request eligible providers or groups of providers to
submit a proposal to participate in the demonstration project by September 1,
2009. The providers who are interested
in participating shall negotiate with the commissioner to determine:
(1) the identified group of patients who are to be enrolled
in the program;
(2) the services that are to be included in the total cost of
care calculation;
(3) the methodology for calculating the total cost of care,
which may take into consideration the impact on costs to other state or local
government programs including, but not limited to, social services and income
maintenance programs;
(4) the time period to be covered under the bid;
(5) the implementation of a risk adjustment mechanism to
adjust for factors that are beyond the control of the provider including
nonclinical factors that will affect the cost or outcomes of treatment;
(6) the payment reforms and payment methods to be used under
the project, which may include but are not limited to adjustments in
fee-for-service payments, payment of care coordination fees, payments for
start-up and implementation costs to be recovered or repaid later in the
project, payments adjusted based on a provider's proportion of patients who are
enrolled in state health care programs; payments adjusted for the clinical or
socioeconomic complexity of the patients served, payment incentives tied to use
of inpatient and emergency room services, and periodic settle-up adjustments;
(7) methods of sharing financial risk and benefit between the
commissioner and the provider or groups of providers, which may include but are
not limited to stop-loss arrangements to cover high-cost outlier cases or costs
that are beyond the control of the provider, and risk-sharing and
benefit-sharing corridors; and
(8) performance and outcome benchmarks to be used to measure
performance, achievement of cost-savings targets, and quality of care provided.
(b) A provider or group of providers may submit a proposal
for a demonstration project in partnership with a health maintenance
organization or county-based purchasing plan for the purposes of sharing risk,
claims processing, or administration of the project, or to extend participation
in the project to persons who are enrolled in prepaid health care programs.
Subd. 3. Total cost of care agreement. Based on negotiations, the commissioner
must enter into an agreement with interested and eligible providers or groups
of providers to implement projects that are designed to reduce the total cost
of care for the identified patients. To
the extent possible, the projects shall begin implementation on January 1,
2010, or upon federal approval, whichever is later.
Subd. 4. Eligibility. To be
eligible to participate, providers or groups of providers must meet
certification standards for health care homes established by the Department of
Health and the Department of Human Services under section 256B.0751.
Subd. 5. Alternative payments.
The commissioner shall seek all federal waivers and approvals
necessary to implement this section and to obtain federal matching funds. To the extent authorized by federal law, the
commissioner may waive existing fee-for-service payment rates, provider
contract or performance requirements, consumer incentive policies, or other
requirements in statute or rule in order to allow the providers or groups of
providers to utilize alternative payment and financing methods that will
appropriately fund necessary and cost-effective primary care and care
coordination services; establish appropriate incentives for prevention, health
promotion, and care coordination; and mitigate financial harm to participating
providers caused by the successful reduction in preventable hospitalization,
emergency room use, and other costly services.
Subd. 6. Cost neutrality. The
total cost, including administrative costs, of this demonstration project must
not exceed the costs that would otherwise be incurred by the state had services
to the state health care program enrollees participating in the demonstration
project been provided, as applicable for the enrollee, under fee-for-service or
through managed care or county-based purchasing plans.
Sec. 28. Minnesota
Statutes 2008, section 256B.08, is amended by adding a subdivision to read:
Subd. 4. Data from Social Security.
The commissioner shall accept data from the Social Security
Administration in accordance with United States Code, title 42, section
1396U-5(a).
EFFECTIVE DATE.
This section is effective January 1, 2010.
Sec. 29. Minnesota
Statutes 2008, section 256B.15, subdivision 1, is amended to read:
Subdivision 1. Policy and applicability. (a) It is the policy of this state that
individuals or couples, either or both of whom participate in the medical
assistance program, use their own assets to pay their share of the total cost
of their care during or after their enrollment in the program according to
applicable federal law and the laws of this state. The following provisions apply:
(1) subdivisions 1c to 1k shall not apply to claims arising
under this section which are presented under section 525.313;
(2) the provisions of subdivisions 1c to 1k expanding the
interests included in an estate for purposes of recovery under this section
give effect to the provisions of United States Code, title 42, section 1396p,
governing recoveries, but do not give rise to any express or implied liens in
favor of any other parties not named in these provisions;
(3) the continuation of a recipient's life estate or joint
tenancy interest in real property after the recipient's death for the purpose
of recovering medical assistance under this section modifies common law
principles holding that these interests terminate on the death of the holder;
(4) all laws, rules, and regulations governing or involved
with a recovery of medical assistance shall be liberally construed to
accomplish their intended purposes;
(5) a deceased recipient's life estate and joint tenancy
interests continued under this section shall be owned by the remaindermen or
surviving joint tenants as their interests may appear on the date of the
recipient's death. They shall not be
merged into the remainder interest or the interests of the surviving joint
tenants by reason of ownership. They
shall be subject to the provisions of this section. Any conveyance, transfer, sale, assignment,
or encumbrance by a remainderman, a surviving joint tenant, or their heirs,
successors, and assigns shall be deemed to include all of their interest in the
deceased recipient's life estate or joint tenancy interest continued under this
section; and
(6) the provisions of subdivisions 1c to 1k continuing a
recipient's joint tenancy interests in real property after the recipient's death
do not apply to a homestead owned of record, on the date the recipient dies, by
the recipient and the recipient's spouse as joint tenants with a right of
survivorship. Homestead means the real
property occupied by the surviving joint tenant spouse as their sole residence
on the date the recipient dies and classified and taxed to the recipient and
surviving joint tenant spouse as homestead property for property tax purposes
in the calendar year in which the recipient dies. For purposes of this exemption, real property
the recipient and their surviving joint tenant spouse purchase solely with the
proceeds from the sale of their prior homestead, own of record as joint
tenants, and qualify as homestead property under section 273.124 in the
calendar year in which the recipient dies and prior to the recipient's death
shall be deemed to be real property classified and taxed to the recipient and
their surviving joint tenant spouse as homestead property in the calendar year
in which the recipient dies. The surviving
spouse, or any person with personal knowledge of the facts, may provide an
affidavit describing the homestead property affected by this clause and stating
facts showing compliance with this clause.
The affidavit shall be prima facie evidence of the facts it states.
(b) For purposes of this section, "medical
assistance" includes the medical assistance program under this chapter and
the general assistance medical care program under chapter 256D and alternative
care for nonmedical assistance recipients under section 256B.0913.
(c) For purposes of this section, beginning January 1, 2010,
"medical assistance" does not include Medicare cost-sharing benefits
in accordance with United States Code, title 42, section 1396p.
(c) (d) All
provisions in this subdivision, and subdivisions 1d, 1f, 1g, 1h, 1i, and 1j,
related to the continuation of a recipient's life estate or joint tenancy
interests in real property after the recipient's death for the purpose of
recovering medical assistance, are effective only for life estates and joint
tenancy interests established on or after August 1, 2003. For purposes of this paragraph, medical
assistance does not include alternative care.
Sec. 30. Minnesota
Statutes 2008, section 256B.15, subdivision 1a, is amended to read:
Subd. 1a. Estates subject to claims. (a) If a person receives any medical
assistance hereunder, on the person's death, if single, or on the death of the
survivor of a married couple, either or both of whom received medical
assistance, or as otherwise provided for in this section, the total amount paid
for medical assistance rendered for the person and spouse shall be filed as a
claim against the estate of the person or the estate of the surviving spouse in
the court having jurisdiction to probate the estate or to issue a decree of
descent according to sections 525.31 to 525.313.
(b) For the purposes of this section, the person's estate
must consist of:
(1) the person's probate estate;
(2) all of the person's interests or proceeds of those
interests in real property the person owned as a life tenant or as a joint
tenant with a right of survivorship at the time of the person's death;
(3) all of the person's interests or proceeds of those
interests in securities the person owned in beneficiary form as provided under
sections 524.6-301 to 524.6-311 at the time of the person's death, to the
extent the interests or proceeds of those interests become part of the probate
estate under section 524.6-307;
(4) all of the person's interests in joint accounts, multiple-party
accounts, and pay-on-death accounts, brokerage accounts, investment accounts,
or the proceeds of those accounts, as provided under sections 524.6-201 to
524.6-214 at the time of the person's death to the extent the interests become
part of the probate estate under section 524.6-207; and
(5) assets conveyed to a survivor, heir, or assign of the
person through survivorship, living trust, or other arrangements.
(c) For the purpose of this section and recovery in a
surviving spouse's estate for medical assistance paid for a predeceased spouse,
the estate must consist of all of the legal title and interests the deceased
individual's predeceased spouse had in jointly owned or marital property at the
time of the spouse's death, as defined in subdivision 2b, and the proceeds of
those interests, that passed to the deceased individual or another individual,
a survivor, an heir, or an assign of the predeceased spouse through a joint
tenancy, tenancy in common, survivorship, life estate, living trust, or other
arrangement. A deceased recipient who,
at death, owned the property jointly with the surviving spouse shall have an
interest in the entire property.
(d) For the purpose of recovery in a single person's estate
or the estate of a survivor of a married couple, "other arrangement"
includes any other means by which title to all or any part of the jointly owned
or marital property or interest passed from the predeceased spouse to another
including, but not limited to, transfers between spouses which are permitted,
prohibited, or penalized for purposes of medical assistance.
(e) A claim shall be filed if medical assistance was rendered for either or
both persons under one of the following circumstances:
(a) (1) the
person was over 55 years of age, and received services under this chapter;
(b) (2) the
person resided in a medical institution for six months or longer, received
services under this chapter, and, at the time of institutionalization or
application for medical assistance, whichever is later, the person could not
have reasonably been expected to be discharged and returned home, as certified
in writing by the person's treating physician.
For purposes of this section only, a "medical institution" means
a skilled nursing facility, intermediate care facility, intermediate care
facility for persons with developmental disabilities, nursing facility, or
inpatient hospital; or
(c) (3) the
person received general assistance medical care services under chapter 256D.
(f) The claim shall be considered an expense of the last illness of the
decedent for the purpose of section 524.3-805.
Notwithstanding any law or rule to the contrary, a state or county
agency with a claim under this section must be a creditor under section
524.6-307. Any statute of limitations
that purports to limit any county agency or the state agency, or both, to
recover for medical assistance granted hereunder shall not apply to any claim
made hereunder for reimbursement for any medical assistance granted hereunder. Notice of the claim shall be given to all
heirs and devisees of the decedent whose identity can be ascertained with
reasonable diligence. The notice must
include procedures and instructions for making an application for a hardship
waiver under subdivision 5; time frames for
submitting an application and determination; and information
regarding appeal rights and procedures.
Counties are entitled to one-half of the nonfederal share of medical
assistance collections from estates that are directly attributable to county
effort. Counties are entitled to ten
percent of the collections for alternative care directly attributable to county
effort.
Sec. 31. Minnesota
Statutes 2008, section 256B.15, subdivision 1h, is amended to read:
Subd. 1h. Estates of specific persons receiving medical
assistance. (a) For purposes of this
section, paragraphs (b) to (k) (j) apply if a person received
medical assistance for which a claim may be filed under this section and died
single, or the surviving spouse of the couple and was not survived by any of
the persons described in subdivisions 3 and 4.
(b) For purposes of this section, the person's estate consists
of: (1) the person's probate estate; (2)
all of the person's interests or proceeds of those interests in real property
the person owned as a life tenant or as a joint tenant with a right of
survivorship at the time of the person's death; (3) all of the person's
interests or proceeds of those interests in securities the person owned in
beneficiary form as provided under sections 524.6-301 to 524.6-311 at the time
of the person's death, to the extent they become part of the probate estate
under section 524.6-307; (4) all of the person's interests in joint accounts,
multiple party accounts, and pay on death accounts, or the proceeds of those accounts,
as provided under sections 524.6-201 to 524.6-214 at the time of the person's
death to the extent they become part of the probate estate under section
524.6-207; and (5) the person's legal title or interest at the time of the
person's death in real property transferred under a transfer on death deed
under section 507.071, or in the proceeds from the subsequent sale of the
person's interest in the real property.
Notwithstanding any law or rule to the contrary, a state or county
agency with a claim under this section shall be a creditor under section
524.6-307.
(c) (b)
Notwithstanding any law or rule to the contrary, the person's life estate or
joint tenancy interest in real property not subject to a medical assistance
lien under sections 514.980 to 514.985 on the date of the person's death shall
not end upon the person's death and shall continue as provided in this
subdivision. The life estate in the
person's estate shall be that portion of the interest in the real property
subject to the life estate that is equal to the life estate percentage factor
for the life estate as listed in the Life Estate Mortality Table of the health
care program's manual for a person who was the age of the medical assistance
recipient on the date of the person's death. The joint tenancy interest in real property in
the estate shall be equal to the fractional interest the person would have
owned in the jointly held interest in the property had they and the other
owners held title to the property as tenants in common on the date the person
died.
(d) (c) The court
upon its own motion, or upon motion by the personal representative or any
interested party, may enter an order directing the remaindermen or surviving
joint tenants and their spouses, if any, to sign all documents, take all
actions, and otherwise fully cooperate with the personal representative and the
court to liquidate the decedent's life estate or joint tenancy interests in the
estate and deliver the cash or the proceeds of those interests to the personal
representative and provide for any legal and equitable sanctions as the court
deems appropriate to enforce and carry out the order, including an award of
reasonable attorney fees.
(e) (d) The
personal representative may make, execute, and deliver any conveyances or other
documents necessary to convey the decedent's life estate or joint tenancy
interest in the estate that are necessary to liquidate and reduce to cash the
decedent's interest or for any other purposes.
(f) (e) Subject to
administration, all costs, including reasonable attorney fees, directly and
immediately related to liquidating the decedent's life estate or joint tenancy
interest in the decedent's estate, shall be paid from the gross proceeds of the
liquidation allocable to the decedent's interest and the net proceeds shall be
turned over to the personal representative and applied to payment of the claim
presented under this section.
(g) (f) The
personal representative shall bring a motion in the district court in which the
estate is being probated to compel the remaindermen or surviving joint tenants
to account for and deliver to the personal representative all or any part of
the proceeds of any sale, mortgage, transfer, conveyance, or any disposition of
real property allocable to the decedent's life estate or joint tenancy interest
in the decedent's estate, and do everything necessary to liquidate
and reduce to cash the decedent's interest and turn the
proceeds of the sale or other disposition over to the personal
representative. The court may grant any
legal or equitable relief including, but not limited to, ordering a partition
of real estate under chapter 558 necessary to make the value of the decedent's
life estate or joint tenancy interest available to the estate for payment of a
claim under this section.
(h) (g) Subject to
administration, the personal representative shall use all of the cash or
proceeds of interests to pay an allowable claim under this section. The remaindermen or surviving joint tenants
and their spouses, if any, may enter into a written agreement with the personal
representative or the claimant to settle and satisfy obligations imposed at any
time before or after a claim is filed.
(i) (h) The
personal representative may, at their discretion, provide any or all of the
other owners, remaindermen, or surviving joint tenants with an affidavit
terminating the decedent's estate's interest in real property the decedent
owned as a life tenant or as a joint tenant with others, if the personal
representative determines in good faith that neither the decedent nor any of
the decedent's predeceased spouses received any medical assistance for which a
claim could be filed under this section, or if the personal representative has
filed an affidavit with the court that the estate has other assets sufficient
to pay a claim, as presented, or if there is a written agreement under
paragraph (h) (g), or if the claim, as allowed, has been paid in
full or to the full extent of the assets the estate has available to pay
it. The affidavit may be recorded in the
office of the county recorder or filed in the Office of the Registrar of Titles
for the county in which the real property is located. Except as provided in section 514.981,
subdivision 6, when recorded or filed, the affidavit shall terminate the
decedent's interest in real estate the decedent owned as a life tenant or a
joint tenant with others. The affidavit
shall:
(1) be signed by the personal representative;
(2) identify the decedent and the interest being terminated;
(3) give recording information sufficient to identify the
instrument that created the interest in real property being terminated;
(4) legally describe the affected real property;
(5) state that the personal representative has determined that
neither the decedent nor any of the decedent's predeceased spouses received any
medical assistance for which a claim could be filed under this section;
(6) state that the decedent's estate has other assets
sufficient to pay the claim, as presented, or that there is a written agreement
between the personal representative and the claimant and the other owners or
remaindermen or other joint tenants to satisfy the obligations imposed under
this subdivision; and
(7) state that the affidavit is being given to terminate the
estate's interest under this subdivision, and any other contents as may be
appropriate.
The
recorder or registrar of titles shall accept the affidavit for recording or
filing. The affidavit shall be effective
as provided in this section and shall constitute notice even if it does not
include recording information sufficient to identify the instrument creating
the interest it terminates. The
affidavit shall be conclusive evidence of the stated facts.
(j) (i) The holder
of a lien arising under subdivision 1c shall release the lien at the holder's
expense against an interest terminated under paragraph (h) (g) to
the extent of the termination.
(k) (j) If a lien
arising under subdivision 1c is not released under paragraph (j) (i),
prior to closing the estate, the personal representative shall deed the
interest subject to the lien to the remaindermen or surviving joint tenants as
their interests may appear. Upon
recording or filing, the deed shall work a merger of the recipient's life
estate or joint tenancy interest, subject to the lien, into the remainder
interest or interest the decedent and others owned jointly. The lien shall attach to and run with the
property to the extent of the decedent's interest at the time of the decedent's
death.
Sec. 32. Minnesota Statutes
2008, section 256B.15, subdivision 2, is amended to read:
Subd. 2. Limitations on claims. The claim shall include only the total amount
of medical assistance rendered after age 55 or during a period of
institutionalization described in subdivision 1a, clause (b)
paragraph (e), and the total amount of general assistance medical care
rendered, and shall not include interest.
Claims that have been allowed but not paid shall bear interest according
to section 524.3-806, paragraph (d). A
claim against the estate of a surviving spouse who did not receive medical
assistance, for medical assistance rendered for the predeceased spouse,
shall be payable from the full value of all of the predeceased spouse's assets
and interests which are part of the surviving spouse's estate under
subdivisions 1a and 2b. Recovery of
medical assistance expenses in the nonrecipient surviving spouse's estate
is limited to the value of the assets of the estate that were marital property
or jointly owned property at any time during the marriage. The claim is not payable from the value of
assets or proceeds of assets in the estate attributable to a predeceased spouse
whom the individual married after the death of the predeceased recipient spouse
for whom the claim is filed or from assets and the proceeds of assets in the
estate which the nonrecipient decedent spouse acquired with assets which were
not marital property or jointly owned property after the death of the
predeceased recipient spouse. Claims
for alternative care shall be net of all premiums paid under section 256B.0913,
subdivision 12, on or after July 1, 2003, and shall be limited to services
provided on or after July 1, 2003. Claims
against marital property shall be limited to claims against recipients who died
on or after July 1, 2009.
Sec. 33. Minnesota
Statutes 2008, section 256B.15, is amended by adding a subdivision to read:
Subd. 2b. Controlling provisions.
(a) For purposes of this subdivision and subdivisions 1a and 2,
paragraphs (b) to (d) apply.
(b) At the time of death of a recipient spouse and solely for
purpose of recovery of medical assistance benefits received, a predeceased
recipient spouse shall have a legal title or interest in the undivided whole of
all of the property which the recipient and the recipient's surviving spouse
owned jointly or which was marital property at any time during their marriage
regardless of the form of ownership and regardless of whether it was owned or
titled in the names of one or both the recipient and the recipient's
spouse. Title and interest in the
property of a predeceased recipient spouse shall not end or extinguish upon the
person's death and shall continue for the purpose of allowing recovery of
medical assistance in the estate of the surviving spouse. Upon the death of the predeceased recipient
spouse, title and interest in the predeceased spouse's property shall vest in
the surviving spouse by operation of law and without the necessity for any
probate or decree of descent proceedings and shall continue to exist after the
death of the predeceased spouse and the surviving spouse to permit recovery of
medical assistance. The recipient spouse
and the surviving spouse of a deceased recipient spouse shall not encumber,
disclaim, transfer, alienate, hypothecate, or otherwise divest themselves of
these interests before or upon death.
(c) For purposes of this section, "marital
property" includes any and all real or personal property of any kind or
interests in such property the predeceased recipient spouse and their spouse,
or either of them, owned at the time of their marriage to each other or
acquired during their marriage regardless of whether it was owned or titled in
the names of one or both of them. If
either or both spouses of a married couple received medical assistance, all
property owned during the marriage or which either or both spouses acquired
during their marriage shall be presumed to be marital property for purposes of
recovering medical assistance unless there is clear and convincing evidence to
the contrary.
(d) The agency responsible for the claim for medical
assistance for a recipient spouse may, at its discretion, release specific real
and personal property from the provisions of this section. The release shall extinguish the interest
created under paragraph (b) in the land it describes upon filing or
recording. The release need not be
attested, certified, or acknowledged as a condition of filing or recording and
shall be filed or recorded in the office of the county recorder or registrar of
titles, as appropriate, in the county where the real property is located. The party to whom the release is given shall
be responsible for paying all fees and costs necessary to record and file the
release. If the
property described in the release is registered property, the registrar of
titles shall accept it for recording and shall record it on the certificate of
title for each parcel of property described in the release. If the property described in the release is abstract
property, the recorder shall accept it for filing and file it in the county's
grantor-grantee indexes and any tract index the county maintains for each
parcel of property described in the release.
Sec. 34. Minnesota
Statutes 2008, section 256B.15, is amended by adding a subdivision to read:
Subd. 9. Commissioner's intervention.
The commissioner shall be permitted to intervene as a party in any
proceeding involving recovery of medical assistance upon filing a notice of
intervention and serving such notice on the other parties.
Sec. 35. Minnesota
Statutes 2008, section 256B.69, subdivision 5a, is amended to read:
Subd. 5a. Managed care contracts. (a) Managed care contracts under this section
and sections 256L.12 and 256D.03, shall be entered into or renewed on a
calendar year basis beginning January 1, 1996.
Managed care contracts which were in effect on June 30, 1995, and set to
renew on July 1, 1995, shall be renewed for the period July 1, 1995 through
December 31, 1995 at the same terms that were in effect on June 30, 1995. The commissioner may issue separate contracts
with requirements specific to services to medical assistance recipients age 65
and older.
(b) A prepaid health plan providing covered health services
for eligible persons pursuant to chapters 256B, 256D, and 256L, is responsible
for complying with the terms of its contract with the commissioner. Requirements applicable to managed care
programs under chapters 256B, 256D, and 256L, established after the effective
date of a contract with the commissioner take effect when the contract is next
issued or renewed.
(c) Effective for services rendered on or after January 1,
2003, the commissioner shall withhold five percent of managed care plan
payments under this section and county-based purchasing plan's payment rate
under section 256B.692 for the prepaid medical assistance and general
assistance medical care programs pending completion of performance
targets. Each performance target must be
quantifiable, objective, measurable, and reasonably attainable, except in the case
of a performance target based on a federal or state law or rule. Criteria for assessment of each performance
target must be outlined in writing prior to the contract effective date. The managed care plan must demonstrate, to
the commissioner's satisfaction, that the data submitted regarding attainment
of the performance target is accurate.
The commissioner shall periodically change the administrative measures
used as performance targets in order to improve plan performance across a
broader range of administrative services.
The performance targets must include measurement of plan efforts to
contain spending on health care services and administrative activities. The commissioner may adopt plan-specific
performance targets that take into account factors affecting only one plan,
including characteristics of the plan's enrollee population. The withheld funds must be returned no sooner
than July of the following year if performance targets in the contract are
achieved. The commissioner may exclude
special demonstration projects under subdivision 23. A managed care plan or a county-based
purchasing plan under section 256B.692 may include as admitted assets under
section 62D.044 any amount withheld under this paragraph that is reasonably
expected to be returned.
(d)(1) Effective for services rendered on or after
January 1, 2009, the commissioner shall withhold three percent of managed care
plan payments under this section and county-based purchasing plan payments
under section 256B.692 for the prepaid medical assistance and general
assistance medical care programs. The
withheld funds must be returned no sooner than July 1 and no later than July 31
of the following year. The commissioner
may exclude special demonstration projects under subdivision 23.
(2) A managed care plan or a county-based purchasing plan
under section 256B.692 may include as admitted assets under section 62D.044 any
amount withheld under this paragraph. The return of the withhold under this
paragraph is not subject to the requirements of paragraph (c).
(e) Effective for services rendered on or after January 1,
2010, the commissioner shall include as part of the performance targets
described in paragraph (a) a reduction in the health plan's emergency room
utilization rate for state health care program enrollees by a measurable rate
of five percent from the plan's utilization rate for state health care program
enrollees for the previous calendar year.
The withheld funds must be returned no sooner than July 1 and
no later than July 31 of the following calendar year if the managed care plan
or county-based purchasing plan demonstrates to the satisfaction of the
commissioner that a reduction in the utilization rate was achieved.
The withhold described in this paragraph shall continue for each
consecutive contract period until the health plan's emergency room utilization
rate for state health care program enrollees is reduced by 25 percent of the
health plan's emergency room utilization rate for state health care program
enrollees for calendar year 2008.
(f) A managed care plan or a county-based purchasing plan
under section 256B.692 may include as admitted assets under section 62D.044 any
amount withheld under this section that is reasonably expected to be returned.
Sec. 36. Minnesota Statutes
2008, section 256B.69, subdivision 5c, is amended to read:
Subd. 5c. Medical education and research fund. (a) Except as provided in paragraph (c), the
commissioner of human services shall transfer each year to the medical
education and research fund established under section 62J.692, the following:
(1) an amount equal to the reduction in the prepaid medical
assistance and prepaid general assistance medical care payments as specified in
this clause. Until January 1, 2002, the
county medical assistance and general assistance medical care capitation base
rate prior to plan specific adjustments and after the regional rate adjustments
under section 256B.69, subdivision 5b, is reduced 6.3 percent for Hennepin
County, two percent for the remaining metropolitan counties, and no reduction
for nonmetropolitan Minnesota counties; and after January 1, 2002, the county
medical assistance and general assistance medical care capitation base rate
prior to plan specific adjustments is reduced 6.3 percent for Hennepin County,
two percent for the remaining metropolitan counties, and 1.6 percent for
nonmetropolitan Minnesota counties.
Nursing facility and elderly waiver payments and demonstration project
payments operating under subdivision 23 are excluded from this reduction. The amount calculated under this clause shall
not be adjusted for periods already paid due to subsequent changes to the
capitation payments;
(2) beginning July 1, 2003, $2,157,000 $4,314,000 from
the capitation rates paid under this section plus any federal matching funds
on this amount;
(3) beginning July 1, 2002, an additional $12,700,000 from the
capitation rates paid under this section; and
(4) beginning July 1, 2003, an additional $4,700,000 from the
capitation rates paid under this section.
(b) This subdivision shall be effective upon approval of a
federal waiver which allows federal financial participation in the medical
education and research fund. Effective
July 1, 2009, and thereafter, the transfers required by paragraph (a), clauses
(1) to (4), shall not exceed the total amount transferred for fiscal year
2009. Any excess shall first reduce the
amounts otherwise required to be transferred under paragraph (a), clauses (2),
(3), and (4). Any excess following this
reduction shall proportionally reduce the transfers under paragraph (a), clause
(1).
(c) Effective July 1, 2003, the amount reduced from the
prepaid general assistance medical care payments under paragraph (a), clause
(1), shall be transferred to the general fund.
(d) Beginning July 1, 2009, of the amounts in paragraph (a),
the commissioner shall transfer $21,714,000 each fiscal year to the medical
education and research fund. The balance
of the transfers under paragraph (a) shall be transferred to the medical
education and research fund no earlier than July 1 of the following fiscal
year.
Sec. 37. Minnesota
Statutes 2008, section 256B.69, subdivision 5f, is amended to read:
Subd. 5f. Capitation rates. (a) Beginning July 1, 2002, the
capitation rates paid under this section are increased by $12,700,000 per
year. Beginning July 1, 2003, the
capitation rates paid under this section are increased by $4,700,000 per year.
(b) Beginning July 1, 2009, the capitation rates paid under
this section are increased each year by the lesser of $21,714,000 or an amount
equal to the difference between the estimated value of the reductions described
in subdivision 5c, paragraph (a), clause (1), and the amount of the limit
described in subdivision 5c, paragraph (b).
Sec. 38. [256B.695] PAYMENT FOR BASIC CARE
SERVICES.
Effective service date July 1, 2009, total payments for basic
care services, except prescription drugs, medical supplies, prosthetics, lab,
radiology, medical transportation, and services subject to or specifically exempted
from section 256B.76, subdivision 1, paragraph (c), shall be reduced by 3.0
percent, prior to third-party liability.
Payments made to managed care and county-based purchasing plans shall be
reduced for services provided on or after January 1, 2010, to reflect this
reduction.
Sec. 39. Minnesota
Statutes 2008, section 256B.76, subdivision 1, is amended to read:
Subdivision 1. Physician reimbursement. (a) Effective for services rendered on or
after October 1, 1992, the commissioner shall make payments for physician
services as follows:
(1) payment for level one Centers for Medicare and Medicaid
Services' common procedural coding system codes titled "office and other
outpatient services," "preventive medicine new and established
patient," "delivery, antepartum, and postpartum care,"
"critical care," cesarean delivery and pharmacologic management
provided to psychiatric patients, and level three codes for enhanced services
for prenatal high risk, shall be paid at the lower of (i) submitted charges, or
(ii) 25 percent above the rate in effect on June 30, 1992. If the rate on any procedure code within
these categories is different than the rate that would have been paid under the
methodology in section 256B.74, subdivision 2, then the larger rate shall be
paid;
(2) payments for all other services shall be paid at the
lower of (i) submitted charges, or (ii) 15.4 percent above the rate in effect
on June 30, 1992; and
(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.
(b) 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. The increases in this paragraph shall be
implemented January 1, 2000, for managed care.
(c) Effective for services rendered on or after July 1, 2009,
payment rates for physician and professional services shall be reduced by three
percent over the rates in effect on June 30, 2009, except for office or other
outpatient services (procedure codes 99201 to 99215) and preventive medicine
services (procedure codes 99381 to 99412) billed by the following primary care
specialties: general practitioner,
internal medicine, pediatrics, geriatric nurse practitioner, pediatric nurse
practitioner, family practice nurse practitioner, adult nurse practitioner,
geriatrics, and family practice. The
commissioner, effective January 1, 2010, shall reduce capitation rates paid to
managed care and county-based purchasing plans under sections 256B.69 and
256B.692 to reflect this payment reduction.
Sec. 40. Minnesota
Statutes 2008, section 256B.76, subdivision 4, is amended to read:
Subd. 4. Critical access dental providers. Effective for dental services rendered on or
after January 1, 2002, the commissioner shall increase reimbursements to
dentists and dental clinics deemed by the commissioner to be critical access
dental providers. For dental services
rendered on or after July 1, 2007, the commissioner shall increase
reimbursement by 30 percent above the reimbursement rate that would otherwise
be paid to the critical access dental provider.
The commissioner shall pay the health plan companies in amounts
sufficient to 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 administer this subdivision within the limits of available
appropriations.
Sec. 41. Minnesota
Statutes 2008, section 256B.76, is amended by adding a subdivision to read:
Subd. 4a. Designation and termination of critical access dental providers. (a) The commissioner shall not designate
an individual dentist or clinic as a critical access dental provider under
subdivision 4 or section 256L.11, subdivision 7, when the owner or any dentist
employed by or under contract with the practice:
(1) has been subject to a corrective or disciplinary action
by the Minnesota Board of Dentistry within the past five years or is currently
subject to a corrective or disciplinary action by the board. Designation shall not be made until the
provider is no longer subject to a corrective or disciplinary action;
(2) does not bill on a clinic-specific location basis;
(3) has been subject, within the past five years, to a
postinvestigation action by the commissioner of human services or contracted
health plan when investigating services provided to Minnesota health care
program enrollees, including administrative sanctions, monetary recovery,
referral to state regulatory agency, referral to the state attorney general or
county attorney general, or issuance of a warning as specified in Minnesota
Rules, parts 9505.2160 to 9505.2245.
Designation shall not be considered until the January of the year
following documentation that the activity that resulted in postinvestigative
action has stopped; or
(4) has not completed the application for critical access
dental provider designation, has submitted the application after the due date,
provided incorrect information, or has knowingly and willfully submitted a
fraudulent designation form.
(b) The commissioner shall terminate a critical access
designation of an individual dentist or clinic, if the owner or any dentist
employed by or under contract with the practice:
(1) becomes subject to a disciplinary or corrective action by
the Minnesota Board of Dentistry. The
provider shall not be considered for critical access designation until the
January following the year in which the action has ended; or
(2) becomes subject to a postinvestigation action by the
commissioner of human services or contracted health plan including
administrative sanctions, monetary recovery, referral to state regulatory
agency, referral to the state attorney general or county attorney general, or
issuance of a warning as specified in Minnesota Rules, parts 9505.2160 to
9505.2245. Designation shall not be
considered until the January of the year following documentation that the
activity that resulted in postinvestigative action has stopped.
(c) Any termination is retroactive to the date of the:
(1) postinvestigative action; or
(2) disciplinary or corrective action by the Minnesota Board
of Dentistry.
(d) A provider who has been terminated or not designated may
appeal only through the contested hearing process as defined in section 14.02,
subdivision 3, by filing with the commissioner a written request of
appeal. The appeal request must be
received by the commissioner no later than 30 days after notification of
termination or nondesignation.
(e) The commissioner may make an exception to paragraph (a),
clauses (1) and (3), and paragraph (b), if an action taken by the Minnesota
Board of Dentistry, commissioner of human services, or contracted health plan
is the result of a onetime event by an individual employed or contracted by a
group practice.
EFFECTIVE DATE.
This section is effective the day following final enactment.
Sec. 42. Minnesota
Statutes 2008, 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) mental health
services covered under chapter 256B;
(16) prescribed
medications for persons who have been diagnosed as mentally ill as necessary to
prevent more restrictive institutionalization;
(17) medical supplies
and equipment, and Medicare premiums, coinsurance and deductible payments;
(18) 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;
(19) 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;
(20) 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;
(21) telemedicine
consultations, to the extent they are covered under section 256B.0625,
subdivision 3b;
(22) care
coordination and patient education services provided by a community health
worker according to section 256B.0625, subdivision 49; and
(23) 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.
(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.
(e) Recipients eligible under subdivision 3, paragraph (a),
shall pay the following co-payments for services provided on or after October
1, 2003, and before January 1, 2009:
(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.
(f) Recipients eligible under subdivision 3, paragraph (a),
shall include the following co-payments for services provided on or after
January 1, 2009:
(1) $25 for nonemergency visits to a hospital-based emergency
room; and
(2) $3 per brand-name drug prescription and $1 per generic
drug prescription, subject to a $7 per month maximum for prescription drug
co-payments. No co-payments shall apply
to antipsychotic drugs when used for the treatment of mental illness.
(g) MS 2007 Supp [Expired]
(h) Effective January 1, 2009, co-payments shall be limited to
one per day per provider for nonemergency visits to a hospital-based emergency
room. Recipients of general assistance
medical care are responsible for all co-payments in this subdivision. The general assistance medical care
reimbursement to the provider shall be reduced by the amount of the co-payment,
except that reimbursement for prescription drugs shall not be reduced once a
recipient has reached the $7 per month maximum for prescription drug
co-payments. The provider collects the
co-payment from the recipient. Providers
may not deny services to recipients who are unable to pay the co-payment.
(i) General assistance medical care reimbursement to
fee-for-service providers and payments to managed care plans shall not be
increased as a result of the removal of the co-payments effective January 1,
2009.
(j) Any county may, from its own resources, provide medical
payments for which state payments are not made.
(k) Chemical dependency services that are reimbursed under
chapter 254B must not be reimbursed under general assistance medical care.
(l) 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.
(m) 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.
(n) 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 (l).
(o) Payments for all other health services except inpatient,
outpatient, and pharmacy services shall be reduced by five percent, effective
July 1, 2003.
(p) Payments to managed care plans shall be reduced by five
percent for services provided on or after October 1, 2003.
(q) 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.
(r) 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.
(s) 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.
(t) Payments for mental health services added as covered
benefits after December 31, 2007, are not subject to the reductions in
paragraphs (l), (n), (o), and (p).
(u) In addition to the reductions in paragraphs (k) and (l),
effective service date July 1, 2009, total payments for basic care services,
except prescription drugs, medical supplies, prosthetics, lab, radiology,
medical transportation, and services subject to or specifically exempted from
paragraph (v), shall be reduced by 3.0 percent, prior to third-party
liability. Payments made to managed care
and county-based purchasing plans shall be reduced for services provided on or
after January 1, 2010, to reflect this reduction.
(v) Effective for services rendered on or after July 1, 2009,
payment rates for physician and professional services shall be reduced by three
percent over the rates in effect on June 30, 2009, except for office or other
outpatient services (procedure codes 99201 to 99215) and preventive medicine
services (procedure codes 99381 to 99412) billed by the following primary care
specialties: general practitioner,
internal medicine, pediatrics, geriatric nurse practitioner, pediatric nurse
practitioner, family practice nurse practitioner, adult nurse practitioner,
geriatrics, and family practice. The
commissioner, effective January 1, 2010, shall reduce capitation rates paid to
managed care and county-based purchasing plans under paragraph (c) to reflect
this payment reduction.
Sec. 43. Minnesota
Statutes 2008, section 256L.04, subdivision 10a, is amended to read:
Subd. 10a. Sponsor's income and resources deemed
available; documentation. When
determining eligibility for any federal or state benefits under sections
256L.01 to 256L.18, the income and resources of all noncitizens whose sponsor
signed an affidavit of support as defined under United States Code, title 8,
section 1183a, shall be deemed to include their sponsors' income and resources
as defined in the Personal Responsibility and Work Opportunity Reconciliation
Act of 1996, title IV, Public Law 104-193, sections 421 and 422, and
subsequently set out in federal rules.
To be eligible for the program, noncitizens must provide documentation
of their immigration status. Beginning
July 1, 2010, or upon federal approval, whichever is later, sponsor deeming
does not apply to pregnant women and children who are qualified noncitizens, as
described in section 256B.06, subdivision 4, paragraph (b).
EFFECTIVE DATE.
This section is effective July 1, 2010, or upon federal approval,
whichever is later. The commissioner
shall notify the revisor of statutes when federal approval has been obtained.
Sec. 44. Minnesota
Statutes 2008, section 256L.04, is amended by adding a subdivision to read:
Subd. 14. Presumptive eligibility.
MinnesotaCare is available during a presumptive period of
eligibility, for children who appear to meet the income requirements of
subdivision 1, on the basis of preliminary information. The presumptive period begins on the first
day of the month following the date on which presumptive eligibility is
determined by the state or local agency.
The agency must provide notice of presumptive eligibility and
information on the procedures for completing the eligibility process. The effective date of coverage for children
who are determined presumptively eligible is in accordance with section
256L.05, subdivision 3. The presumptive
period ends on the earlier of the date of the determination for MinnesotaCare
eligibility, or the last day of the month following the month the presumptive
eligibility period begins if a complete application with requested
verifications is not submitted by that date.
Applicants and enrollees who are denied or terminated for failure to
complete an application or provide verifications cannot be granted presumptive
eligibility again for 12 months.
EFFECTIVE DATE.
This section is effective January 1, 2010, or upon federal approval,
whichever is later.
Sec. 45. Minnesota
Statutes 2008, section 256L.05, subdivision 1, is amended to read:
Subdivision 1. Application assistance and
information availability. (a) Applications
and application assistance must be made available at provider offices, local
human services agencies, school districts, public and private elementary
schools in which 25 percent or more of the students receive free or reduced
price lunches, community health offices, Women, Infants and Children (WIC)
program sites, Head Start program sites, public housing councils, crisis
nurseries, child care centers, early childhood education and preschool program
sites, legal aid offices, and libraries.
These sites may accept applications and forward the forms to the
commissioner or local county human services agencies that choose to
participate as an enrollment site.
Otherwise, applicants may apply directly to the commissioner or to
participating local county human services agencies.
(b) Application assistance must be available for applicants
choosing to file an online application.
(c) The commissioner and local agencies shall assist enrollees
in choosing a managed care organization by:
(1) establishing a Web site to provide information about
managed care organizations and to allow online enrollment;
(2) making applications and information on managed care
organizations available to applicants and enrollees according to Title VI of
the Civil Rights Act and federal regulations adopted under that law, or any
guidance from the United States Department of Health and Human Services; and
(3) making benefit educators available to assist applicants in
choosing a managed care organization.
Sec. 46. Minnesota
Statutes 2008, section 256L.05, is amended by adding a subdivision to read:
Subd. 1c. Open enrollment and streamlined application and enrollment process. (a) The commissioner and local agencies
working in partnership must develop a streamlined and efficient application and
enrollment process for medical assistance and MinnesotaCare enrollees that
meets the criteria specified in this subdivision.
(b) The commissioners of human services and education shall
provide recommendations to the legislature by January 15, 2010, on the creation
of an open enrollment process for medical assistance and MinnesotaCare that is
coordinated with the public education system.
The recommendations must:
(1) be developed in consultation with medical assistance and
MinnesotaCare enrollees and representatives from organizations that advocate on
behalf of children and families, low-income persons and minority populations,
counties, school administrators and nurses, health plans, and health care
providers;
(2) be based on enrollment and renewal procedures best practices,
including express lane eligibility as required under subdivision 1d;
(3) simplify the enrollment and renewal processes wherever
possible; and
(4) establish a process:
(i) to disseminate information on medical assistance and
MinnesotaCare to all children in the public education system, including
prekindergarten programs; and
(ii) for the commissioner of human services to enroll
children and other household members who are eligible.
The commissioner of human services in coordination with the commissioner
of education shall implement an open enrollment process by August 1, 2010, to
be effective beginning with the 2010-2011 school year.
(c) The commissioner and local agencies shall develop an
online application process for medical assistance and MinnesotaCare.
(d) The commissioner shall develop an application that is
easily understandable and does not exceed four pages in length.
(e) The commissioner of human services shall present to the
legislature, by January 15, 2010, an implementation plan for the open
enrollment period and online application process.
EFFECTIVE DATE. This section is effective July 1, 2010, or upon federal approval, whi