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(b) The funds available for targeted funding shall be the total appropriation for each fiscal year minus county lead agency allocations determined under subdivision 10 as adjusted for any inflation increases provided in appropriations for the biennium.

 

(c) The commissioner shall allocate targeted funds to counties lead agencies that demonstrate to the satisfaction of the commissioner that they have developed feasible plans to increase alternative care spending. In making targeted funding allocations, the commissioner shall use the following priorities:

 

(1) counties lead agencies that received a lower allocation in fiscal year 1991 than in fiscal year 1990. Counties remain in this priority until they have been restored to their fiscal year 1990 level plus inflation;

 

(2) counties lead agencies that sustain a base allocation reduction for failure to spend 95 percent of the allocation if they demonstrate that the base reduction should be restored;

 

(3) counties lead agencies that propose projects to divert community residents from nursing home placement or convert nursing home residents to community living; and

 

(4) counties lead agencies that can otherwise justify program growth by demonstrating the existence of waiting lists, demographically justified needs, or other unmet needs.

 

(d) Counties Lead agencies that would receive targeted funds according to paragraph (c) must demonstrate to the commissioner's satisfaction that the funds would be appropriately spent by showing how the funds would be used to further the state's alternative care goals as described in subdivision 1, and that the county has the administrative and service delivery capability to use them.

 

(e) The commissioner shall request applications make applications available for targeted funds by November 1 of each year. The counties lead agencies selected for targeted funds shall be notified of the amount of their additional funding. Targeted funds allocated to a county lead agency in one year shall be treated as part of the county's lead agency's base allocation for that year in determining allocations for subsequent years. No reallocations between counties lead agencies shall be made.

 

Sec. 36. Minnesota Statutes 2006, section 256B.0913, subdivision 12, is amended to read:

 

Subd. 12. Client fees. (a) A fee is required for all alternative care eligible clients to help pay for the cost of participating in the program. The amount of the fee for the alternative care client shall be determined as follows:

 

(1) when the alternative care client's income less recurring and predictable medical expenses is less than 100 percent of the federal poverty guideline effective on July 1 of the state fiscal year in which the fee is being computed, and total assets are less than $10,000, the fee is zero;

 

(2) when the alternative care client's income less recurring and predictable medical expenses is equal to or greater than 100 percent but less than 150 percent of the federal poverty guideline effective on July 1 of the state fiscal year in which the fee is being computed, and total assets are less than $10,000, the fee is five percent of the cost of alternative care services;

 

(3) when the alternative care client's income less recurring and predictable medical expenses is equal to or greater than 150 percent but less than 200 percent of the federal poverty guidelines effective on July 1 of the state fiscal year in which the fee is being computed and assets are less than $10,000, the fee is 15 percent of the cost of alternative care services;

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(4) when the alternative care client's income less recurring and predictable medical expenses is equal to or greater than 200 percent of the federal poverty guidelines effective on July 1 of the state fiscal year in which the fee is being computed and assets are less than $10,000, the fee is 30 percent of the cost of alternative care services; and

 

(5) when the alternative care client's assets are equal to or greater than $10,000, the fee is 30 percent of the cost of alternative care services.

 

For married persons, total assets are defined as the total marital assets less the estimated community spouse asset allowance, under section 256B.059, if applicable. For married persons, total income is defined as the client's income less the monthly spousal allotment, under section 256B.058.

 

All alternative care services shall be included in the estimated costs for the purpose of determining the fee.

 

Fees are due and payable each month alternative care services are received unless the actual cost of the services is less than the fee, in which case the fee is the lesser amount.

 

(b) The fee shall be waived by the commissioner when:

 

(1) a person who is residing in a nursing facility is receiving case management only;

 

(2) a married couple is requesting an asset assessment under the spousal impoverishment provisions;

 

(3) a person is found eligible for alternative care, but is not yet receiving alternative care services including case management services; or

 

(4) a person has chosen to participate in a consumer-directed service plan for which the cost is no greater than the total cost of the person's alternative care service plan less the monthly fee amount that would otherwise be assessed.

 

(c) The county agency must record in the state's receivable system the client's assessed fee amount or the reason the fee has been waived. The commissioner will bill and collect the fee from the client. Money collected must be deposited in the general fund and is appropriated to the commissioner for the alternative care program. The client must supply the county lead agency with the client's Social Security number at the time of application. The county lead agency shall supply the commissioner with the client's Social Security number and other information the commissioner requires to collect the fee from the client. The commissioner shall collect unpaid fees using the Revenue Recapture Act in chapter 270A and other methods available to the commissioner. The commissioner may require counties lead agencies to inform clients of the collection procedures that may be used by the state if a fee is not paid. This paragraph does not apply to alternative care pilot projects authorized in Laws 1993, First Special Session chapter 1, article 5, section 133, if a county operating under the pilot project reports the following dollar amounts to the commissioner quarterly:

 

(1) total fees billed to clients;

 

(2) total collections of fees billed; and

 

(3) balance of fees owed by clients.

 

If a county lead agency does not adhere to these reporting requirements, the commissioner may terminate the billing, collecting, and remitting portions of the pilot project and require the county lead agency involved to operate under the procedures set forth in this paragraph.

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Sec. 37. Minnesota Statutes 2006, section 256B.0913, subdivision 13, is amended to read:

 

Subd. 13. County Lead agency biennial plan. The county lead agency biennial plan for long-term care consultation services under section 256B.0911, the alternative care program under this section, and waivers for the elderly under section 256B.0915, shall be submitted by the lead agency as the home and community-based services quality assurance plan on a form provided by the commissioner.

 

Sec. 38. Minnesota Statutes 2006, section 256B.0913, subdivision 14, is amended to read:

 

Subd. 14. Provider requirements, payment, and rate adjustments. (a) Unless otherwise specified in statute, providers must be enrolled as Minnesota health care program providers and abide by the requirements for provider participation according to Minnesota Rules, part 9505.0195.

 

(b) Payment for provided alternative care services as approved by the client's case manager shall occur through the invoice processing procedures of the department's Medicaid Management Information System (MMIS). To receive payment, the county lead agency or vendor must submit invoices within 12 months following the date of service. The county lead agency and its vendors under contract shall not be reimbursed for services which exceed the county allocation.

 

(c) The county lead agency shall negotiate individual rates with vendors and may authorize service payment for actual costs up to the county's current approved rate. Notwithstanding any other rule or statutory provision to the contrary, the commissioner shall not be authorized to increase rates by an annual inflation factor, unless so authorized by the legislature. To improve access to community services and eliminate payment disparities between the alternative care program and the elderly waiver program, the commissioner shall establish statewide maximum service rate limits and eliminate county-specific service rate limits.

 

(1) Effective July 1, 2001, for service rate limits, except those in subdivision 5, paragraphs (d) and (i), the rate limit for each service shall be the greater of the alternative care statewide maximum rate or the elderly waiver statewide maximum rate.

 

(2) Counties Lead agencies may negotiate individual service rates with vendors for actual costs up to the statewide maximum service rate limit.

 

Sec. 39. Minnesota Statutes 2006, section 256B.0919, subdivision 3, is amended to read:

 

Subd. 3. County certification of persons providing adult foster care to related persons. A person exempt from licensure under section 245A.03, subdivision 2, who provides adult foster care to a related individual age 65 and older, and who meets the requirements in Minnesota Rules, parts 9555.5105 to 9555.6265, may be certified by the county to provide adult foster care. A person certified by the county to provide adult foster care may be reimbursed for services provided and eligible for funding under sections 256B.0913 and section 256B.0915, if the relative would suffer a financial hardship as a result of providing care. For purposes of this subdivision, financial hardship refers to a situation in which a relative incurs a substantial reduction in income as a result of resigning from a full-time job or taking a leave of absence without pay from a full-time job to care for the client.

 

Sec. 40. Minnesota Statutes 2006, section 256B.27, subdivision 2a, is amended to read:

 

Subd. 2a. On-site Cost and statistical data audits. Each year The commissioner shall provide for the on-site an audit of the cost reports and statistical data of nursing homes facilities participating as vendors of medical assistance. The commissioner shall select for audit at least 15 percent of these the nursing homes facility's data reported at random or using factors including, but not limited to: data reported to the public as criteria for rating nursing facilities; data used to set limits for other medical assistance programs or vendors of services to nursing

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facilities; change in ownership; frequent changes in administration in excess of normal turnover rates; complaints to the commissioner of health about care, safety, or rights; where previous inspections or reinspections under section 144A.10 have resulted in correction orders related to care, safety, or rights; or where persons involved in ownership or administration of the facility have been indicted for alleged criminal activity.

 

The commissioner shall meet the 15 percent requirement by either conducting an audit focused on an individual nursing facility, a group of facilities, or targeting specific data categories in multiple nursing facilities. These audits may be conducted on site at the nursing facility, at office space used by a nursing facility or a nursing facility's parent organization, or at the commissioner's office. Data being audited may be collected electronically, in person, or by any other means the commissioner finds acceptable.

 

Sec. 41. Minnesota Statutes 2006, section 256B.431, subdivision 1, is amended to read:

 

Subdivision 1. In general. The commissioner shall determine prospective payment rates for resident care costs. For rates established on or after July 1, 1985, the commissioner shall develop procedures for determining operating cost payment rates that take into account the mix of resident needs, geographic location, and other factors as determined by the commissioner. The commissioner shall consider whether the fact that a facility is attached to a hospital or has an average length of stay of 180 days or less should be taken into account in determining rates. The commissioner shall consider the use of the standard metropolitan statistical areas when developing groups by geographic location. The commissioner shall provide notice to each nursing facility on or before May 1 August 15 of the rates effective for the following rate year except that if legislation is pending on May 1 August 15 that may affect rates for nursing facilities, the commissioner shall set the rates after the legislation is enacted and provide notice to each facility as soon as possible.

 

Compensation for top management personnel shall continue to be categorized as a general and administrative cost and is subject to any limits imposed on that cost category.

 

Sec. 42. Minnesota Statutes 2006, section 256B.431, subdivision 3f, is amended to read:

 

Subd. 3f. Property costs after July 1, 1988. (a) Investment per bed limit. For the rate year beginning July 1, 1988, the replacement-cost-new per bed limit must be $32,571 per licensed bed in multiple bedrooms and $48,857 per licensed bed in a single bedroom. For the rate year beginning July 1, 1989, the replacement-cost-new per bed limit for a single bedroom must be $49,907 adjusted according to Minnesota Rules, part 9549.0060, subpart 4, item A, subitem (1). Beginning January 1, 1990, the replacement-cost-new per bed limits must be adjusted annually as specified in Minnesota Rules, part 9549.0060, subpart 4, item A, subitem (1). Beginning January 1, 1991, the replacement-cost-new per bed limits will be adjusted annually as specified in Minnesota Rules, part 9549.0060, subpart 4, item A, subitem (1), except that the index utilized will be the Bureau of the Census: Composite fixed-weighted price index as published in the C30 Report, Value of New Construction Put in Place Economic Analysis: Price Indexes for Private Fixed Investments in Structures; Special Care.

 

(b) Rental factor. For the rate year beginning July 1, 1988, the commissioner shall increase the rental factor as established in Minnesota Rules, part 9549.0060, subpart 8, item A, by 6.2 percent rounded to the nearest 100th percent for the purpose of reimbursing nursing facilities for soft costs and entrepreneurial profits not included in the cost valuation services used by the state's contracted appraisers. For rate years beginning on or after July 1, 1989, the rental factor is the amount determined under this paragraph for the rate year beginning July 1, 1988.

 

(c) Occupancy factor. For rate years beginning on or after July 1, 1988, in order to determine property-related payment rates under Minnesota Rules, part 9549.0060, for all nursing facilities except those whose average length of stay in a skilled level of care within a nursing facility is 180 days or less, the commissioner shall use 95 percent of capacity days. For a nursing facility whose average length of stay in a skilled level of care within a nursing facility is 180 days or less, the commissioner shall use the greater of resident days or 80 percent of capacity days but in no event shall the divisor exceed 95 percent of capacity days.

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(d) Equipment allowance. For rate years beginning on July 1, 1988, and July 1, 1989, the commissioner shall add ten cents per resident per day to each nursing facility's property-related payment rate. The ten-cent property-related payment rate increase is not cumulative from rate year to rate year. For the rate year beginning July 1, 1990, the commissioner shall increase each nursing facility's equipment allowance as established in Minnesota Rules, part 9549.0060, subpart 10, by ten cents per resident per day. For rate years beginning on or after July 1, 1991, the adjusted equipment allowance must be adjusted annually for inflation as in Minnesota Rules, part 9549.0060, subpart 10, item E. For the rate period beginning October 1, 1992, the equipment allowance for each nursing facility shall be increased by 28 percent. For rate years beginning after June 30, 1993, the allowance must be adjusted annually for inflation.

 

(e) Post chapter 199 related-organization debts and interest expense. For rate years beginning on or after July 1, 1990, Minnesota Rules, part 9549.0060, subpart 5, item E, shall not apply to outstanding related organization debt incurred prior to May 23, 1983, provided that the debt was an allowable debt under Minnesota Rules, parts 9510.0010 to 9510.0480, the debt is subject to repayment through annual principal payments, and the nursing facility demonstrates to the commissioner's satisfaction that the interest rate on the debt was less than market interest rates for similar arm's-length transactions at the time the debt was incurred. If the debt was incurred due to a sale between family members, the nursing facility must also demonstrate that the seller no longer participates in the management or operation of the nursing facility. Debts meeting the conditions of this paragraph are subject to all other provisions of Minnesota Rules, parts 9549.0010 to 9549.0080.

 

(f) Building capital allowance for nursing facilities with operating leases. For rate years beginning on or after July 1, 1990, a nursing facility with operating lease costs incurred for the nursing facility's buildings shall receive its building capital allowance computed in accordance with Minnesota Rules, part 9549.0060, subpart 8. If an operating lease provides that the lessee's rent is adjusted to recognize improvements made by the lessor and related debt, the costs for capital improvements and related debt shall be allowed in the computation of the lessee's building capital allowance, provided that reimbursement for these costs under an operating lease shall not exceed the rate otherwise paid.

 

Sec. 43. Minnesota Statutes 2006, section 256B.431, subdivision 17e, is amended to read:

 

Subd. 17e. Replacement-costs-new per bed limit effective July October 1, 2001 2007. Notwithstanding Minnesota Rules, part 9549.0060, subpart 11, item C, subitem (2), for a total replacement, as defined in paragraph (f) subdivision 17d, authorized under section 144A.071 or 144A.073 after July 1, 1999, or any building project that is a relocation, renovation, upgrading, or conversion completed on or after July 1, 2001, or any building project eligible for reimbursement under section 256B.434, subdivision 4f, the replacement-costs-new per bed limit shall be $74,280 per licensed bed in multiple-bed rooms, $92,850 per licensed bed in semiprivate rooms with a fixed partition separating the resident beds, and $111,420 per licensed bed in single rooms. Minnesota Rules, part 9549.0060, subpart 11, item C, subitem (2), does not apply. These amounts must be adjusted annually as specified in subdivision 3f, paragraph (a), beginning January 1, 2000.

 

Sec. 44. Minnesota Statutes 2006, section 256B.431, subdivision 41, is amended to read:

 

Subd. 41. Rate increases for October 1, 2005, and October 1, 2006. (a) For the rate period beginning October 1, 2005, the commissioner shall make available to each nursing facility reimbursed under this section or section 256B.434 an adjustment equal to 2.2553 percent of the total operating payment rate, and for the rate year beginning October 1, 2006, the commissioner shall make available to each nursing facility reimbursed under this section or section 256B.434 an adjustment equal to 1.2553 percent of the total operating payment rate.

 

(b) 75 percent of the money resulting from the rate adjustment under paragraph (a) must be used to increase wages and benefits and pay associated costs for all employees, except management fees, the administrator, and central office staff. Except as provided in paragraph (c), 75 percent of the money received by a facility as a result of

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the rate adjustment provided in paragraph (a) must be used only for wage, benefit, and staff increases implemented on or after the effective date of the rate increase each year, and must not be used for increases implemented prior to that date.

 

(c) With respect only to the October 1, 2005, rate increase, a nursing facility that incurred costs for salary and employee benefit increases first provided after July 1, 2003, may count those costs towards the amount required to be spent on salaries and benefits under paragraph (b). These costs must be reported to the commissioner in the form and manner specified by the commissioner.

 

(d) Nursing facilities may apply for the portion of the rate adjustment under paragraph (a) for employee wages and benefits and associated costs. The application must be made to the commissioner and contain a plan by which the nursing facility will distribute the funds according to paragraph (b). For nursing facilities in which the employees are represented by an exclusive bargaining representative, an agreement negotiated and agreed to by the employer and the exclusive bargaining representative constitutes the plan. A negotiated agreement may constitute the plan only if the agreement is finalized after the date of enactment of all increases for the rate year and signed by both parties prior to submission to the commissioner. The commissioner shall review the plan to ensure that the rate adjustments are used as provided in paragraph (b). To be eligible, a facility must submit its distribution plan by March 31, 2006, and March 31, 2007, respectively. The commissioner may approve distribution plans on or before June 30, 2006, and June 30, 2007, respectively. The commissioner may waive the deadlines in this paragraph under extraordinary circumstances, either retroactively or prospectively, to be determined at the sole discretion of the commissioner. If a facility's distribution plan is effective after the first day of the applicable rate period that the funds are available, the rate adjustments are effective the same date as the facility's plan.

 

(e) A copy of the approved distribution plan must be made available to all employees by giving each employee a copy or by posting a copy in an area of the nursing facility to which all employees have access. If an employee does not receive the wage and benefit adjustment described in the facility's approved plan and is unable to resolve the problem with the facility's management or through the employee's union representative, the employee may contact the commissioner at an address or telephone number provided by the commissioner and included in the approved plan.

 

EFFECTIVE DATE. This section is effective upon enactment and is retroactive from October 1, 2005.

 

Sec. 45. Minnesota Statutes 2006, section 256B.49, subdivision 11, is amended to read:

 

Subd. 11. Authority. (a) The commissioner is authorized to apply for home and community-based service waivers, as authorized under section 1915(c) of the Social Security Act to serve persons under the age of 65 who are determined to require the level of care provided in a nursing home and persons who require the level of care provided in a hospital. The commissioner shall apply for the home and community-based waivers in order to:

 

(i) promote the support of persons with disabilities in the most integrated settings;

 

(ii) expand the availability of services for persons who are eligible for medical assistance;

 

(iii) promote cost-effective options to institutional care; and

 

(iv) obtain federal financial participation.

 

(b) The provision of waivered services to medical assistance recipients with disabilities shall comply with the requirements outlined in the federally approved applications for home and community-based services and subsequent amendments, including provision of services according to a service plan designed to meet the needs of the individual. For purposes of this section, the approved home and community-based application is considered the necessary federal requirement.

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(c) The commissioner shall provide interested persons serving on agency advisory committees and, task forces, the Centers for Independent Living, and others upon who request, with to be on a list to receive, notice of, and an opportunity to comment on, at least 30 days before any effective dates, (1) any substantive changes to the state's disability services program manual, or (2) changes or amendments to the federally approved applications for home and community-based waivers, prior to their submission to the federal Centers for Medicare and Medicaid Services.

 

(d) The commissioner shall seek approval, as authorized under section 1915(c) of the Social Security Act, to allow medical assistance eligibility under this section for children under age 21 without deeming of parental income or assets.

 

(e) The commissioner shall seek approval, as authorized under section 1915(c) of the Social Act, to allow medical assistance eligibility under this section for individuals under age 65 without deeming the spouse's income or assets.

 

Sec. 46. Laws 2000, chapter 340, section 19, is amended to read:

 

Sec. 19. ALTERNATIVE CARE PILOT PROJECTS.

 

(a) Expenditures for housing with services and adult foster care shall be excluded when determining average monthly expenditures per client for alternative care pilot projects authorized in Laws 1993, First Special Session chapter 1, article 5, section 133.

 

(b) Alternative care pilot projects shall not expire on June 30, 2001, but shall continue until June 30, 2005 2007.

 

EFFECTIVE DATE. This section is effective retroactively from June 29, 2005, for activities related to discontinuing pilot projects under this section.

 

Sec. 47. LICENSURE; SERVICES FOR YOUTH WITH DISABILITIES.

 

(a) Notwithstanding the requirements of Minnesota Statutes, chapter 245A, upon the recommendation of a county agency, the commissioner of human services shall grant a license with any necessary variances to a nonresidential program for youth that provides services to youth with disabilities under age 21 during nonschool hours established to ensure health and safety, prevent out-of-home placement, and increase community inclusion of youth with disabilities. The nonresidential youth program is subject to the conditions of any variances granted and to consumer rights standards under Minnesota Statutes, section 245B.04; consumer protection standards under Minnesota Statutes, section 245B.05; service standards under Minnesota Statutes, section 245B.06; management standards under Minnesota Statutes, section 245B.07; and fire marshal inspections under Minnesota Statutes, section 245A.151, until the commissioner develops other licensure requirements for this type of program.

 

(b) By February 1, 2008, the commissioner shall recommend amendments to licensure requirements in Minnesota Statutes, chapter 245A, to allow licensure of appropriate services for school-age youth with disabilities under age 21 who need supervision and services to develop skills necessary to maintain personal safety and increase their independence, productivity, and participation in their communities during nonschool hours. As part of developing the recommendations, the commissioner shall survey county agencies to determine how the needs of youth with disabilities under age 21 who require supervision and support services are being met and the funding sources used. The recommendations must be provided to the house and senate chairs of the committees with jurisdiction over licensing of programs for youth with disabilities.

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ARTICLE 7

 

CONTINUING CARE

 

Section 1. Minnesota Statutes 2006, section 47.58, subdivision 8, is amended to read:

 

Subd. 8. Counseling; requirement; penalty. A lender, mortgage banking company, or other mortgage lender not related to the mortgagor must keep a certificate on file documenting that the borrower, prior to entering into the reverse mortgage loan, received counseling as defined in this subdivision from an organization that meets the requirements of section 462A.209 and is a housing counseling agency approved by the Department of Housing and Urban Development. The certificate must be signed by the mortgagor and the counselor and include the date of the counseling, the name, address, and telephone number of both the mortgagor and the organization providing counseling. A failure by the lender to comply with this subdivision results in a $1,000 civil penalty payable to the mortgagor. For the purposes of this subdivision, "counseling" means the following services are provided to the borrower:

 

(1) a review of the advantages and disadvantages of reverse mortgage programs;

 

(2) an explanation of how the reverse mortgage affects the borrower's estate and public benefits;

 

(3) an explanation of the lending process;

 

(4) a discussion of the borrower's supplemental income needs; and

 

(5) an explanation of the provisions of sections 256B.0913, subdivision 17, and 462A.05, subdivision 42; and

 

(6) an opportunity to ask questions of the counselor.

 

Sec. 2. Minnesota Statutes 2006, section 144A.073, subdivision 4, is amended to read:

 

Subd. 4. Criteria for review. The following criteria shall be used in a consistent manner to compare, evaluate, and rank all proposals submitted. Except for the criteria specified in clause (3), the application of criteria listed under this subdivision shall not reflect any distinction based on the geographic location of the proposed project:

 

(1) the extent to which the proposal furthers state long-term care goals, including the goal of enhancing the availability and use of alternative care services and the goal of reducing the number of long-term care resident rooms with more than two beds;

 

(2) the proposal's long-term effects on state costs including the cost estimate of the project according to section 144A.071, subdivision 5a;

 

(3) the extent to which the proposal promotes equitable access to long-term care services in nursing homes through redistribution of the nursing home bed supply, as measured by the number of beds relative to the population 85 or older, projected to the year 2000 by the state demographer, and according to items (i) to (iv):

 

(i) reduce beds in counties where the supply is high, relative to the statewide mean, and increase beds in counties where the supply is low, relative to the statewide mean;

 

(ii) adjust the bed supply so as to create the greatest benefits in improving the distribution of beds;

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(iii) adjust the existing bed supply in counties so that the bed supply in a county moves toward the statewide mean; and

 

(iv) adjust the existing bed supply so that the distribution of beds as projected for the year 2020 would be consistent with projected need, based on the methodology outlined in the Interagency Long-Term Care Committee's nursing home bed distribution study;

 

(4) the extent to which the project improves conditions that affect the health or safety of residents, such as narrow corridors, narrow door frames, unenclosed fire exits, and wood frame construction, and similar provisions contained in fire and life safety codes and licensure and certification rules;

 

(5) the extent to which the project improves conditions that affect the comfort or quality of life of residents in a facility or the ability of the facility to provide efficient care, such as a relatively high number of residents in a room; inadequate lighting or ventilation; poor access to bathing or toilet facilities; a lack of available ancillary space for dining rooms, day rooms, or rooms used for other activities; problems relating to heating, cooling, or energy efficiency; inefficient location of nursing stations; narrow corridors; or other provisions contained in the licensure and certification rules;

 

(6) the extent to which the applicant demonstrates the delivery of quality care, as defined in state and federal statutes and rules, to residents as evidenced by the two most recent state agency certification surveys and the applicants' response to those surveys;

 

(7) the extent to which the project removes the need for waivers or variances previously granted by either the licensing agency, certifying agency, fire marshal, or local government entity;

 

(8) the extent to which the project increases the number of private or single bed rooms; and

 

(9) the extent to which the applicant demonstrates the continuing need for nursing facility care in the community and adjacent communities; and

 

(10) other factors that may be developed in permanent rule by the commissioner of health that evaluate and assess how the proposed project will further promote or protect the health, safety, comfort, treatment, or well-being of the facility's residents.

 

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

 

Sec. 3. Minnesota Statutes 2006, section 252.27, subdivision 2a, is amended to read:

 

Subd. 2a. Contribution amount. (a) The natural or adoptive parents of a minor child, including a child determined eligible for medical assistance without consideration of parental income, must contribute to the cost of services used by making monthly payments on a sliding scale based on income, unless the child is married or has been married, parental rights have been terminated, or the child's adoption is subsidized according to section 259.67 or through title IV-E of the Social Security Act. The parental contribution is a partial or full payment for medical services provided for diagnostic, therapeutic, curing, treating, mitigating, rehabilitation, maintenance, and personal care services as defined in United States Code, title 26, section 213, needed by the child with a chronic illness or disability.

 

(b) For households with adjusted gross income equal to or greater than 100 percent of federal poverty guidelines, the parental contribution shall be computed by applying the following schedule of rates to the adjusted gross income of the natural or adoptive parents:

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(1) if the adjusted gross income is equal to or greater than 100 percent of federal poverty guidelines and less than 175 percent of federal poverty guidelines, the parental contribution is $4 per month;

 

(2) if the adjusted gross income is equal to or greater than 175 percent of federal poverty guidelines and less than or equal to 545 percent of federal poverty guidelines, the parental contribution shall be determined using a sliding fee scale established by the commissioner of human services which begins at one percent of adjusted gross income at 175 percent of federal poverty guidelines and increases to 7.5 percent of adjusted gross income for those with adjusted gross income up to 545 percent of federal poverty guidelines;

 

(3) if the adjusted gross income is greater than 545 percent of federal poverty guidelines and less than 675 percent of federal poverty guidelines, the parental contribution shall be 7.5 percent of adjusted gross income;

 

(4) if the adjusted gross income is equal to or greater than 675 percent of federal poverty guidelines and less than 975 percent of federal poverty guidelines, the parental contribution shall be determined using a sliding fee scale established by the commissioner of human services which begins at 7.5 percent of adjusted gross income at 675 percent of federal poverty guidelines and increases to ten percent of adjusted gross income for those with adjusted gross income up to 975 percent of federal poverty guidelines; and

 

(5) if the adjusted gross income is equal to or greater than 975 percent of federal poverty guidelines, the parental contribution shall be 12.5 percent of adjusted gross income.

 

If the child lives with the parent, the annual adjusted gross income is reduced by $2,400 prior to calculating the parental contribution. If the child resides in an institution specified in section 256B.35, the parent is responsible for the personal needs allowance specified under that section in addition to the parental contribution determined under this section. The parental contribution is reduced by any amount required to be paid directly to the child pursuant to a court order, but only if actually paid.

 

(c) The household size to be used in determining the amount of contribution under paragraph (b) includes natural and adoptive parents and their dependents, including the child receiving services. Adjustments in the contribution amount due to annual changes in the federal poverty guidelines shall be implemented on the first day of July following publication of the changes.

 

(d) For purposes of paragraph (b), "income" means the adjusted gross income of the natural or adoptive parents determined according to the previous year's federal tax form, except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds have been used to purchase a home shall not be counted as income.

 

(e) The contribution shall be explained in writing to the parents at the time eligibility for services is being determined. The contribution shall be made on a monthly basis effective with the first month in which the child receives services. Annually upon redetermination or at termination of eligibility, if the contribution exceeded the cost of services provided, the local agency or the state shall reimburse that excess amount to the parents, either by direct reimbursement if the parent is no longer required to pay a contribution, or by a reduction in or waiver of parental fees until the excess amount is exhausted.

 

(f) The monthly contribution amount must be reviewed at least every 12 months; when there is a change in household size; and when there is a loss of or gain in income from one month to another in excess of ten percent. The local agency shall mail a written notice 30 days in advance of the effective date of a change in the contribution amount. A decrease in the contribution amount is effective in the month that the parent verifies a reduction in income or change in household size.

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(g) Parents of a minor child who do not live with each other shall each pay the contribution required under paragraph (a). An amount equal to the annual court-ordered child support payment actually paid on behalf of the child receiving services shall be deducted from the adjusted gross income of the parent making the payment prior to calculating the parental contribution under paragraph (b).

 

(h) The contribution under paragraph (b) shall be increased by an additional five percent if the local agency determines that insurance coverage is available but not obtained for the child. For purposes of this section, "available" means the insurance is a benefit of employment for a family member at an annual cost of no more than five percent of the family's annual income. For purposes of this section, "insurance" means health and accident insurance coverage, enrollment in a nonprofit health service plan, health maintenance organization, self-insured plan, or preferred provider organization.

 

Parents who have more than one child receiving services shall not be required to pay more than the amount for the child with the highest expenditures. There shall be no resource contribution from the parents. The parent shall not be required to pay a contribution in excess of the cost of the services provided to the child, not counting payments made to school districts for education-related services. Notice of an increase in fee payment must be given at least 30 days before the increased fee is due.

 

(i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if, in the 12 months prior to July 1:

 

(1) the parent applied for insurance for the child;

 

(2) the insurer denied insurance;

 

(3) the parents submitted a complaint or appeal, in writing to the insurer, submitted a complaint or appeal, in writing, to the commissioner of health or the commissioner of commerce, or litigated the complaint or appeal; and

 

(4) as a result of the dispute, the insurer reversed its decision and granted insurance.

 

For purposes of this section, "insurance" has the meaning given in paragraph (h).

 

A parent who has requested a reduction in the contribution amount under this paragraph shall submit proof in the form and manner prescribed by the commissioner or county agency, including, but not limited to, the insurer's denial of insurance, the written letter or complaint of the parents, court documents, and the written response of the insurer approving insurance. The determinations of the commissioner or county agency under this paragraph are not rules subject to chapter 14.

 

Sec. 4. [252.295] LICENSING EXCEPTION.

 

(a) Notwithstanding section 252.294, the commissioner may license two six-bed, level B intermediate care facilities for persons with developmental disabilities (ICF's/MR) to replace a 15-bed level A facility in Minneapolis that is not accessible to persons with disabilities. The new facilities must be accessible to persons with disabilities and must be located on a different site or sites in Hennepin County. Notwithstanding section 256B.5012, the payment rate at the new facilities is $200.47 plus any rate adjustments for ICF's/MR effective on or after July 1, 2007.

 

(b) Notwithstanding section 252.294, the commissioner may license one six-bed level B intermediate care facility for persons with developmental disabilities to replace a downsized 21-bed facility attached to a day training and habilitation program in Chisholm. Notwithstanding section 256B.5012, the facility must serve persons who require substantial nursing care and are able to leave the facility to receive day training and habilitation services. The payment rate at this facility is $274.50.

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(c) Notwithstanding section 256B.5012, the payment rate of a six-bed level B intermediate care facility for persons with developmental disabilities in Hibbing, with a per diem rate of $164.13 as of March 1, 2007, for persons who require substantial nursing care and are able to leave the facility to receive day training and habilitation services shall be increased to $250.84.

 

(d) The payment rates in paragraphs (b) and (c) are effective October 1, 2009.

 

Sec. 5. Minnesota Statutes 2006, section 256.01, is amended by adding a subdivision to read:

 

Subd. 23. Reverse mortgage information and referral. The commissioner, in cooperation with the commissioner of the Minnesota Housing Finance Agency, shall:

 

(1) establish an information and referral system to inform eligible persons regarding the availability of reverse mortgages and state incentives available to persons who take out certain reverse mortgages. The information and referral system shall be established involving the Senior LinkAge Line, county and tribal agencies, community housing agencies and organizations, Minnesota-certified reverse mortgage counselors, reverse mortgage lenders, senior and elder community organizations, and other relevant entities; and

 

(2) coordinate necessary training for Senior LinkAge Line employees, mortgage counselors, and lenders regarding the provisions of sections 256B.0913, subdivision 17, and 462A.05, subdivision 42.

 

Sec. 6. Minnesota Statutes 2006, section 256.01, is amended by adding a subdivision to read:

 

Subd. 24. Disability linkage line. The commissioner shall establish the disability linkage line, a statewide consumer information, referral, and assistance system for people with disabilities and chronic illnesses that:

 

(1) provides information about state and federal eligibility requirements, benefits, and service options;

 

(2) makes referrals to appropriate support entities;

 

(3) delivers information and assistance based on national and state standards;

 

(4) assists people to make well-informed decisions; and

 

(5) supports the timely resolution of service access and benefit issues.

 

Sec. 7. Minnesota Statutes 2006, section 256.975, subdivision 7, is amended to read:

 

Subd. 7. Consumer information and assistance; senior linkage. (a) The Minnesota Board on Aging shall operate a statewide information and assistance service to aid older Minnesotans and their families in making informed choices about long-term care options and health care benefits. Language services to persons with limited English language skills may be made available. The service, known as Senior LinkAge Line, must be available during business hours through a statewide toll-free number and must also be available through the Internet.

 

(b) The service must assist older adults, caregivers, and providers in accessing information about choices in long-term care services that are purchased through private providers or available through public options. The service must:

 

(1) develop a comprehensive database that includes detailed listings in both consumer- and provider-oriented formats;

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(2) make the database accessible on the Internet and through other telecommunication and media-related tools;

 

(3) link callers to interactive long-term care screening tools and make these tools available through the Internet by integrating the tools with the database;

 

(4) develop community education materials with a focus on planning for long-term care and evaluating independent living, housing, and service options;

 

(5) conduct an outreach campaign to assist older adults and their caregivers in finding information on the Internet and through other means of communication;

 

(6) implement a messaging system for overflow callers and respond to these callers by the next business day;

 

(7) link callers with county human services and other providers to receive more in-depth assistance and consultation related to long-term care options; and

 

(8) link callers with quality profiles for nursing facilities and other providers developed by the commissioner of health.;

 

(9) provide information and assistance to inform older adults about reverse mortgages, including the provisions of sections 47.58, 256B.0913, subdivision 17, and 462A.05, subdivision 42; and

 

(10) incorporate information about housing with services and consumer rights within the MinnesotaHelp.info network long-term care database to facilitate consumer comparison of services and costs among housing with services establishments and with other in-home services and to support financial self-sufficiency as long as possible. Housing with services establishments and their arranged home care providers shall provide information to the commissioner of human services that is consistent with information required by the commissioner of health under section 144G.06, the Uniform Consumer Information Guide. The commissioner of human services shall provide the data to the Minnesota Board on Aging for inclusion in the MinnesotaHelp.info network long-term care database.

 

(c) The Minnesota Board on Aging shall conduct an evaluation of the effectiveness of the statewide information and assistance, and submit this evaluation to the legislature by December 1, 2002. The evaluation must include an analysis of funding adequacy, gaps in service delivery, continuity in information between the service and identified linkages, and potential use of private funding to enhance the service.

 

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

 

Sec. 8. Minnesota Statutes 2006, section 256B.056, subdivision 1a, is amended to read:

 

Subd. 1a. Income and assets generally. Unless specifically required by state law or rule or federal law or regulation, the methodologies used in counting income and assets to determine eligibility for medical assistance for persons whose eligibility category is based on blindness, disability, or age of 65 or more years, the methodologies for the supplemental security income program shall be used, except as provided under subdivision 3, paragraph (f). Increases in benefits under title II of the Social Security Act shall not be counted as income for purposes of this subdivision until July 1 of each year. Effective upon federal approval, for children eligible under section 256B.055, subdivision 12, or for home and community-based waiver services whose eligibility for medical assistance is determined without regard to parental income, child support payments, including any payments made by an obligor in satisfaction of or in addition to a temporary or permanent order for child support, and Social Security payments are not counted as income. For families and children, which includes all other eligibility categories, the methodologies under the state's AFDC plan in effect as of July 16, 1996, as required by the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), Public Law 104-193, shall be used, except that

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effective October 1, 2003, the earned income disregards and deductions are limited to those in subdivision 1c. For these purposes, a "methodology" does not include an asset or income standard, or accounting method, or method of determining effective dates.

 

Sec. 9. Minnesota Statutes 2006, section 256B.056, subdivision 3, is amended to read:

 

Subd. 3. Asset limitations for aged, blind, or disabled individuals and families. To be eligible for medical assistance, a person 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:

 

(a) Household goods and personal effects are not considered.

 

(b) Capital and operating assets of a trade or business that the local agency determines are necessary to the person's ability to earn an income are not considered.

 

(c) Motor vehicles are excluded to the same extent excluded by the supplemental security income program.

 

(d) Assets designated as burial expenses are excluded to the same extent excluded by the supplemental security income program. Burial expenses funded by annuity contracts or life insurance policies must irrevocably designate the individual's estate as contingent beneficiary to the extent proceeds are not used for payment of selected burial expenses.

 

(e) Effective upon federal approval, for a person who no longer qualifies as an employed person with a disability due to loss of earnings, assets allowed while eligible for medical assistance under section 256B.057, subdivision 9, are not considered for 12 months, beginning with the first month of ineligibility as an employed person with a disability, to the extent that the person's total assets remain within the allowed limits of section 256B.057, subdivision 9, paragraph (b).

 

(f) When a person enrolled in medical assistance under section 256B.057, subdivision 9, reaches age 65 and has been enrolled during each of the 24 consecutive months before the person's 65th birthday, the assets owned by the person and the person's spouse must be disregarded, up to the limits of section 256B.057, subdivision 9, paragraph (b), when determining eligibility for medical assistance under section 256B.055, subdivision 7. The income of a spouse of a person enrolled in medical assistance under section 256B.057, subdivision 9, during each of the 24 consecutive months before the person's 65th birthday must be disregarded when determining eligibility for medical assistance under section 256B.055, subdivision 7, when the person reaches age 65. This paragraph does not apply at the time the person or the person's spouse requests medical assistance payment for long-term care services.

 

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

 

Sec. 10. Minnesota Statutes 2006, section 256B.0625, subdivision 18a, is amended to read:

 

Subd. 18a. Access to medical services. (a) Medical assistance reimbursement for meals for persons traveling to receive medical care may not exceed $5.50 for breakfast, $6.50 for lunch, or $8 for dinner.

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(b) Medical assistance reimbursement for lodging for persons traveling to receive medical care may not exceed $50 per day unless prior authorized by the local agency.

 

(c) Medical assistance direct mileage reimbursement to the eligible person or the eligible person's driver may not exceed 20 cents per mile.

 

(d) Regardless of the number of employees that an enrolled health care provider may have, medical assistance covers sign and oral language interpreter services when provided by an enrolled health care provider during the course of providing a direct, person-to-person covered health care service to an enrolled recipient with limited English proficiency or who has a hearing loss and uses interpreting services.

 

Sec. 11. Minnesota Statutes 2006, section 256B.0625, is amended by adding a subdivision to read:

 

Subd. 49. Self-directed supports option. Upon federal approval, medical assistance covers the self-directed supports option as defined under section 256B.0657 and section 6087 of the Federal Deficit Reduction Act of 2005, Public Law 109-171.

 

EFFECTIVE DATE. This section is effective upon federal approval of the state Medicaid plan amendment. The commissioner of human services shall inform the Office of the Revisor of Statutes when approval is obtained.

 

Sec. 12. Minnesota Statutes 2006, section 256B.0651, subdivision 7, is amended to read:

 

Subd. 7. Prior authorization; time limits. The commissioner or the commissioner's designee shall determine the time period for which a prior authorization shall be effective and, if flexible use has been requested, whether to allow the flexible use option. If the recipient continues to require home care services beyond the duration of the prior authorization, the home care provider must request a new prior authorization. A personal care provider agency must request a new personal care assistant services assessment, or service update if allowed, at least 60 days prior to the end of the current prior authorization time period. The request for the assessment must be made on a form approved by the commissioner. Under no circumstances, other than the exceptions in subdivision 4, shall a prior authorization be valid prior to the date the commissioner receives the request or for more than 12 months. A recipient who appeals a reduction in previously authorized home care services may continue previously authorized services, other than temporary services under subdivision 8, pending an appeal under section 256.045. The commissioner must provide a detailed explanation of why the authorized services are reduced in amount from those requested by the home care provider.

 

Sec. 13. Minnesota Statutes 2006, section 256B.0655, subdivision 1b, is amended to read:

 

Subd. 1b. Assessment. "Assessment" means a review and evaluation of a recipient's need for home care services conducted in person. Assessments for personal care assistant services shall be conducted by the county public health nurse or a certified public health nurse under contract with the county. A face-to-face assessment must include: documentation of health status, determination of need, evaluation of service effectiveness, identification of appropriate services, service plan development or modification, coordination of services, referrals and follow-up to appropriate payers and community resources, completion of required reports, recommendation of service authorization, and consumer education. Once the need for personal care assistant services is determined under this section or sections 256B.0651, 256B.0653, 256B.0654, and 256B.0656, the county public health nurse or certified public health nurse under contract with the county is responsible for communicating this recommendation to the commissioner and the recipient. A face-to-face assessment for personal care assistant services is conducted on those recipients who have never had a county public health nurse assessment. A face-to-face assessment must occur at least annually or when there is a significant change in the recipient's condition or when there is a change in the need for personal care assistant services. A service update may substitute for the annual face-to-face assessment when

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there is not a significant change in recipient condition or a change in the need for personal care assistant service. A service update may be completed by telephone, used when there is no need for an increase in personal care assistant services, and used for two consecutive assessments if followed by a face-to-face assessment. A service update must be completed on a form approved by the commissioner. A service update or review for temporary increase includes a review of initial baseline data, evaluation of service effectiveness, redetermination of service need, modification of service plan and appropriate referrals, update of initial forms, obtaining service authorization, and on going consumer education. Assessments must be completed on forms provided by the commissioner within 30 days of a request for home care services by a recipient or responsible party or personal care provider agency.

 

Sec. 14. Minnesota Statutes 2006, section 256B.0655, subdivision 3, is amended to read:

 

Subd. 3. Assessment and service plan. Assessments under subdivision 1b and sections 256B.0651, subdivision 1, paragraph (b), and 256B.0654, subdivision 1, paragraph (a), shall be conducted initially, and at least annually thereafter, in person with the recipient and result in a completed service plan using forms specified by the commissioner. A personal care provider agency must use a form approved by the commissioner to request a county public health nurse to conduct a personal care assistant services assessment. When requesting a reassessment, the personal care provider agency must notify the county and the recipient at least 60 days prior to the end of the current prior authorization for personal care assistant services. The recipient notice shall include information on the recipient's appeal rights. Within 30 days of recipient or responsible party or personal care assistant provider agency request for home care services, the assessment, the service plan, and other information necessary to determine medical necessity such as diagnostic or testing information, social or medical histories, and hospital or facility discharge summaries shall be submitted to the commissioner. Notwithstanding the provisions of subdivision 8, the commissioner shall maximize federal financial participation to pay for public health nurse assessments for personal care services. For personal care assistant services:

 

(1) The amount and type of service authorized based upon the assessment and service plan will follow the recipient if the recipient chooses to change providers.

 

(2) If the recipient's need changes, the recipient's provider may assess the need for a change in service authorization and request the change from the county public health nurse. The request must be made on a form approved by the commissioner. Within 30 days of the request, the public health nurse will determine whether to request the change in services based upon the provider assessment, or conduct a home visit to assess the need and determine whether the change is appropriate. If the change in service need is due to a change in medical condition, a new physician's statement of need required by section 256B.0625, subdivision 19c, must be obtained.

 

(3) To continue to receive personal care assistant services after the first year, the recipient or the responsible party, in conjunction with the public health nurse, may complete a service update on forms developed by the commissioner according to criteria and procedures in subdivisions 1a to 1i and sections 256B.0651, subdivision 1; 256B.0653, subdivision 1; and 256B.0654, subdivision 1.

 

Sec. 15. Minnesota Statutes 2006, section 256B.0655, subdivision 8, is amended to read:

 

Subd. 8. Public health nurse assessment rate. (a) The reimbursement rates for public health nurse visits that relate to the provision of personal care services under this section and section 256B.0625, subdivision 19a, are:

 

(i) $210.50 for a face-to-face assessment visit;

 

(ii) $105.25 for each service update; and

 

(iii) $105.25 for each request for a temporary service increase.

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(b) The rates specified in paragraph (a) must be adjusted to reflect provider rate increases for personal care assistant services that are approved by the legislature for the fiscal year ending June 30, 2000, and subsequent fiscal years. Any requirements applied by the legislature to provider rate increases for personal care assistant services also apply to adjustments under this paragraph.

 

(c) Effective July 1, 2008, the payment rate for an assessment under this section and section 256B.0651 shall be reduced by 25 percent when the assessment is not completed on time or the service agreement documentation is not submitted in time to continue services. The commissioner shall recoup these amounts on a retroactive basis.

 

Sec. 16. [256B.0657] SELF-DIRECTED SUPPORTS OPTION.

 

Subdivision 1. Definition. "Self-directed supports option" means personal assistance, supports, items, and related services purchased under an approved budget plan and budget by a recipient.

 

Subd. 2. Eligibility. (a) The self-directed supports option is available to a person who:

 

(1) is a recipient of medical assistance as determined under sections 256B.055, 256B.056, and 256B.057, subdivision 9;

 

(2) is eligible for personal care assistant services under section 256B.0655;

 

(3) lives in the person's own apartment or home, which is not owned, operated, or controlled by a provider of services not related by blood or marriage;

 

(4) has the ability to hire, fire, supervise, establish staff compensation for, and manage the individuals providing services, and to choose and obtain items, related services, and supports as described in the participant's plan. If the recipient is not able to carry out these functions but has a legal guardian or parent to carry them out, the guardian or parent may fulfill these functions on behalf of the recipient; and

 

(5) has not been excluded or disenrolled by the commissioner.

 

(b) The commissioner may disenroll or exclude recipients, including guardians and parents, under the following circumstances:

 

(1) recipients who have been restricted by the Primary Care Utilization Review Committee may be excluded for a specified time period; and

 

(2) recipients who exit the self-directed supports option during the recipient's service plan year shall not access the self-directed supports option for the remainder of that service plan year.

 

Subd. 3. Eligibility for other services. Selection of the self-directed supports option by a recipient shall not restrict access to other medically necessary care and services furnished under the state plan medical assistance benefit, including home care targeted case management, except that a person receiving home and community-based waiver services, a family support grant or a consumer support grant is not eligible for funding under the self-directed supports option.

 

Subd. 4. Assessment requirements. (a) The self-directed supports option assessment must meet the following requirements:

 

(1) it shall be conducted by the county public health nurse or a certified public health nurse under contract with the county;

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(2) it shall be conducted face-to-face in the recipient's home initially, and at least annually thereafter; when there is a significant change in the recipient's condition; and when there is a change in the need for personal care assistant services. A recipient who is residing in a facility may be assessed for the self-directed support option for the purpose of returning to the community using this option; and

 

(3) it shall be completed using the format established by the commissioner.

 

(b) The results of the assessment and recommendations shall be communicated to the commissioner and the recipient by the county public health nurse or certified public health nurse under contract with the county.

 

Subd. 5. Self-directed supports option plan requirements. (a) The plan for the self-directed supports option must meet the following requirements:

 

(1) the plan must be completed using a person-centered process that:

 

(i) builds upon the recipient's capacity to engage in activities that promote community life;

 

(ii) respects the recipient's preferences, choices, and abilities;

 

(iii) involves families, friends, and professionals in the planning or delivery of services or supports as desired or required by the recipient; and

 

(iv) addresses the need for personal care assistant services identified in the recipient's self-directed supports option assessment;

 

(2) the plan shall be developed by the recipient or by the guardian of an adult recipient or by a parent or guardian of a minor child, with the assistance of an enrolled medical assistance home care targeted case manager provider who meets the requirements established for using a person-centered planning process and shall be reviewed at least annually upon reassessment or when there is a significant change in the recipient's condition; and

 

(3) the plan must include the total budget amount available divided into monthly amounts that cover the number of months of personal care assistant services authorization included in the budget. The amount used each month may vary, but additional funds shall not be provided above the annual personal care assistant services authorized amount unless a change in condition is documented.

 

(b) The commissioner shall:

 

(1) establish the format and criteria for the plan as well as the requirements for providers who assist with plan development;

 

(2) review the assessment and plan and, within 30 days after receiving the assessment and plan, make a decision on approval of the plan;

 

(3) notify the recipient, parent, or guardian of approval or denial of the plan and provide notice of the right to appeal under section 256.045; and

 

(4) provide a copy of the plan to the fiscal support entity selected by the recipient.

 

Subd. 6. Services covered. (a) Services covered under the self-directed supports option include:

 

(1) personal care assistant services under section 256B.0655; and

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(2) items, related services, and supports, including assistive technology, that increase independence or substitute for human assistance to the extent expenditures would otherwise be used for human assistance.

 

(b) Items, supports, and related services purchased under this option shall not be considered home care services for the purposes of section 144A.43.

 

Subd. 7. Noncovered services. Services or supports that are not eligible for payment under the self-directed supports option include:

 

(1) services, goods, or supports that do not benefit the recipient;

 

(2) any fees incurred by the recipient, such as Minnesota health care program fees and co-pays, legal fees, or costs related to advocate agencies;

 

(3) insurance, except for insurance costs related to employee coverage or fiscal support entity payments;

 

(4) room and board and personal items that are not related to the disability, except that medically prescribed specialized diet items may be covered if they reduce the need for human assistance;

 

(5) home modifications that add square footage;

 

(6) home modifications for a residence other than the primary residence of the recipient, or in the event of a minor with parents not living together, the primary residences of the parents;

 

(7) expenses for travel, lodging, or meals related to training the recipient, the parent or guardian of an adult recipient, or the parent or guardian of a minor child, or paid or unpaid caregivers that exceed $500 in a 12-month period;

 

(8) experimental treatment;

 

(9) any service or item covered by other medical assistance state plan services, including prescription and over-the-counter medications, compounds, and solutions and related fees, including premiums and co-payments;

 

(10) membership dues or costs, except when the service is necessary and appropriate to treat a physical condition or to improve or maintain the recipient's physical condition. The condition must be identified in the recipient's plan of care and monitored by a Minnesota health care program enrolled physician;

 

(11) vacation expenses other than the cost of direct services;

 

(12) vehicle maintenance or modifications not related to the disability;

 

(13) tickets and related costs to attend sporting or other recreational events; and

 

(14) costs related to Internet access, except when necessary for operation of assistive technology, to increase independence, or to substitute for human assistance.

 

Subd. 8. Self-directed budget requirements. The budget for the provision of the self-directed service option shall be equal to the greater of either:

 

(1) the annual amount of personal care assistant services under section 256B.0655 that the recipient has used in the most recent 12-month period; or

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(2) the amount determined using the consumer support grant methodology under section 256.476, subdivision 11, except that the budget amount shall include the federal and nonfederal share of the average service costs.

 

Subd. 9. Quality assurance and risk management. (a) The commissioner shall establish quality assurance and risk management measures for use in developing and implementing self-directed plans and budgets that (1) recognize the roles and responsibilities involved in obtaining services in a self-directed manner, and (2) assure the appropriateness of such plans and budgets based upon a recipient's resources and capabilities. These measures must include (i) background studies, and (ii) backup and emergency plans, including disaster planning.

 

(b) The commissioner shall provide ongoing technical assistance and resource and educational materials for families and recipients selecting the self-directed option.

 

(c) Performance assessments measures, such as of a recipient's satisfaction with the services and supports, and ongoing monitoring of health and well-being shall be identified in consultation with the stakeholder group.

 

Subd. 10. Fiscal support entity. (a) Each recipient shall choose a fiscal support entity provider certified by the commissioner to make payments for services, items, supports, and administrative costs related to managing a self-directed service plan authorized for payment in the approved plan and budget. Recipients shall also choose the payroll, agency with choice, or the fiscal conduit model of financial and service management.

 

(b) The fiscal support entity:

 

(1) may not limit or restrict the recipient's choice of service or support providers, including use of the payroll, agency with choice, or fiscal conduit model of financial and service management;

 

(2) must have a written agreement with the recipient or the recipient's representative that identifies the duties and responsibilities to be performed and the specific related charges;

 

(3) must provide the recipient and the home care targeted case manager with a monthly written summary of the self-directed supports option services that were billed, including charges from the fiscal support entity;

 

(4) must be knowledgeable of and comply with Internal Revenue Service requirements necessary to process employer and employee deductions, provide appropriate and timely submission of employer tax liabilities, and maintain documentation to support medical assistance claims;

 

(5) must have current and adequate liability insurance and bonding and sufficient cash flow and have on staff or under contract a certified public accountant or an individual with a baccalaureate degree in accounting; and

 

(6) must maintain records to track all self-directed supports option services expenditures, including time records of persons paid to provide supports and receipts for any goods purchased. The records must be maintained for a minimum of five years from the claim date and be available for audit or review upon request. Claims submitted by the fiscal support entity must correspond with services, amounts, and time periods as authorized in the recipient's self-directed supports option plan.

 

(c) The commissioner shall have authority to:

 

(1) set or negotiate rates with fiscal support entities;

 

(2) limit the number of fiscal support entities;

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(3) identify a process to certify and recertify fiscal support entities and assure fiscal support entities are available to recipients throughout the state; and

 

(4) establish a uniform format and protocol to be used by eligible fiscal support entities.

 

Subd. 11. Stakeholder consultation. The commissioner shall consult with a statewide consumer-directed services stakeholder group, including representatives of all types of consumer-directed service users, advocacy organizations, counties, and consumer-directed service providers. The commissioner shall seek recommendations from this stakeholder group in developing:

 

(1) the self-directed plan format;

 

(2) requirements and guidelines for the person-centered plan assessment and planning process;

 

(3) implementation of the option and the quality assurance and risk management techniques; and

 

(4) standards and requirements, including rates for the personal support plan development provider and the fiscal support entity; policies; training; and implementation. The stakeholder group shall provide recommendations on the repeal of the personal care assistant choice option, transition issues, and whether the consumer support grant program under section 256.476 should be modified. The stakeholder group shall meet at least three times each year to provide advice on policy, implementation, and other aspects of consumer and self-directed services.

 

EFFECTIVE DATE. Subdivisions 1 to 10 are effective upon federal approval of the state Medicaid plan amendment. The commissioner of human services shall inform the Office of the Revisor of Statutes when federal approval is obtained. Subdivision 11 is effective July 1, 2007.

 

Sec. 17. Minnesota Statutes 2006, section 256B.0911, subdivision 1a, is amended to read:

 

Subd. 1a. Definitions. For purposes of this section, the following definitions apply:

 

(a) "Long-term care consultation services" means:

 

(1) providing information and education to the general public regarding availability of the services authorized under this section;

 

(2) an intake process that provides access to the services described in this section;

 

(3) assessment of the health, psychological, and social needs of referred individuals;

 

(4) assistance in identifying services needed to maintain an individual in the least restrictive environment;

 

(5) providing recommendations on cost-effective community services that are available to the individual;

 

(6) development of an individual's community support plan, which may include the use of reverse mortgage payments to pay for services needed to maintain the individual in the person's home;

 

(7) providing information regarding eligibility for Minnesota health care programs;

 

(8) preadmission screening to determine the need for a nursing facility level of care;

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(9) preliminary determination of Minnesota health care programs eligibility for individuals who need a nursing facility level of care, with appropriate referrals for final determination;

 

(10) providing recommendations for nursing facility placement when there are no cost-effective community services available; and

 

(11) assistance to transition people back to community settings after facility admission.

 

(b) "Minnesota health care programs" means the medical assistance program under chapter 256B and the alternative care program under section 256B.0913.

 

Sec. 18. Minnesota Statutes 2006, section 256B.0911, subdivision 3a, is amended to read:

 

Subd. 3a. Assessment and support planning. (a) Persons requesting assessment, services planning, or other assistance intended to support community-based living, including persons who need assessment in order to determine waiver or alternative care program eligibility, must be visited by a long-term care consultation team within ten working days after the date on which an assessment was requested or recommended. Assessments must be conducted according to paragraphs (b) to (g) (i).

 

(b) The county may utilize a team of either the social worker or public health nurse, or both, to conduct the assessment in a face-to-face interview. The consultation team members must confer regarding the most appropriate care for each individual screened or assessed.

 

(c) The long-term care consultation team must assess the health and social needs of the person, using an assessment form provided by the commissioner.

 

(d) The team must conduct the assessment in a face-to-face interview with the person being assessed and the person's legal representative, if applicable.

 

(e) The team must provide the person, or the person's legal representative, with written recommendations for facility- or community-based services. The team must document that the most cost-effective alternatives available were offered to the individual. For purposes of this requirement, "cost-effective alternatives" means community services and living arrangements that cost the same as or less than nursing facility care.

 

(f) If the person chooses to use community-based services, the team must provide the person or the person's legal representative with a written community support plan, regardless of whether the individual is eligible for Minnesota health care programs. The person may request assistance in developing a community support plan without participating in a complete assessment. If the person chooses to obtain a reverse mortgage under section 47.58 as part of the community support plan, the plan must include a spending plan for the reverse mortgage payments.

 

(g) The person has the right to make the final decision between nursing facility placement and community placement after the screening team's recommendation, except as provided in subdivision 4a, paragraph (c).

 

(h) The team must give the person receiving assessment or support planning, or the person's legal representative, materials, and forms supplied by the commissioner containing the following information:

 

(1) the need for and purpose of preadmission screening and assessment if the person selects nursing facility placement;

 

(2) the role of the long-term care consultation assessment and support planning in waiver and alternative care program eligibility determination;

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(2) (3) information about Minnesota health care programs and about reverse mortgages, including the provisions of sections 47.58; 256B.0913, subdivision 17; and 462A.05, subdivision 42;

 

(3) (4) the person's freedom to accept or reject the recommendations of the team;

 

(4) (5) the person's right to confidentiality under the Minnesota Government Data Practices Act, chapter 13; and

 

(6) the long-term care consultant's decision regarding the person's need for nursing facility level of care;

 

(5) (7) the person's right to appeal the decision regarding the need for nursing facility level of care or the county's final decisions regarding public programs eligibility according to section 256.045, subdivision 3.

 

(i) Face-to-face assessment completed as part of eligibility determination for the alternative care, elderly waiver, community alternatives for disabled individuals, community alternative care, and traumatic brain injury waiver programs under sections 256B.0915, 256B.0917, and 256B.49 is valid to establish service eligibility for no more than 60 calendar days after the date of assessment. The effective eligibility start date for these programs can never be prior to the date of assessment. If an assessment was completed more than 60 days before the effective waiver or alternative care program eligibility start date, assessment and support plan information must be updated in a face-to-face visit and documented in the department's Medicaid Management Information System (MMIS). The effective date of program eligibility in this case cannot be prior to the date the updated assessment is completed.

 

Sec. 19. Minnesota Statutes 2006, section 256B.0911, is amended by adding a subdivision to read:

 

Subd. 3c. Transition to housing with services. (a) Housing with services establishments offering or providing assisted living under chapter 144G shall inform all prospective residents of the availability of and contact information for transitional consultation services under this subdivision prior to executing a lease or contract with the prospective resident. The purpose of transitional long-term care consultation is to support persons with current or anticipated long-term care needs in making informed choices among options that include the most cost-effective and least restrictive settings, and to delay spenddown to eligibility for publicly funded programs by connecting people to alternative services in their homes before transition to housing with services. Regardless of the consultation, prospective residents maintain the right to choose housing with services or assisted living if that option is their preference.

 

(b) Transitional consultation services are provided as determined by the commissioner of human services in partnership with county long-term care consultation units, and the Area Agencies on Aging, and are a combination of telephone-based and in-person assistance provided under models developed by the commissioner. The consultation shall be performed in a manner that provides objective and complete information. Transitional consultation must be provided within five working days of the request of the prospective resident as follows:

 

(1) the consultation must be provided by a qualified professional as determined by the commissioner;

 

(2) the consultation must include a review of the prospective resident's reasons for considering assisted living, the prospective resident's personal goals, a discussion of the prospective resident's immediate and projected long-term care needs, and alternative community services or assisted living settings that may meet the prospective resident's needs; and

 

(3) the prospective resident shall be informed of the availability of long-term care consultation services described in subdivision 3a that are available at no charge to the prospective resident to assist the prospective resident in assessment and planning to meet the prospective resident's long-term care needs.

 

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

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Sec. 20. Minnesota Statutes 2006, section 256B.0913, is amended by adding a subdivision to read:

 

Subd. 17. Services for persons using reverse mortgages. (a) Alternative care services are available to a person if:

 

(1) the person qualifies for the reverse mortgage incentive program under section 462A.05, subdivision 42, and has received the final payment on a qualifying reverse mortgage, or the person satisfies the criteria in section 462A.05, subdivision 42, paragraph (b), clauses (1) to (5), and has otherwise obtained a reverse mortgage and payments from the reverse mortgage for a period of at least 24 months or in an amount of at least $15,000 are used for services and supports, including basic shelter needs, home maintenance, and modifications or adaptations, necessary to allow the person to remain in the home as an alternative to a nursing facility placement; and

 

(2) the person satisfies the eligibility criteria under this section, other than age, income, and assets, and verifies that reverse mortgage expenditures were made according to the spending plan established under section 256B.0911, if one has been established.

 

(b) In addition to the other services provided under this section, a person who qualifies under this subdivision shall not be assessed a monthly participation fee under subdivision 12 nor be subject to an estate claim under section 256B.15 for services received under this section.

 

(c) The commissioner shall require a certification of loan satisfaction or other documentation that the person qualifies under this subdivision.

 

Sec. 21. Minnesota Statutes 2006, section 256B.0915, is amended to read:

 

256B.0915 MEDICAID WAIVER FOR ELDERLY SERVICES.

 

Subdivision 1. Authority. The commissioner is authorized to apply for a home and community-based services waiver for the elderly, authorized under section 1915(c) of the Social Security Act, in order to obtain federal financial participation to expand the availability of services for persons who are eligible for medical assistance. The commissioner may apply for additional waivers or pursue other federal financial participation which is advantageous to the state for funding home care services for the frail elderly who are eligible for medical assistance. The provision of waivered services to elderly and disabled medical assistance recipients must comply with the criteria for service definitions and provider standards approved in the waiver.

 

Subd. 1a. Elderly waiver case management services. (a) Elderly case management services under the home and community-based services waiver for elderly individuals are available from providers meeting qualification requirements and the standards specified in subdivision 1b. Eligible recipients may choose any qualified provider of elderly case management services.

 

Case management services assist individuals who receive waiver services in gaining access to needed waiver and other state plan services, as well as needed medical, social, educational, and other services regardless of the funding source for the services to which access is gained.

 

A case aide shall provide assistance to the case manager in carrying out administrative activities of the case management function. The case aide may not assume responsibilities that require professional judgment including assessments, reassessments, and care plan development. The case manager is responsible for providing oversight of the case aide.

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Case managers shall be responsible for ongoing monitoring of the provision of services included in the individual's plan of care. Case managers shall initiate and oversee the process of assessment and reassessment of the individual's care and review plan of care at intervals specified in the federally approved waiver plan.

 

(b) The county of service or tribe must provide access to and arrange for case management services. County of service has the meaning given it in Minnesota Rules, part 9505.0015, subpart 11.

 

Subd. 1b. Provider qualifications and standards. The commissioner must enroll qualified providers of elderly case management services under the home and community-based waiver for the elderly under section 1915(c) of the Social Security Act. The enrollment process shall ensure the provider's ability to meet the qualification requirements and standards in this subdivision and other federal and state requirements of this service. An elderly case management provider is an enrolled medical assistance provider who is determined by the commissioner to have all of the following characteristics:

 

(1) the demonstrated capacity and experience to provide the components of case management to coordinate and link community resources needed by the eligible population;

 

(2) administrative capacity and experience in serving the target population for whom it will provide services and in ensuring quality of services under state and federal requirements;

 

(3) a financial management system that provides accurate documentation of services and costs under state and federal requirements;

 

(4) the capacity to document and maintain individual case records under state and federal requirements; and

 

(5) the county lead agency may allow a case manager employed by the county lead agency to delegate certain aspects of the case management activity to another individual employed by the county lead agency provided there is oversight of the individual by the case manager. The case manager may not delegate those aspects which require professional judgment including assessments, reassessments, and care plan development. Lead agencies include counties, health plans, and federally recognized tribes who authorize services under this section.

 

Subd. 1c. Case management activities under the state plan. The commissioner shall seek an amendment to the home and community-based services waiver for the elderly to implement the provisions of subdivisions 1a and 1b. If the commissioner is unable to secure the approval of the secretary of health and human services for the requested waiver amendment by December 31, 1993, the commissioner shall amend the medical assistance state plan to provide that case management provided under the home and community-based services waiver for the elderly is performed by counties as an administrative function for the proper and effective administration of the state medical assistance plan. The state shall reimburse counties for the nonfederal share of costs for case management performed as an administrative function under the home and community-based services waiver for the elderly.

 

Subd. 1d. Posteligibility treatment of income and resources for elderly waiver. Notwithstanding the provisions of section 256B.056, the commissioner shall make the following amendment to the medical assistance elderly waiver program effective July 1, 1999, or upon federal approval, whichever is later.

 

A recipient's maintenance needs will be an amount equal to the Minnesota supplemental aid equivalent rate as defined in section 256I.03, subdivision 5, plus the medical assistance personal needs allowance as defined in section 256B.35, subdivision 1, paragraph (a), when applying posteligibility treatment of income rules to the gross income of elderly waiver recipients, except for individuals whose income is in excess of the special income standard according to Code of Federal Regulations, title 42, section 435.236. Recipient maintenance needs shall be adjusted under this provision each July 1.

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Subd. 2. Spousal impoverishment policies. The commissioner shall seek to amend the federal waiver and the medical assistance state plan to allow apply:

 

(1) the spousal impoverishment criteria as authorized under United States Code, title 42, section 1396r-5, and as implemented in sections 256B.0575, 256B.058, and 256B.059, except that the amendment shall seek to add to;

 

(2) the personal needs allowance permitted in section 256B.0575,; and

 

(3) an amount equivalent to the group residential housing rate as set by section 256I.03, subdivision 5, and according to the approved federal waiver and medical assistance state plan.

 

Subd. 3. Limits of cases. The number of medical assistance waiver recipients that a county lead agency may serve must be allocated according to the number of medical assistance waiver cases open on July 1 of each fiscal year. Additional recipients may be served with the approval of the commissioner.

 

Subd. 3a. Elderly waiver cost limits. (a) The monthly limit for the cost of waivered services to an individual elderly waiver client shall be the weighted average monthly nursing facility rate of the case mix resident class to which the elderly waiver client would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, less the recipient's maintenance needs allowance as described in subdivision 1d, paragraph (a), until the first day of the state fiscal year in which the resident assessment system as described in section 256B.437 for nursing home rate determination is implemented. Effective on the first day of the state fiscal year in which the resident assessment system as described in section 256B.437 for nursing home rate determination is implemented and the first day of each subsequent state fiscal year, the monthly limit for the cost of waivered services to an individual elderly waiver client shall be the rate of the case mix resident class to which the waiver client would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect on the last day of the previous state fiscal year, adjusted by the greater of any legislatively adopted home and community-based services percentage rate increase or the average statewide percentage increase in nursing facility payment rates.

 

(b) If extended medical supplies and equipment or environmental modifications are or will be purchased for an elderly waiver client, the costs may be prorated for up to 12 consecutive months beginning with the month of purchase. If the monthly cost of a recipient's waivered services exceeds the monthly limit established in paragraph (a), the annual cost of all waivered services shall be determined. In this event, the annual cost of all waivered services shall not exceed 12 times the monthly limit of waivered services as described in paragraph (a).

 

Subd. 3b. Cost limits for elderly waiver applicants who reside in a nursing facility. (a) For a person who is a nursing facility resident at the time of requesting a determination of eligibility for elderly waivered services, a monthly conversion limit for the cost of elderly waivered services may be requested. The monthly conversion limit for the cost of elderly waiver services shall be the resident class assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, for that resident in the nursing facility where the resident currently resides until July 1 of the state fiscal year in which the resident assessment system as described in section 256B.437 256B.438 for nursing home rate determination is implemented. Effective on July 1 of the state fiscal year in which the resident assessment system as described in section 256B.437 256B.438 for nursing home rate determination is implemented, the monthly conversion limit for the cost of elderly waiver services shall be the per diem nursing facility rate as determined by the resident assessment system as described in section 256B.437 256B.438 for that resident in the nursing facility where the resident currently resides multiplied by 365 and divided by 12, less the recipient's maintenance needs allowance as described in subdivision 1d. The initially approved conversion rate may be adjusted by the greater of any subsequent legislatively adopted home and community-based services percentage rate increase or the average statewide percentage increase in nursing facility payment rates. The limit under this subdivision only applies to persons discharged from a nursing facility after a minimum 30-day stay and found eligible for waivered services on

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or after July 1, 1997. For conversions from the nursing home to the elderly waiver with consumer directed community support services, the conversion rate limit is equal to the nursing facility rate reduced by a percentage equal to the percentage difference between the consumer directed services budget limit that would be assigned according to the federally approved waiver plan and the corresponding community case mix cap, but not to exceed 50 percent.

 

(b) The following costs must be included in determining the total monthly costs for the waiver client:

 

(1) cost of all waivered services, including extended medical supplies and equipment and environmental modifications and adaptations; and

 

(2) cost of skilled nursing, home health aide, and personal care services reimbursable by medical assistance.

 

Subd. 3c. Service approval and contracting provisions. (a) Medical assistance funding for skilled nursing services, private duty nursing, home health aide, and personal care services for waiver recipients must be approved by the case manager and included in the individual care plan.

 

(b) A county lead agency is not required to contract with a provider of supplies and equipment if the monthly cost of the supplies and equipment is less than $250.

 

Subd. 3d. Adult foster care rate. The adult foster care rate shall be considered a difficulty of care payment and shall not include room and board. The adult foster care service rate shall be negotiated between the county lead agency and the foster care provider. The elderly waiver payment for the foster care service in combination with the payment for all other elderly waiver services, including case management, must not exceed the limit specified in subdivision 3a, paragraph (a).

 

Subd. 3e. Assisted living Customized living service rate. (a) Payment for assisted living service customized living services shall be a monthly rate negotiated and authorized by the county agency based on an individualized service plan for each resident and may not cover direct rent or food costs. lead agency within the parameters established by the commissioner. The payment agreement must delineate the services that have been customized for each recipient and specify the amount of each service to be provided. The lead agency shall ensure that there is a documented need for all services authorized. Customized living services must not include rent or raw food costs. The negotiated payment rate must be based on services to be provided. Negotiated rates must not exceed payment rates for comparable elderly waiver or medical assistance services and must reflect economies of scale.

 

(b) The individualized monthly negotiated payment for assisted living customized living services as described in section 256B.0913, subdivisions 5d to 5f, and residential care services as described in section 256B.0913, subdivision 5c, shall not exceed the nonfederal share, in effect on July 1 of the state fiscal year for which the rate limit is being calculated, of the greater of either the statewide or any of the geographic groups' weighted average monthly nursing facility rate of the case mix resident class to which the elderly waiver eligible client would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, less the maintenance needs allowance as described in subdivision 1d, paragraph (a), until the July 1 of the state fiscal year in which the resident assessment system as described in section 256B.437 for nursing home rate determination is implemented. Effective on July 1 of the state fiscal year in which the resident assessment system as described in section 256B.437 for nursing home rate determination is implemented and July 1 of each subsequent state fiscal year, the individualized monthly negotiated payment for the services described in this clause shall not exceed the limit described in this clause which was in effect on June 30 of the previous state fiscal year and which has been adjusted by the greater of any legislatively adopted home and community-based services cost-of-living percentage increase or any legislatively adopted statewide percent rate increase for nursing facilities.

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(c) The individualized monthly negotiated payment for assisted Customized living services described in section 144A.4605 and are delivered by a provider licensed by the Department of Health as a class A or class F home care provider or an assisted living home care provider and provided in a building that is registered as a housing with services establishment under chapter 144D and that provides 24-hour supervision in combination with the payment for other elderly waiver services, including case management, must not exceed the limit specified in subdivision 3a.

 

Subd. 3f. Individual service rates; expenditure forecasts. (a) The county lead agency shall negotiate individual service rates with vendors and may authorize payment for actual costs up to the county's lead agency's current approved rate. Persons or agencies must be employed by or under a contract with the county lead agency or the public health nursing agency of the local board of health in order to receive funding under the elderly waiver program, except as a provider of supplies and equipment when the monthly cost of the supplies and equipment is less than $250.

 

(b) Reimbursement for the medical assistance recipients under the approved waiver shall be made from the medical assistance account through the invoice processing procedures of the department's Medicaid Management Information System (MMIS), only with the approval of the client's case manager. The budget for the state share of the Medicaid expenditures shall be forecasted with the medical assistance budget, and shall be consistent with the approved waiver.

 

Subd. 3g. Service rate limits; state assumption of costs. (a) To improve access to community services and eliminate payment disparities between the alternative care program and the elderly waiver, the commissioner shall establish statewide maximum service rate limits and eliminate county-specific lead agency-specific service rate limits.

 

(b) Effective July 1, 2001, for service rate limits, except those described or defined in subdivisions 3d and 3e, the rate limit for each service shall be the greater of the alternative care statewide maximum rate or the elderly waiver statewide maximum rate.

 

(c) Counties Lead agencies may negotiate individual service rates with vendors for actual costs up to the statewide maximum service rate limit.

 

Subd. 3h. Service rate limits; 24-hour customized living services. The payment rates for 24-hour customized living services is a monthly rate negotiated and authorized by the lead agency within the parameters established by the commissioner of human services. The payment agreement must delineate the services that have been customized for each recipient and specify the amount of each service to be provided. The lead agency shall ensure that there is a documented need for all services authorized. The lead agency shall not authorize 24-hour customized living services unless there is a documented need for 24-hour supervision. For purposes of this section, "24-hour supervision" means that the recipient requires assistance due to needs related to one or more of the following:

 

(1) intermittent assistance with toileting or transferring;

 

(2) cognitive or behavioral issues;

 

(3) a medical condition that requires clinical monitoring; or

 

(4) other conditions or needs as defined by the commissioner of human services. The lead agency shall ensure that the frequency and mode of supervision of the recipient and the qualifications of staff providing supervision are described and meet the needs of the recipient. Customized living services must not include rent or raw food costs. The negotiated payment rate for 24-hour customized living services must be based on services to be provided. Negotiated rates must not exceed payment rates for comparable elderly waiver or medical assistance services and must reflect economies of scale. The individually negotiated 24-hour customized living payments, in combination with the payment for other elderly waiver services, including case management, must not exceed the recipient's community budget cap specified in subdivision 3a.

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Subd. 4. Termination notice. The case manager must give the individual a ten-day written notice of any denial, reduction, or termination of waivered services.

 

Subd. 5. Assessments and reassessments for waiver clients. Each client shall receive an initial assessment of strengths, informal supports, and need for services in accordance with section 256B.0911, subdivisions 3, 3a, and 3b. A reassessment of a client served under the elderly waiver must be conducted at least every 12 months and at other times when the case manager determines that there has been significant change in the client's functioning. This may include instances where the client is discharged from the hospital.

 

Subd. 6. Implementation of care plan. Each elderly waiver client shall be provided a copy of a written care plan that meets the requirements outlined in section 256B.0913, subdivision 8. The care plan must be implemented by the county administering waivered services of service when it is different than the county of financial responsibility. The county of service administering waivered services must notify the county of financial responsibility of the approved care plan.

 

Subd. 7. Prepaid elderly waiver services. An individual for whom a prepaid health plan is liable for nursing home services or elderly waiver services according to section 256B.69, subdivision 6a, is not eligible to also receive county-administered elderly waiver services under this section.

 

Subd. 8. Services and supports. (a) Services and supports shall meet the requirements set out in United States Code, title 42, section 1396n.

 

(b) Services and supports shall promote consumer choice and be arranged and provided consistent with individualized, written care plans.

 

(c) The state of Minnesota, county, managed care organization, or tribal government under contract to administer the elderly waiver shall not be liable for damages, injuries, or liabilities sustained through the purchase of direct supports or goods by the person, the person's family, or the authorized representatives with funds received through consumer-directed community support services under the federally approved waiver plan. Liabilities include, but are not limited to, workers' compensation liability, the Federal Insurance Contributions Act (FICA), or the Federal Unemployment Tax Act (FUTA).

 

Subd. 9. Tribal management of elderly waiver. Notwithstanding contrary provisions of this section, or those in other state laws or rules, the commissioner may develop a model for tribal management of the elderly waiver program and implement this model through a contract between the state and any of the state's federally recognized tribal governments. The model shall include the provision of tribal waiver case management, assessment for personal care assistance, and administrative requirements otherwise carried out by counties lead agencies but shall not include tribal financial eligibility determination for medical assistance.

 

EFFECTIVE DATE. Subdivision 3h is effective the day following final enactment.

 

Sec. 22. Minnesota Statutes 2006, section 256B.095, is amended to read:

 

256B.095 QUALITY ASSURANCE SYSTEM ESTABLISHED.

 

(a) Effective July 1, 1998, a quality assurance system for persons with developmental disabilities, which includes an alternative quality assurance licensing system for programs, is established in Dodge, Fillmore, Freeborn, Goodhue, Houston, Mower, Olmsted, Rice, Steele, Wabasha, and Winona Counties for the purpose of improving the quality of services provided to persons with developmental disabilities. A county, at its option, may choose to have all programs for persons with developmental disabilities located within the county licensed under chapter 245A using standards determined under the alternative quality assurance licensing system or may continue regulation of these programs under the licensing system operated by the commissioner. The project expires on June 30, 2009 2014.

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(b) Effective July 1, 2003, a county not listed in paragraph (a) may apply to participate in the quality assurance system established under paragraph (a). The commission established under section 256B.0951 may, at its option, allow additional counties to participate in the system.

 

(c) Effective July 1, 2003, any county or group of counties not listed in paragraph (a) may establish a quality assurance system under this section. A new system established under this section shall have the same rights and duties as the system established under paragraph (a). A new system shall be governed by a commission under section 256B.0951. The commissioner shall appoint the initial commission members based on recommendations from advocates, families, service providers, and counties in the geographic area included in the new system. Counties that choose to participate in a new system shall have the duties assigned under section 256B.0952. The new system shall establish a quality assurance process under section 256B.0953. The provisions of section 256B.0954 shall apply to a new system established under this paragraph. The commissioner shall delegate authority to a new system established under this paragraph according to section 256B.0955.

 

(d) Effective July 1, 2007, the quality assurance system may be expanded to include programs for persons with disabilities and older adults.

 

Sec. 23. Minnesota Statutes 2006, section 256B.0951, subdivision 1, is amended to read:

 

Subdivision 1. Membership. The Quality Assurance Commission is established. The commission consists of at least 14 but not more than 21 members as follows: at least three but not more than five members representing advocacy organizations; at least three but not more than five members representing consumers, families, and their legal representatives; at least three but not more than five members representing service providers; at least three but not more than five members representing counties; and the commissioner of human services or the commissioner's designee. The first commission shall establish membership guidelines for the transition and recruitment of membership for the commission's ongoing existence. Members of the commission who do not receive a salary or wages from an employer for time spent on commission duties may receive a per diem payment when performing commission duties and functions. All members may be reimbursed for expenses related to commission activities. Notwithstanding the provisions of section 15.059, subdivision 5, the commission expires on June 30, 2009 2014.

 

Sec. 24. [256B.096] QUALITY MANAGEMENT, ASSURANCE, AND IMPROVEMENT SYSTEM FOR MINNESOTANS RECEIVING DISABILITY SERVICES.

 

Subdivision 1. Scope. In order to improve the quality of services provided to Minnesotans with disabilities and to meet the requirements of the federally approved home and community-based waivers under section 1915c of the Social Security Act, a statewide quality assurance and improvement system for Minnesotans receiving disability services shall be developed. The disability services included are the home and community-based services waiver programs for persons with developmental disabilities under section 256B.092, subdivision 4, and for persons with disabilities under section 256B.49.

 

Subd. 2. Stakeholder advisory group. The commissioner shall consult with a stakeholder advisory group on the development and implementation of the state quality management, assurance, and improvement system, including representatives of disability service recipients, disability service providers, disability advocacy groups, county human service agencies, and state agency staff from the Departments of Human Services and Health, and the ombudsman for mental health and developmental disabilities on the development of a statewide quality assurance and improvement system.

 

Subd. 3. Annual survey of service recipients. The commissioner, in consultation with the stakeholder advisory group, shall develop an annual independent random statewide survey of between five and ten percent of service recipients to determine the effectiveness and quality of disability services. The survey shall be consistent with the system performance expectations of the Centers for Medicare and Medicaid Services quality management

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requirements and framework. The survey shall analyze whether desired outcomes have been achieved for persons with different demographic, diagnostic, health, and functional needs receiving different types of services, in different settings, with different costs. The survey shall be field tested during 2008. The biennial report established in subdivision 5 shall include recommendations on statewide and regional reports of the survey results that, if published, would be useful to regions, counties, and providers to plan and measure the impact of quality improvement activities.

 

Subd. 4. Improvements for incident reporting, investigation, analysis, and follow-up. In consultation with the stakeholder advisory group, the commissioner shall identify the information, data sources, and technology needed to improve the system of incident reporting, including:

 

(1) reports made under the Maltreatment of Minors and Vulnerable Adults Acts; and

 

(2) investigation, analysis, and follow-up for disability services.

 

The commissioner must ensure that the federal home and community-based waiver requirements are met and that incidents that may have jeopardized safety and health or violated service-related assurances, civil and human rights, and other protections designed to prevent abuse, neglect, and exploitation, are reviewed, investigated, and acted upon in a timely manner.

 

Subd. 5. Biennial report. The commissioner shall provide a biennial report to the chairs of the legislative committees with jurisdiction over health and human services policy and funding beginning January 15, 2009, on the development and activities of the quality management, assurance, and improvement system designed to meet the federal requirements under the home and community-based services waiver programs for persons with disabilities. By January 15, 2008, the commissioner shall provide a preliminary report on priorities for meeting the federal requirements, progress on development and field testing of the annual survey, appropriations necessary to implement an annual survey of service recipients once field testing is completed, recommendations for improvements in the incident reporting system, and a plan for incorporating quality assurance efforts under section 256B.095 and other regional efforts into the statewide system.

 

Sec. 25. Minnesota Statutes 2006, section 256B.15, is amended by adding a subdivision to read:

 

Subd. 9. Recovery of alternative care and certain reverse mortgages. The state and a county agency shall not recover alternative care paid for a person under section 256B.0913, subdivision 17, under this section.

 

Sec. 26. Minnesota Statutes 2006, section 256B.431, subdivision 2e, is amended to read:

 

Subd. 2e. Contracts for services for ventilator-dependent persons. (a) The commissioner may negotiate with a nursing facility eligible to receive medical assistance payments to provide services to a ventilator-dependent person identified by the commissioner according to criteria developed by the commissioner, including:

 

(1) nursing facility care has been recommended for the person by a preadmission screening team;

 

(2) the person has been hospitalized and no longer requires inpatient acute care hospital services; and

 

(3) the commissioner has determined that necessary services for the person cannot be provided under existing nursing facility rates.

 

The commissioner may negotiate an adjustment to the operating cost payment rate for a nursing facility with a resident who is ventilator-dependent, for that resident. The negotiated adjustment must reflect only the actual additional cost of meeting the specialized care needs of a ventilator-dependent person identified by the

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commissioner for whom necessary services cannot be provided under existing nursing facility rates and which are not otherwise covered under Minnesota Rules, parts 9549.0010 to 9549.0080 or 9505.0170 to 9505.0475. For persons who are initially admitted to a nursing facility before July 1, 2001, and have their payment rate under this subdivision negotiated after July 1, 2001, the negotiated payment rate must not exceed 200 percent of the highest multiple bedroom payment rate for the facility, as initially established by the commissioner for the rate year for case mix classification K; or, upon implementation of the RUG's-based case mix system, 200 percent of the highest RUG's rate. For persons initially admitted to a nursing facility on or after July 1, 2001, the negotiated payment rate must not exceed 300 percent of the facility's multiple bedroom payment rate for case mix classification K; or, upon implementation of the RUG's-based case mix system, 300 percent of the highest RUG's rate. The negotiated adjustment shall not affect the payment rate charged to private paying residents under the provisions of section 256B.48, subdivision 1.

 

(b) Effective July 1, 2007, or upon opening a unit of at least ten beds dedicated to care of ventilator-dependent persons in partnership with Mayo Health Systems, whichever is later, the operating payment rates for residents determined eligible under paragraph (a) of a nursing facility in Waseca County that on February 1, 2007, was licensed for 70 beds and reimbursed under this section, section 256B.434, or section 256B.441, shall be 300 percent of the facility's highest RUG rate.

 

Sec. 27. Minnesota Statutes 2006, section 256B.431, subdivision 17a, is amended to read:

 

Subd. 17a. Allowable interest expense. (a) Notwithstanding Minnesota Rules, part 9549.0060, subparts 5, item A, subitems (1) and (3), and 7, item D, allowable interest expense on debt shall include:

 

(1) interest expense on debt related to the cost of purchasing or replacing depreciable equipment, excluding vehicles, not to exceed six ten percent of the total historical cost of the project; and

 

(2) interest expense on debt related to financing or refinancing costs, including costs related to points, loan origination fees, financing charges, legal fees, and title searches; and issuance costs including bond discounts, bond counsel, underwriter's counsel, corporate counsel, printing, and financial forecasts. Allowable debt related to items in this clause shall not exceed seven percent of the total historical cost of the project. To the extent these costs are financed, the straight-line amortization of the costs in this clause is not an allowable cost; and

 

(3) interest on debt incurred for the establishment of a debt reserve fund, net of the interest earned on the debt reserve fund.

 

(b) Debt incurred for costs under paragraph (a) is not subject to Minnesota Rules, part 9549.0060, subpart 5, item A, subitem (5) or (6).

 

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

 

Sec. 28. Minnesota Statutes 2006, section 256B.434, subdivision 4, is amended to read:

 

Subd. 4. Alternate rates for nursing facilities. (a) For nursing facilities which have their payment rates determined under this section rather than section 256B.431, the commissioner shall establish a rate under this subdivision. The nursing facility must enter into a written contract with the commissioner.

 

(b) A nursing facility's case mix payment rate for the first rate year of a facility's contract under this section is the payment rate the facility would have received under section 256B.431.

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(c) A nursing facility's case mix payment rates for the second and subsequent years of a facility's contract under this section are the previous rate year's contract payment rates plus an inflation adjustment and, for facilities reimbursed under this section or section 256B.431, an adjustment to include the cost of any increase in Health Department licensing fees for the facility taking effect on or after July 1, 2001. The index for the inflation adjustment must be based on the change in the Consumer Price Index-All Items (United States City average) (CPI-U) forecasted by the commissioner of finance's national economic consultant, as forecasted in the fourth quarter of the calendar year preceding the rate year. The inflation adjustment must be based on the 12-month period from the midpoint of the previous rate year to the midpoint of the rate year for which the rate is being determined. For the rate years beginning on July 1, 1999, July 1, 2000, July 1, 2001, July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006, July 1, 2007, and July 1, 2008, July 1, 2009, and July 1, 2010, this paragraph shall apply only to the property-related payment rate, except that adjustments to include the cost of any increase in Health Department licensing fees taking effect on or after July 1, 2001, shall be provided. Beginning in 2005, adjustment to the property payment rate under this section and section 256B.431 shall be effective on October 1. In determining the amount of the property-related payment rate adjustment under this paragraph, the commissioner shall determine the proportion of the facility's rates that are property-related based on the facility's most recent cost report.

 

(d) The commissioner shall develop additional incentive-based payments of up to five percent above a facility's operating payment rate for achieving outcomes specified in a contract. The commissioner may solicit contract amendments and implement those which, on a competitive basis, best meet the state's policy objectives. The commissioner shall limit the amount of any incentive payment and the number of contract amendments under this paragraph to operate the incentive payments within funds appropriated for this purpose. The contract amendments may specify various levels of payment for various levels of performance. Incentive payments to facilities under this paragraph may be in the form of time-limited rate adjustments or onetime supplemental payments. In establishing the specified outcomes and related criteria, the commissioner shall consider the following state policy objectives:

 

(1) successful diversion or discharge of residents to the residents' prior home or other community-based alternatives;

 

(2) adoption of new technology to improve quality or efficiency;

 

(3) improved quality as measured in the Nursing Home Report Card;

 

(4) reduced acute care costs; and

 

(5) any additional outcomes proposed by a nursing facility that the commissioner finds desirable.

 

(e) Notwithstanding the threshold in section 256B.431, subdivision 16, facilities that take action to come into compliance with existing or pending requirements of the life safety code provisions or federal regulations governing sprinkler systems must receive reimbursement for the costs associated with compliance if all of the following conditions are met:

 

(1) the expenses associated with compliance occurred on or after January 1, 2005, and before December 31, 2008;

 

(2) the costs were not otherwise reimbursed under subdivision 4f or section 144A.071 or 144A.073; and

 

(3) the total allowable costs reported under this paragraph are less than the minimum threshold established under section 256B.431, subdivision 15, paragraph (e), and subdivision 16.

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The commissioner shall use money appropriated for this purpose to provide to qualifying nursing facilities a rate adjustment beginning October 1, 2007, and ending September 30, 2008. Nursing facilities that have spent money or anticipate the need to spend money to satisfy the most recent life safety code requirements by (1) installing a sprinkler system or (2) replacing all or portions of an existing sprinkler system may submit to the commissioner by June 30, 2007, on a form provided by the commissioner the actual costs of a completed project or the estimated costs, based on a project bid, of a planned project. The commissioner shall calculate a rate adjustment equal to the allowable costs of the project divided by the resident days reported for the report year ending September 30, 2006. If the costs from all projects exceed the appropriation for this purpose, the commissioner shall allocate the money appropriated on a pro rata basis to the qualifying facilities by reducing the rate adjustment determined for each facility by an equal percentage. Facilities that used estimated costs when requesting the rate adjustment shall report to the commissioner by January 31, 2009, on the use of this money on a form provided by the commissioner. If the nursing facility fails to provide the report, the commissioner shall recoup the money paid to the facility for this purpose. If the facility reports expenditures allowable under this subdivision that are less than the amount received in the facility's annualized rate adjustment, the commissioner shall recoup the difference.

 

Sec. 29. Minnesota Statutes 2006, section 256B.434, is amended by adding a subdivision to read:

 

Subd. 4j. Rate increase for facilities in Chisago County. Effective October 1, 2007, to September 30, 2008, operating payment rates of all nursing facilities in Chisago County that are reimbursed under this section or section 256B.441 shall be increased to be equal, for a RUG's rate with a weight of 1.00, to the geographic group III median rate for the same RUG's weight. The percentage of the operating payment rate for each facility to be case-mix adjusted shall be equal to the percentage that is case-mix adjusted in that facility's September 30, 2007, operating payment rate. This subdivision applies only if it results in a rate increase. Increases provided by this subdivision shall be added to the rate determined under any new reimbursement system established under section 256B.441.

 

Sec. 30. Minnesota Statutes 2006, section 256B.434, is amended by adding a subdivision to read:

 

Subd. 19. Nursing facility rate increases beginning October 1, 2007. (a) For the rate year beginning October 1, 2007, the commissioner shall make available to each nursing facility reimbursed under this section operating payment rate adjustments equal to 2.87 percent of the operating payment rates in effect on September 30, 2007.

 

(b) Seventy-five percent of the money resulting from the rate adjustment under paragraph (a) must be used for increases in compensation-related costs for employees directly employed by the nursing facility on or after the effective date of the rate adjustment, except:

 

(1) the administrator;

 

(2) persons employed in the central office of a corporation that has an ownership interest in the nursing facility or exercises control over the nursing facility; and

 

(3) persons paid by the nursing facility under a management contract.

 

(c) Two-thirds of the money available under paragraph (b) must be used for wage increases for all employees directly employed by the nursing facility on or after the effective date of the rate adjustment, except those listed in paragraph (b), clauses (1) to (3). The wage adjustment that employees receive under this paragraph must be paid as an equal hourly percentage wage increase for all eligible employees. Only costs associated with the portion of the equal hourly percentage wage increase that goes to all employees shall qualify under this paragraph. Costs associated with wage increases in excess of the amount of the equal hourly percentage wage increase provided to all employees shall be allowed only for meeting the requirements in paragraph (b). This paragraph shall not apply to:

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(1) employees eligible for a Taft-Hartley insurance plan established under United States Code, title 29, section 186(c)(5); or

 

(2) public employees.

 

(d) The commissioner shall allow as compensation-related costs all costs for:

 

(1) wages and salaries;

 

(2) FICA taxes, Medicare taxes, state and federal unemployment taxes, and workers' compensation;

 

(3) the employer's share of health and dental insurance, life insurance, disability insurance, long-term care insurance, uniform allowance, and pensions; and

 

(4) other benefits provided, subject to the approval of the commissioner.

 

(e) The portion of the rate adjustment under paragraph (a) that is not subject to the requirements in paragraphs (b) and (c) shall be provided to nursing facilities effective October 1, 2007.

 

(f) Nursing facilities may apply for the portion of the rate adjustment under paragraph (a) that is subject to the requirements in paragraphs (b) and (c). The application must be submitted to the commissioner within six months of the effective date of the rate adjustment, and the nursing facility must provide additional information required by the commissioner within nine months of the effective date of the rate adjustment. The commissioner must respond to all applications within three weeks of receipt. The commissioner may waive the deadlines in this paragraph under extraordinary circumstances, to be determined at the sole discretion of the commissioner. The application must contain:

 

(1) an estimate of the amounts of money that must be used as specified in paragraphs (b) and (c);

 

(2) a detailed distribution plan specifying the allowable compensation-related and wage increases the nursing facility will implement to use the funds available in clause (1);

 

(3) a description of how the nursing facility will notify eligible employees of the contents of the approved application, which must provide for giving each eligible employee a copy of the approved application, excluding the information required in clause (1), or posting a copy of the approved application, excluding the information required in clause (1), for a period of at least six weeks in an area of the nursing facility to which all eligible employees have access; and

 

(4) instructions for employees who believe they have not received the compensation-related or wage increases specified in clause (2), as approved by the commissioner, and which must include a mailing address, e-mail address, and the telephone number that may be used by the employee to contact the commissioner or the commissioner's representative.

 

(g) The commissioner shall ensure that cost increases in distribution plans under paragraph (f), clause (2), that may be included in approved applications, comply with the following requirements:

 

(1) costs to be incurred during the applicable rate year resulting from wage and salary increases effective prior to the first day of the nursing facility's payroll period that includes October 1, 2007, shall be allowed if they were not used in a prior year's application;

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(2) a portion of the costs resulting from tenure-related wage or salary increases may be considered to be allowable wage increases, according to formulas that the commissioner shall provide, where employee retention is above the average statewide rate of retention of direct care employees;

 

(3) the annualized amount of increases in costs for the employer's share of health and dental insurance, life insurance, disability insurance, and workers' compensation shall be allowable compensation-related increases if they are effective on or after April 1, 2007, and prior to April 1, 2008; and

 

(4) for nursing facilities in which employees are represented by an exclusive bargaining representative, the commissioner shall approve the application only upon receipt of a letter of acceptance of the distribution plan, in regard to members of the bargaining unit, signed by the exclusive bargaining agent and dated after enactment of this subdivision. Upon receipt of the letter of acceptance, the commissioner shall deem all requirements of this section as having been met in regard to the members of the bargaining unit.

 

(h) The commissioner shall review applications received under paragraph (f) and shall provide the portion of the rate adjustment under paragraphs (b) and (c) if the requirements of this subdivision have been met. The rate adjustment shall be effective October 1. Notwithstanding paragraph (a), if the approved application distributes less money than is available, the amount of the rate adjustment shall be reduced so that the amount of money made available is equal to the amount to be distributed.

 

Sec. 31. Minnesota Statutes 2006, section 256B.434, is amended by adding a subdivision to read:

 

Subd. 20. Payment of Public Employees Retirement Association costs. Nursing facilities that participate in the Public Employees Retirement Association (PERA) shall have the component of their payment rate associated with the costs of PERA determined for each rate year. Effective for rate years beginning on and after October 1, 2007, the commissioner shall determine the portion of the payment rate in effect on September 30 each year and shall subtract that amount from the payment rate to be effective on the following October 1. The portion that shall be deemed to be included in the September 30, 2007, rate that is associated with PERA costs shall be the allowed costs in the facility's base for determining rates under this section, divided by the resident days reported for that year. The commissioner shall add to the payment rate to be effective on October 1 each year an amount equal to the reported costs associated with PERA, for the year ended on the most recent September 30 for which data is available, divided by total resident days for that year, as reported by the facility and audited under section 256B.441.

 

Sec. 32. Minnesota Statutes 2006, section 256B.437, is amended by adding a subdivision to read:

 

Subd. 10. Big Stone County rate adjustment. Notwithstanding the requirements of this section, the commissioner shall approve a planned closure rate adjustment in Big Stone County for an eight-bed facility in Clinton for reassignment to a 50-bed facility in Graceville. The adjustment shall be calculated according to subdivisions 3 and 6.

 

Sec. 33. Minnesota Statutes 2006, section 256B.441, subdivision 1, is amended to read:

 

Subdivision 1. Rate determination Rebasing of nursing facility operating cost payment rates. (a) The commissioner shall establish a value-based nursing facility reimbursement system which will provide facility-specific, prospective rates for nursing facilities participating in the medical assistance program. The rates shall be determined using an annual statistical and cost report filed by each nursing facility. The total payment rate shall be composed of four rate components: direct care services, support services, external fixed, and property-related rate components. The payment rate shall be derived from statistical measures of actual costs incurred in facility operation of nursing facilities. From this cost basis, the components of the total payment rate shall be adjusted for quality of services provided, recognition of staffing levels, geographic variation in labor costs, and resident acuity. The commissioner shall rebase nursing facility operating cost payment rates to align payments to facilities with the cost of providing care. The rebased operating cost payment rates shall be calculated using the statistical and cost report filed by each nursing facility for the report period ending one year prior to the rate year.

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(b) Rates shall be rebased annually. The new operating cost payment rates based on this section shall take effect beginning with the rate year beginning October 1, 2008, and shall be phased in over five rate years through October 1, 2012.

 

(c) Operating cost payment rates shall be rebased on October 1, 2013, and every two years after that date.

 

(d) Each cost reporting year shall begin on October 1 and end on the following September 30. Beginning in 2006, a statistical and cost report shall be filed by each nursing facility by January 15. Notice of rates shall be distributed by August 15 and the rates shall go into effect on October 1 for one year.

 

(c) The commissioner shall begin to phase in the new reimbursement system beginning October 1, 2007. Full phase-in shall be completed by October 1, 2011.

 

(e) Effective October 1, 2011, property rates shall be rebased in accordance with section 256B.431 and Minnesota Rules, chapter 9549. The commissioner shall determine what the property payment rate for a nursing facility would be had the facility not had its property rate determined under section 256B.434. The commissioner shall allow nursing facilities to provide information affecting this rate determination that would have been filed annually under Minnesota Rules, chapter 9549, and nursing facilities shall report information necessary to determine allowable debt. The commissioner shall use this information to determine the property payment rate.

 

Sec. 34. Minnesota Statutes 2006, section 256B.441, subdivision 2, is amended to read:

 

Subd. 2. Definitions. For purposes of this section, the terms in subdivisions 3 to 42 42a have the meanings given unless otherwise provided for in this section.

 

Sec. 35. Minnesota Statutes 2006, section 256B.441, subdivision 5, is amended to read:

 

Subd. 5. Administrative costs. "Administrative costs" means the direct costs for administering the overall activities of the nursing home. These costs include salaries and wages of the administrator, assistant administrator, business office employees, security guards, and associated fringe benefits and payroll taxes, fees, contracts, or purchases related to business office functions, licenses, and permits except as provided in the external fixed costs category, employee recognition, travel including meals and lodging, training, voice and data communication or transmission, office supplies, liability insurance and other forms of insurance not designated to other areas, personnel recruitment, legal services, accounting services, management or business consultants, data processing, information technology, Web site, central or home office costs, business meetings and seminars, postage, fees for professional organizations, subscriptions, security services, advertising, board of director's fees, working capital interest expense, and bad debts and bad debt collection fees.

 

Sec. 36. Minnesota Statutes 2006, section 256B.441, subdivision 6, is amended to read:

 

Subd. 6. Allowed costs. "Allowed costs" means the amounts reported by the facility which are necessary for the operation of the facility and the care of residents and which are reviewed by the department for accuracy, reasonableness, in accordance with the requirements set forth in Title XVIII of the federal Social Security Act and the interpretations in the provider reimbursement manual, and compliance with this section and generally accepted accounting principles. All references to costs in this section shall be assumed to refer to allowed costs.

 

Sec. 37. Minnesota Statutes 2006, section 256B.441, subdivision 10, is amended to read:

 

Subd. 10. Dietary costs. "Dietary costs" means the costs for the salaries and wages of the dietary supervisor, dietitians, chefs, cooks, dishwashers, and other employees assigned to the kitchen and dining room, and associated fringe benefits and payroll taxes. Dietary costs also includes the salaries or fees of dietary consultants, direct costs

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of raw food (both normal and special diet food), dietary supplies, and food preparation and serving. Also included are special dietary supplements used for tube feeding or oral feeding, such as elemental high nitrogen diet, even if written as a prescription item by a physician.

 

Sec. 38. Minnesota Statutes 2006, section 256B.441, subdivision 11, is amended to read:

 

Subd. 11. Direct care costs category. "Direct care costs category" "Direct care costs" means costs for nursing services, activities, and social services the wages of nursing administration, staff education, direct care registered nurses, licensed practical nurses, certified nursing assistants, trained medication aides, and associated fringe benefits and payroll taxes; services from a supplemental nursing services agency; supplies that are stocked at nursing stations or on the floor and distributed or used individually, including, but not limited to: alcohol, applicators, cotton balls, incontinence pads, disposable ice bags, dressings, bandages, water pitchers, tongue depressors, disposable gloves, enemas, enema equipment, soap, medication cups, diapers, plastic waste bags, sanitary products, thermometers, hypodermic needles and syringes, clinical reagents or similar diagnostic agents, drugs that are not paid on a separate fee schedule by the medical assistance program or any other payer, and technology related to the provision of nursing care to residents, such as electronic charting systems.

 

Sec. 39. Minnesota Statutes 2006, section 256B.441, subdivision 13, is amended to read:

 

Subd. 13. External fixed costs category. "External fixed costs category" "External fixed costs" means costs related to the nursing home surcharge under section 256.9657, subdivision 1; licensure fees under section 144.122; long-term care consultation fees under section 256B.0911, subdivision 6; family advisory council fee under section 144A.33; scholarships under section 256B.431, subdivision 36; planned closure rate adjustments under section 256B.436 or 256B.437; or single bed room incentives under section 256B.431, subdivision 42; property taxes and property insurance; and PERA.

 

Sec. 40. Minnesota Statutes 2006, section 256B.441, subdivision 14, is amended to read:

 

Subd. 14. Facility average case mix index. "Facility average case mix index" or "CMI" means a numerical value score that describes the relative resource use for all residents within the groups under the resource utilization group (RUG-III) classification system prescribed by the commissioner based on an assessment of each resident. The facility average CMI shall be computed as the standardized days divided by total days for all residents in the facility. The RUG's weights used in this section shall be as follows for each RUG's class: SE3 1.605; SE2 1.247; SE1 1.081; RAD 1.509; RAC 1.259; RAB 1.109; RAA 0.957; SSC 1.453; SSB 1.254; SSA 1.047; CC2 1.292; CC1 1.200; CB2 1.086; CB1 1.017; CA2 0.908; CA1 0.834; IB2 0.877; IB1 0.817; IA2 0.720; IA1 0.676; BB2 0.956; BB1 0.885; BA2 0.716; BA1 0.673; PE2 1.199; PE1 1.104; PD2 1.023; PD1 0.948; PC2 0.926; PC1 0.860; PB2 0.786; PB1 0.734; PA2 0.691; PA1 0.651; BC1 0.651; and DDF 1.000.

 

Sec. 41. Minnesota Statutes 2006, section 256B.441, is amended by adding a subdivision to read:

 

Subd. 14a. Facility type groups. Facilities shall be classified into two groups, called "facility type groups," which shall consist of:

 

(1) C&NC/R80: facilities that are hospital-attached, or are licensed under Minnesota Rules, parts 9570.2000 to 9570.3400; and

 

(2) freestanding: all other facilities.

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Sec. 42. Minnesota Statutes 2006, section 256B.441, subdivision 17, is amended to read:

 

Subd. 17. Fringe benefit costs. "Fringe benefit costs" means the costs for group life, health, dental, workers' compensation, and other employee insurances and pension, profit-sharing, and retirement plans for which the employer pays all or a portion of the costs and that are available to at least all employees who work at least 20 hours per week.

 

Sec. 43. Minnesota Statutes 2006, section 256B.441, subdivision 20, is amended to read:

 

Subd. 20. Housekeeping costs. "Housekeeping costs" means the costs for the salaries and wages of the housekeeping supervisor, housekeepers, and other cleaning employees and associated fringe benefits and payroll taxes. It also includes the cost of housekeeping supplies, including, but not limited to, cleaning and lavatory supplies and contract services.

 

Sec. 44. Minnesota Statutes 2006, section 256B.441, subdivision 24, is amended to read:

 

Subd. 24. Maintenance and plant operations costs. "Maintenance and plant operations costs" means the costs for the salaries and wages of the maintenance supervisor, engineers, heating-plant employees, and other maintenance employees and associated fringe benefits and payroll taxes. It also includes direct costs for maintenance and operation of the building and grounds, including, but not limited to, fuel, electricity, medical waste and garbage removal, water, sewer, supplies, tools, and repairs.

 

Sec. 45. Minnesota Statutes 2006, section 256B.441, is amended by adding a subdivision to read:

 

Subd. 28a. Other direct care costs. "Other direct care costs" means the costs for the salaries and wages and associated fringe benefits and payroll taxes of mental health workers, religious personnel, and other direct care employees not specified in the definition of direct care costs.

 

Sec. 46. Minnesota Statutes 2006, section 256B.441, subdivision 30, is amended to read:

 

Subd. 30. Peer groups. Facilities shall be classified into three groups, called "peer groups," which by county. The groups shall consist of:

 

(1) C&NC/Short Stay/R80 - facilities that have three or more admissions per bed per year, are hospital-attached, or are licensed under Minnesota Rules, parts 9570.2000 to 9570.3600 group one: facilities in Anoka, Benton, Carlton, Carver, Chisago, Dakota, Dodge, Goodhue, Hennepin, Isanti, Mille Lacs, Morrison, Olmsted, Ramsey, Rice, Scott, Sherburne, St. Louis, Stearns, Steele, Wabasha, Washington, Winona, or Wright County;

 

(2) boarding care homes - facilities that have more than 50 percent of their beds licensed as boarding care homes group two: facilities in Aitkin, Beltrami, Blue Earth, Brown, Cass, Clay, Cook, Crow Wing, Faribault, Fillmore, Freeborn, Houston, Hubbard, Itasca, Kanabec, Koochiching, Lake, Lake of the Woods, Le Sueur, Martin, McLeod, Meeker, Mower, Nicollet, Norman, Pine, Roseau, Sibley, Todd, Wadena, Waseca, Watonwan, or Wilkin County; and

 

(3) standard - all other facilities group three: facilities in all other counties.

 

Sec. 47. Minnesota Statutes 2006, section 256B.441, subdivision 31, is amended to read:

 

Subd. 31. Prior rate-setting method system operating cost payment rate. "Prior rate-setting method" "Prior system operating cost payment rate" means the operating cost payment rate determination process in effect prior to October 1, 2006 on September 30, 2008, under Minnesota Rules and Minnesota Statutes, not including planned closure rate adjustments under section 256B.436 or 256B.437, or single bed room incentives under section 256B.431, subdivision 42.

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Sec. 48. Minnesota Statutes 2006, section 256B.441, is amended by adding a subdivision to read:

 

Subd. 33a. Raw food costs. "Raw food costs" means the cost of food provided to nursing facility residents. Also included are special dietary supplements used for tube feeding or oral feeding, such as elemental high nitrogen diet.

 

Sec. 49. Minnesota Statutes 2006, section 256B.441, subdivision 34, is amended to read:

 

Subd. 34. Related organization. "Related organization" means a person that furnishes goods or services to a nursing facility and that is a close relative of a nursing facility, an affiliate of a nursing facility, a close relative of an affiliate of a nursing facility, or an affiliate of a close relative of an affiliate of a nursing facility. As used in this subdivision, paragraphs (a) to (d) apply:

 

(a) "Affiliate" means a person that directly, or indirectly through one or more intermediaries, controls or is controlled by, or is under common control with another person.

 

(b) "Person" means an individual, a corporation, a partnership, an association, a trust, an unincorporated organization, or a government or political subdivision.

 

(c) "Close relative of an affiliate of a nursing facility" means an individual whose relationship by blood, marriage, or adoption to an individual who is an affiliate of a nursing facility is no more remote than first cousin.

 

(d) "Control" including the terms "controlling," "controlled by," and "under common control with" means the possession, direct or indirect, of the power to direct or cause the direction of the management, operations, or policies of a person, whether through the ownership of voting securities, by contract, or otherwise, or to influence in any manner other than through an arms length, legal transaction.

 

Sec. 50. Minnesota Statutes 2006, section 256B.441, subdivision 38, is amended to read:

 

Subd. 38. Social services costs. "Social services costs" means the costs for the salaries and wages of the supervisor and other social work employees, associated fringe benefits and payroll taxes, supplies, services, and consultants. This category includes the cost of those employees who manage and process admission to the nursing facility.

 

Sec. 51. Minnesota Statutes 2006, section 256B.441, is amended by adding a subdivision to read:

 

Subd. 42a. Therapy costs. "Therapy costs" means any costs related to medical assistance therapy services provided to residents that are not billed separately from the daily operating rate.

 

Sec. 52. Minnesota Statutes 2006, section 256B.441, is amended by adding a subdivision to read:

 

Subd. 46a. Calculation of quality add-on for October 1, 2007. (a) The payment rate for the rate year beginning October 1, 2007, for the quality add-on, is a variable amount based on each facility's quality score. For the rate year, the maximum quality add-on is .3 percent of the operating payment rate in effect on September 30, 2007. The commissioner shall determine the quality add-on for each facility according to paragraphs (b) to (d).

 

(b) For each facility, the commissioner shall determine the operating payment rate in effect on September 30, 2007.

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(c) For each facility, the commissioner shall determine a ratio of the quality score of the facility determined in subdivision 44, subtract 40, and then divide by 60. If this value is less than zero, the commissioner shall use the value zero.

 

(d) For each facility, the quality add-on is the value determined in paragraph (b), multiplied by the value determined in paragraph (c), multiplied by .3 percent.

 

Sec. 53. Minnesota Statutes 2006, section 256B.441, is amended by adding a subdivision to read:

 

Subd. 48. Calculation of operating per diems. The direct care per diem for each facility shall be the facility's direct care costs divided by its standardized days. The other care-related per diem shall be the sum of the facility's activities costs, other direct care costs, raw food costs, therapy costs, and social services costs, divided by the facility's resident days. The other operating per diem shall be the sum of the facility's administrative costs, dietary costs, housekeeping costs, laundry costs, and maintenance and plant operations costs divided by the facility's resident days.

 

Sec. 54. Minnesota Statutes 2006, section 256B.441, is amended by adding a subdivision to read:

 

Subd. 49. Determination of total care-related per diem. The total care-related per diem for each facility shall be the sum of the direct care per diem and the other care-related per diem.

 

Sec. 55. Minnesota Statutes 2006, section 256B.441, is amended by adding a subdivision to read:

 

Subd. 50. Determination of total care-related limit. (a) The limit on the total care-related per diem shall be determined for each peer group and facility type group combination. A facility's total care-related per diems shall be limited to 120 percent of the median for the facility's peer and facility type group. The facility-specific direct care costs used in making this comparison and in the calculation of the median shall be based on a RUG's weight of 1.00. A facility that is above that limit shall have its total care-related per diem reduced to the limit. If a reduction of the total care-related per diem is necessary because of this limit, the reduction shall be made proportionally to both the direct care per diem and the other care-related per diem.

 

(b) Beginning with rates determined for October 1, 2014, the total care-related limit shall be a variable amount based on each facility's quality score, as determined under section 256B.441, subdivision 44, in accordance with clauses (1) to (4):

 

(1) for each facility, the commissioner shall determine the quality score, subtract 40, divide by 40, and convert to a percentage;

 

(2) if the value determined in clause (1) is less than zero, the total care-related limit shall be 105 percent of the median for the facility's peer and facility type group;

 

(3) if the value determined in clause (1) is greater than 100 percent, the total care-related limit shall be 125 percent of the median for the facility's peer and facility type group; and

 

(4) if the value determined in clause (1) is greater than zero and less than 100 percent, the total care-related limit shall be 105 percent of the median for the facility's peer and facility type group plus one-fifth of the percentage determined in clause (1).

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Sec. 56. Minnesota Statutes 2006, section 256B.441, is amended by adding a subdivision to read:

 

Subd. 50a. Determination of proximity adjustments. For a nursing facility located in close proximity to another nursing facility of the same facility group type but in a different peer group and that has higher limits for care-related or other operating costs, the commissioner shall adjust the limits in accordance with clauses (1) to (4):

 

(1) determine the difference between the limits;

 

(2) determine the distance between the two facilities, by the shortest driving route. If the distance exceeds 20 miles, no adjustment shall be made;

 

(3) subtract the value in clause (2) from 20 miles, divide by 20, and convert to a percentage; and

 

(4) increase the limits for the nursing facility with the lower limits by the value determined in clause (1) multiplied by the value determined in clause (3).

 

Sec. 57. Minnesota Statutes 2006, section 256B.441, is amended by adding a subdivision to read:

 

Subd. 51. Determination of other operating limit. The limit on the other operating per diem shall be determined for each peer group. A facility's other operating per diem shall be limited to 105 percent of the median for its peer group. A facility that is above that limit shall have its other operating per diem reduced to the limit.

 

Sec. 58. Minnesota Statutes 2006, section 256B.441, is amended by adding a subdivision to read:

 

Subd. 51a. Exception allowing contracting for specialized care. (a) For rate years beginning October 1, 2013, the commissioner may negotiate increases to the care-related limit for nursing facilities that provide specialized care, at a cost to the general fund not to exceed $600,000 per year. The commissioner shall publish a request for proposals annually, and may negotiate increases to the limits that shall apply for either one or two years before the increase shall be subject to a new proposal and negotiation. The care-related limit may be increased by up to 50 percent.

 

(b) In selecting facilities with which to negotiate, the commissioner shall consider:

 

(1) the diagnoses or other circumstances of residents in the specialized program that require care that costs substantially more than the RUG's rates associated with those residents;

 

(2) the nature of the specialized program or programs offered to meet the needs of these individuals; and

 

(3) outcomes achieved by the specialized program.

 

Sec. 59. Minnesota Statutes 2006, section 256B.441, is amended by adding a subdivision to read:

 

Subd. 52. Determination of efficiency incentive. Each facility shall be eligible for an efficiency incentive based on its other operating per diem. A facility with an other operating per diem that exceeds the limit in subdivision 51 shall receive no efficiency incentive. All other facilities shall receive an incentive calculated as 50 percent times the difference between the facility's other operating per diem and its other operating per diem limit, up to a maximum incentive of $3.

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Sec. 60. Minnesota Statutes 2006, section 256B.441, is amended by adding a subdivision to read:

 

Subd. 53. Calculation of payment rate for external fixed costs. The commissioner shall calculate a payment rate for external fixed costs.

 

(a) For a facility licensed as a nursing home, the portion related to section 256.9657 shall be equal to $8.86. For a facility licensed as both a nursing home and a boarding care home, the portion related to section 256.9657 shall be equal to $8.86 multiplied by the result of its number of nursing home beds divided by its total number of licensed beds.

 

(b) The portion related to the licensure fee under section 144.122, paragraph (d), shall be the amount of the fee divided by actual resident days.

 

(c) The portion related to scholarships shall be determined under section 256B.431, subdivision 36.

 

(d) The portion related to long-term care consultation shall be determined according to section 256B.0911, subdivision 6.

 

(e) The portion related to development and education of resident and family advisory councils under section 144A.33 shall be $5 divided by 365.

 

(f) The portion related to planned closure rate adjustments shall be as determined under sections 256B.436 and 256B.437, subdivision 6. Planned closure rate adjustments that take effect before October 1, 2011, shall no longer be included in the payment rate for external fixed costs beginning October 1, 2013. Planned closure rate adjustments that take effect on or after October 1, 2011, shall no longer be included in the payment rate for external fixed costs beginning on October 1 of the first year not less than two years after their effective date.

 

(g) The portions related to property insurance, real estate taxes, special assessments, and payments made in lieu of real estate taxes directly identified or allocated to the nursing facility shall be the actual amounts divided by actual resident days.

 

(h) The portion related to the Public Employees Retirement Association shall be actual costs divided by resident days.

 

(i) The single bed room incentives shall be as determined under section 256B.431, subdivision 42. Single bed room incentives that take effect before October 1, 2011, shall no longer be included in the payment rate for external fixed costs beginning October 1, 2013. Single bed room incentives that take effect on or after October 1, 2011, shall no longer be included in the payment rate for external fixed costs beginning on October 1 of the first year not less than two years after their effective date.

 

(j) The payment rate for external fixed costs shall be the sum of the amounts in paragraphs (a) to (i).

 

Sec. 61. Minnesota Statutes 2006, section 256B.441, is amended by adding a subdivision to read:

 

Subd. 54. Determination of total payment rates. In rate years when rates are rebased, the total payment rate for a RUG's weight of 1.00 shall be the sum of the total care-related payment rate, other operating payment rate, efficiency incentive, external fixed cost rate, and the property rate determined under section 256B.434. To determine a total payment rate for each RUG's level, the total care-related payment rate shall be divided into the direct care payment rate and the other care-related payment rate, and the direct care payment rate multiplied by the RUG's weight for each RUG's level using the weights in subdivision 14.

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Sec. 62. Minnesota Statutes 2006, section 256B.441, is amended by adding a subdivision to read:

 

Subd. 55. Phase-in of rebased operating cost payment rates. (a) For the rate years beginning October 1, 2008, to October 1, 2012, the operating cost payment rate calculated under this section shall be phased in by blending the operating cost rate with the operating cost payment rate determined under section 256B.434. For the rate year beginning October 1, 2008, the operating cost payment rate for each facility shall be 24.9 percent of the operating cost payment rate from this section, and 75.1 percent of the operating cost payment rate from section 256B.434. For the rate year beginning October 1, 2009, the operating cost payment rate for each facility shall be 57.6 percent of the operating cost payment rate from this section, and 42.4 percent of the operating cost payment rate from section 256B.434. For the rate year beginning October 1, 2010, the operating cost payment rate for each facility shall be 92.1 percent of the operating cost payment rate from this section, and 7.9 percent of the operating cost payment rate from section 256B.434. For the rate year beginning October 1, 2011, the operating cost payment rate for each facility shall be 96 percent of the operating cost payment rate from this section, and 4 percent of the operating cost payment rate from section 256B.434. For the rate year beginning October 1, 2012, the operating cost payment rate for each facility shall be the operating cost payment rate determined under this section. The blending of operating cost payment rates under this section shall be performed separately for each RUG's class.

 

(b) A portion of the funds received under this subdivision that are in excess of operating cost payment rates that a facility would have received under section 256B.434, as determined in accordance with clauses (1) to (3), shall be subject to the requirements in section 256B.434, subdivision 19, paragraphs (b) to (h).

 

(1) Determine the amount of additional funding available to a facility, which shall be equal to total medical assistance resident days from the most recent reporting year times the difference between the blended rate determined in paragraph (a) for the rate year being computed and the blended rate for the prior year.

 

(2) Determine the portion of all operating costs, for the most recent reporting year, that are compensation related. If this value exceeds 75 percent, use 75 percent.

 

(3) Subtract the amount determined in clause (2) from 75 percent.

 

(4) The portion of the fund received under this subdivision that shall be subject to the requirements in section 256B.434, subdivision 19, paragraphs (b) to (h), shall equal the amount determined in clause (1) times the amount determined in clause (3).

 

Sec. 63. Minnesota Statutes 2006, section 256B.441, is amended by adding a subdivision to read:

 

Subd. 56. Hold harmless. For the rate years beginning October 1, 2008, to October 1, 2012, no nursing facility shall receive an operating cost payment rate less than its operating cost payment rate under section 256B.434. The comparison of operating cost payment rates under this section shall be made for a RUG's rate with a weight of 1.00.

 

Sec. 64. Minnesota Statutes 2006, section 256B.441, is amended by adding a subdivision to read:

 

Subd. 57. Appeals. Nursing facilities may appeal, as described under section 256B.50, the determination of a payment rate established under this chapter.

 

Sec. 65. Minnesota Statutes 2006, section 256B.441, is amended by adding a subdivision to read:

 

Subd. 58. Implementation delay. Within six months prior to the effective date of (1) rebasing of property payment rates under subdivision 1; (2) quality-based rate limits under subdivision 50; and (3) the removal of planned closure rate adjustments and single bed room incentives from external fixed costs under subdivision 53, the commissioner shall compare the average operating cost for all facilities combined from the most recent cost reports

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to the average medical assistance operating payment rates for all facilities combined from the same time period. Each provision shall not go into effect until the average medical assistance operating payment rate is at least 92 percent of the average operating cost.

 

Sec. 66. Minnesota Statutes 2006, section 256B.49, is amended by adding a subdivision to read:

 

Subd. 16a. Medical assistance reimbursement. (a) The commissioner shall seek federal approval for medical assistance reimbursement of independent living skills services, foster care waiver service, supported employment, prevocational service, structured day service, and adult day care under the home and community-based waiver for persons with a traumatic brain injury, the community alternatives for disabled individuals waivers, and the community alternative care waivers.

 

(b) Medical reimbursement shall be made only when the provider demonstrates evidence of its capacity to meet basic health, safety, and protection standards through one of the methods in paragraphs (c) to (e).

 

(c) The provider is licensed to provide services under chapter 245B and agrees to apply these standards to services funded through the traumatic brain injury, community alternatives for disabled, or community alternative care home and community-based waivers.

 

(d) The local agency contracting for the services certifies on a form provided by the commissioner that the provider has the capacity to meet the individual needs as identified in each person's individual service plan. When certifying that the service provider meets the necessary provider qualifications, the local agency shall verify that the provider has policies and procedures governing the following:

 

(1) protection of the consumer's rights and privacy;

 

(2) risk assessment and planning;

 

(3) record keeping and reporting of incidents and emergencies with documentation of corrective action if needed;

 

(4) service outcomes, regular reviews of progress, and periodic reports;

 

(5) complaint and grievance procedures;

 

(6) service termination or suspension;

 

(7) necessary training and supervision of direct care staff that includes:

 

(i) documentation in personnel files of 20 hours of orientation training in providing training related to service provision;

 

(ii) training in recognizing the symptoms and effects of certain disabilities, health conditions, and positive behavioral supports and interventions; and

 

(iii) a minimum of five hours of related training annually; and

 

(iv) when applicable:

 

(A) safe medication administration;

 

(B) proper handling of consumer funds; and

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(C) compliance with prohibitions and standards developed by the commissioner to satisfy federal requirements regarding the use of restraints and restrictive interventions. The local agency shall review at least annually each service provider's continued compliance with the standards governing basic health, safety, and protection of rights.

 

(h) The commissioner shall seek federal approval for Medicaid reimbursement of foster care services under the home and community-based waiver for persons with a traumatic brain injury, the community alternatives for disabled individuals waiver, and community alternative care waiver when the provider demonstrates evidence of its capacity to meet basic health, safety, and protection standards. The local agency shall verify that the provider is licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, and certify that the provider has policies and procedures that govern:

 

(1) compliance with prohibitions and standards developed by the commissioner to meet federal requirements regarding the use of restraints and restrictive interventions; and

 

(2) documentation of service needs and outcomes, regular reviews of progress, and periodic reports.

 

The local agency shall review at least annually each service provider's continued compliance with the standards governing basic health, safety, and protection of rights standards.

 

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

 

Sec. 67. Minnesota Statutes 2006, section 256B.5012, is amended by adding a subdivision to read:

 

Subd. 7. ICF/MR rate increases effective October 1, 2007, and October 1, 2008. (a) For the rate year beginning October 1, 2007, the commissioner shall make available to each facility reimbursed under this section operating payment rate adjustments equal to 3.0 percent of the operating payment rates in effect on September 30, 2007. For the rate year beginning October 1, 2008, the commissioner shall make available to each facility reimbursed under this section operating payment rate adjustments equal to 3.0 percent of the operating payment rates in effect on September 30, 2008. For each facility, the commissioner shall make available an adjustment, based on occupied beds, using the percentage specified in this paragraph multiplied by the total payment rate, including the variable rate but excluding the property-related payment rate, in effect on the preceding day. The total payment rate shall include the adjustment provided in section 256B.501, subdivision 12. A facility whose payment rates are governed by closure agreements, receivership agreements, or Minnesota Rules, part 9553.0075, is not eligible for an adjustment otherwise granted under this subdivision.

 

(b) Seventy-five percent of the money resulting from the rate adjustments under paragraph (a) must be used for increases in compensation-related costs for employees directly employed by the facility on or after the effective date of the rate adjustments, except:

 

(1) the administrator;

 

(2) persons employed in the central office of a corporation that has an ownership interest in the facility or exercises control over the facility; and

 

(3) persons paid by the facility under a management contract.

 

(c) Two-thirds of the money available under paragraph (b) must be used for wage increases for all employees directly employed by the facility on or after the effective date of the rate adjustments, except those listed in paragraph (b), clauses (1) to (3). The wage adjustment that employees receive under this paragraph must be paid as an equal hourly percentage wage increase for all eligible employees. Only costs associated with the portion of the equal hourly percentage wage increase that goes to all employees shall qualify under this paragraph. Costs associated with wage increases in excess of the amount of the equal hourly percentage wage increase provided to all employees shall be allowed only for meeting the requirements in paragraph (b). This paragraph shall not apply to:

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(1) employees eligible for a Taft-Hartley insurance plan established under United States Code, title 29, section 186(c)(5); or

 

(2) public employees.

 

(d) The commissioner shall allow as compensation-related costs all costs for:

 

(1) wages and salaries;

 

(2) FICA taxes, Medicare taxes, state and federal unemployment taxes, and workers' compensation;

 

(3) the employer's share of health and dental insurance, life insurance, disability insurance, long-term care insurance, uniform allowance, and pensions; and

 

(4) other benefits provided, subject to the approval of the commissioner.

 

(e) The portion of the rate adjustments under paragraph (a) that is not subject to the requirements in paragraphs (b) and (c) shall be provided to facilities effective October 1 of each year.

 

(f) Facilities may apply for the portion of the rate adjustments under paragraph (a) that is subject to the requirements in paragraphs (b) and (c). The application must be submitted to the commissioner within six months of the effective date of the rate adjustments, and the facility must provide additional information required by the commissioner within nine months of the effective date of the rate adjustments. The commissioner must respond to all applications within three weeks of receipt. The commissioner may waive the deadlines in this paragraph under extraordinary circumstances, to be determined at the sole discretion of the commissioner. The application must contain:

 

(1) an estimate of the amounts of money that must be used as specified in paragraphs (b) and (c);

 

(2) a detailed distribution plan specifying the allowable compensation-related and wage increases the facility will implement to use the funds available in clause (1);

 

(3) a description of how the facility will notify eligible employees of the contents of the approved application, which must provide for giving each eligible employee a copy of the approved application, excluding the information required in clause (1), or posting a copy of the approved application, excluding the information required in clause (1), for a period of at least six weeks in an area of the facility to which all eligible employees have access; and

 

(4) instructions for employees who believe they have not received the compensation-related or wage increases specified in clause (2), as approved by the commissioner, and which must include a mailing address, e-mail address, and the telephone number that may be used by the employee to contact the commissioner or the commissioner's representative.

 

(g) The commissioner shall ensure that cost increases in distribution plans under paragraph (f), clause (2), that may be included in approved applications, comply with requirements in clauses (1) to (4):

 

(1) costs to be incurred during the applicable rate year resulting from wage and salary increases effective prior to the first day of the facility's payroll period that includes October 1 of each year shall be allowed if they were not used in a prior year's application and they meet the requirements of paragraphs (b) and (c);

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(2) a portion of the costs resulting from tenure-related wage or salary increases may be considered to be allowable wage increases, according to formulas that the commissioner shall provide, where employee retention is above the average statewide rate of retention of direct care employees;

 

(3) the annualized amount of increases in costs for the employer's share of health and dental insurance, life insurance, disability insurance, and workers' compensation shall be allowable compensation-related increases if they are effective on or after April 1 of the year in which the rate adjustments are effective and prior to April 1 of the following year; and

 

(4) for facilities in which employees are represented by an exclusive bargaining representative, the commissioner shall approve the application only upon receipt of a letter of acceptance of the distribution plan, as regards members of the bargaining unit, signed by the exclusive bargaining agent and dated after enactment of this subdivision. Upon receipt of the letter of acceptance, the commissioner shall deem all requirements of this section as having been met in regard to the members of the bargaining unit.

 

(h) The commissioner shall review applications received under paragraph (f) and shall provide the portion of the rate adjustments under paragraphs (b) and (c) if the requirements of this subdivision have been met. The rate adjustments shall be effective October 1 of each year. Notwithstanding paragraph (a), if the approved application distributes less money than is available, the amount of the rate adjustment shall be reduced so that the amount of money made available is equal to the amount to be distributed.

 

Sec. 68. Minnesota Statutes 2006, section 256B.69, subdivision 23, is amended to read:

 

Subd. 23. Alternative services; elderly and disabled persons. (a) The commissioner may implement demonstration projects to create alternative integrated delivery systems for acute and long-term care services to elderly persons and persons with disabilities as defined in section 256B.77, subdivision 7a, that provide increased coordination, improve access to quality services, and mitigate future cost increases. The commissioner may seek federal authority to combine Medicare and Medicaid capitation payments for the purpose of such demonstrations and may contract with Medicare-approved special needs plans to provide Medicaid services. Medicare funds and services shall be administered according to the terms and conditions of the federal contract and demonstration provisions. For the purpose of administering medical assistance funds, demonstrations under this subdivision are subject to subdivisions 1 to 22. The provisions of Minnesota Rules, parts 9500.1450 to 9500.1464, apply to these demonstrations, with the exceptions of parts 9500.1452, subpart 2, item B; and 9500.1457, subpart 1, items B and C, which do not apply to persons enrolling in demonstrations under this section. An initial open enrollment period may be provided. Persons who disenroll from demonstrations under this subdivision remain subject to Minnesota Rules, parts 9500.1450 to 9500.1464. When a person is enrolled in a health plan under these demonstrations and the health plan's participation is subsequently terminated for any reason, the person shall be provided an opportunity to select a new health plan and shall have the right to change health plans within the first 60 days of enrollment in the second health plan. Persons required to participate in health plans under this section who fail to make a choice of health plan shall not be randomly assigned to health plans under these demonstrations. Notwithstanding section 256L.12, subdivision 5, and Minnesota Rules, part 9505.5220, subpart 1, item A, if adopted, for the purpose of demonstrations under this subdivision, the commissioner may contract with managed care organizations, including counties, to serve only elderly persons eligible for medical assistance, elderly and disabled persons, or disabled persons only. For persons with a primary diagnosis of developmental disability, serious and persistent mental illness, or serious emotional disturbance, the commissioner must ensure that the county authority has approved the demonstration and contracting design. Enrollment in these projects for persons with disabilities shall be voluntary. The commissioner shall not implement any demonstration project under this subdivision for persons with a primary diagnosis of developmental disabilities, serious and persistent mental illness, or serious emotional disturbance, without approval of the county board of the county in which the demonstration is being implemented.

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(b) Notwithstanding chapter 245B, sections 252.40 to 252.46, 256B.092, 256B.501 to 256B.5015, and Minnesota Rules, parts 9525.0004 to 9525.0036, 9525.1200 to 9525.1330, 9525.1580, and 9525.1800 to 9525.1930, the commissioner may implement under this section projects for persons with developmental disabilities. The commissioner may capitate payments for ICF/MR services, waivered services for developmental disabilities, including case management services, day training and habilitation and alternative active treatment services, and other services as approved by the state and by the federal government. Case management and active treatment must be individualized and developed in accordance with a person-centered plan. Costs under these projects may not exceed costs that would have been incurred under fee-for-service. Beginning July 1, 2003, and until two four years after the pilot project implementation date, subcontractor participation in the long-term care developmental disability pilot is limited to a nonprofit long-term care system providing ICF/MR services, home and community-based waiver services, and in-home services to no more than 120 consumers with developmental disabilities in Carver, Hennepin, and Scott Counties. The commissioner shall report to the legislature prior to expansion of the developmental disability pilot project. This paragraph expires two four years after the implementation date of the pilot project.

 

(c) Before implementation of a demonstration project for disabled persons, the commissioner must provide information to appropriate committees of the house of representatives and senate and must involve representatives of affected disability groups in the design of the demonstration projects.

 

(d) A nursing facility reimbursed under the alternative reimbursement methodology in section 256B.434 may, in collaboration with a hospital, clinic, or other health care entity provide services under paragraph (a). The commissioner shall amend the state plan and seek any federal waivers necessary to implement this paragraph.

 

(e) The commissioner, in consultation with the commissioners of commerce and health, may approve and implement programs for all-inclusive care for the elderly (PACE) according to federal laws and regulations governing that program and state laws or rules applicable to participating providers. The process for approval of these programs shall begin only after the commissioner receives grant money in an amount sufficient to cover the state share of the administrative and actuarial costs to implement the programs during state fiscal years 2006 and 2007. Grant amounts for this purpose shall be deposited in an account in the special revenue fund and are appropriated to the commissioner to be used solely for the purpose of PACE administrative and actuarial costs. A PACE provider is not required to be licensed or certified as a health plan company as defined in section 62Q.01, subdivision 4. Persons age 55 and older who have been screened by the county and found to be eligible for services under the elderly waiver or community alternatives for disabled individuals or who are already eligible for Medicaid but meet level of care criteria for receipt of waiver services may choose to enroll in the PACE program. Medicare and Medicaid services will be provided according to this subdivision and federal Medicare and Medicaid requirements governing PACE providers and programs. PACE enrollees will receive Medicaid home and community-based services through the PACE provider as an alternative to services for which they would otherwise be eligible through home and community-based waiver programs and Medicaid State Plan Services. The commissioner shall establish Medicaid rates for PACE providers that do not exceed costs that would have been incurred under fee-for-service or other relevant managed care programs operated by the state.

 

(f) The commissioner shall seek federal approval to expand the Minnesota disability health options (MnDHO) program established under this subdivision in stages, first to regional population centers outside the seven-county metro area and then to all areas of the state. Until January 1, 2008 July 1, 2009, expansion for MnDHO projects that include home and community-based services is limited to the two projects and service areas in effect on March 1, 2006. Enrollment in integrated MnDHO programs that include home and community-based services shall remain voluntary. Costs for home and community-based services included under MnDHO must not exceed costs that would have been incurred under the fee-for-service program. In developing program specifications for expansion of integrated programs, the commissioner shall involve and consult the state-level stakeholder group established in subdivision 28, paragraph (d), including consultation on whether and how to include home and community-based waiver programs. Plans for further expansion of MnDHO projects shall be presented to the chairs of the house and senate committees with jurisdiction over health and human services policy and finance by February 1, 2007.

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(g) Notwithstanding section 256B.0261, health plans providing services under this section are responsible for home care targeted case management and relocation targeted case management. Services must be provided according to the terms of the waivers and contracts approved by the federal government.

 

Sec. 69. [256C.261] SERVICES FOR DEAF-BLIND PERSONS.

 

(a) The commissioner of human services shall combine the existing biennial base level funding for deaf-blind services into a single grant program. At least 35 percent of the total funding is awarded for services and other supports to deaf-blind children and their families and at least 25 percent is awarded for services and other supports to deaf-blind adults.

 

The commissioner shall award grants for the purposes of:

 

(1) providing services and supports to individuals who are deaf-blind; and

 

(2) developing and providing training to counties and the network of senior citizen service providers. The purpose of the training grants is to teach counties how to use existing programs that capture federal financial participation to meet the needs of eligible deaf-blind persons and to build capacity of senior service programs to meet the needs of seniors with a dual sensory hearing and vision loss.

 

(b) The commissioner may make grants:

 

(1) for services and training provided by organizations; and

 

(2) to develop and administer consumer-directed services.

 

(c) Any entity that is able to satisfy the grant criteria is eligible to receive a grant under paragraph (a).

 

(d) Deaf-blind service providers may, but are not required to, provide intervenor services as part of the service package provided with grant funds under this section.

 

Sec. 70. Minnesota Statutes 2006, section 256I.04, subdivision 3, is amended to read:

 

Subd. 3. Moratorium on the development of group residential housing beds. (a) County agencies shall not enter into agreements for new group residential housing beds with total rates in excess of the MSA equivalent rate except:  (1) for group residential housing establishments licensed under Minnesota Rules, parts 9525.0215 to 9525.0355, provided the facility is needed to meet the census reduction targets for persons with developmental disabilities at regional treatment centers; (2) to ensure compliance with the federal Omnibus Budget Reconciliation Act alternative disposition plan requirements for inappropriately placed persons with developmental disabilities or mental illness; (3) up to 80 beds in a single, specialized facility located in Hennepin County that will provide housing for chronic inebriates who are repetitive users of detoxification centers and are refused placement in emergency shelters because of their state of intoxication, and planning for the specialized facility must have been initiated before July 1, 1991, in anticipation of receiving a grant from the Housing Finance Agency under section 462A.05, subdivision 20a, paragraph (b); (4) notwithstanding the provisions of subdivision 2a, for up to 190 supportive housing units in Anoka, Dakota, Hennepin, or Ramsey County for homeless adults with a mental illness, a history of substance abuse, or human immunodeficiency virus or acquired immunodeficiency syndrome. For purposes of this section, "homeless adult" means a person who is living on the street or in a shelter or discharged from a regional treatment center, community hospital, or residential treatment program and has no appropriate housing available and lacks the resources and support necessary to access appropriate housing. At least 70 percent of the supportive housing units must serve homeless adults with mental illness, substance abuse problems, or human

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immunodeficiency virus or acquired immunodeficiency syndrome who are about to be or, within the previous six months, has been discharged from a regional treatment center, or a state-contracted psychiatric bed in a community hospital, or a residential mental health or chemical dependency treatment program. If a person meets the requirements of subdivision 1, paragraph (a), and receives a federal or state housing subsidy, the group residential housing rate for that person is limited to the supplementary rate under section 256I.05, subdivision 1a, and is determined by subtracting the amount of the person's countable income that exceeds the MSA equivalent rate from the group residential housing supplementary rate. A resident in a demonstration project site who no longer participates in the demonstration program shall retain eligibility for a group residential housing payment in an amount determined under section 256I.06, subdivision 8, using the MSA equivalent rate. Service funding under section 256I.05, subdivision 1a, will end June 30, 1997, if federal matching funds are available and the services can be provided through a managed care entity. If federal matching funds are not available, then service funding will continue under section 256I.05, subdivision 1a; or (6) (5) for group residential housing beds in settings meeting the requirements of subdivision 2a, clauses (1) and (3), which are used exclusively for recipients receiving home and community-based waiver services under sections 256B.0915, 256B.092, subdivision 5, 256B.093, and 256B.49, and who resided in a nursing facility for the six months immediately prior to the month of entry into the group residential housing setting. The group residential housing rate for these beds must be set so that the monthly group residential housing payment for an individual occupying the bed when combined with the nonfederal share of services delivered under the waiver for that person does not exceed the nonfederal share of the monthly medical assistance payment made for the person to the nursing facility in which the person resided prior to entry into the group residential housing establishment. The rate may not exceed the MSA equivalent rate plus $426.37 for any case.; or (6) for an additional two beds, resulting in a total of 32 beds, for a facility located in Hennepin County providing services for recovering and chemically dependent men that has had a group residential housing contract with the county and has been licensed as a board and lodge facility with special services since 1980; (7) for a group residential housing provider located in Stearns County that operates a 40-bed facility, that received financing through the Minnesota Housing Finance Agency Ending Long-Term Homelessness Initiative and serves chemically dependent clientele, providing 24-hour-a-day supervision; and (8) for a new 65-bed facility in Crow Wing County that will serve chemically dependent persons, operated by a group residential housing provider that currently operates a 304-bed facility in Minneapolis, and a 44-bed facility in Duluth.

 

(b) A county agency may enter into a group residential housing agreement for beds with rates in excess of the MSA equivalent rate in addition to those currently covered under a group residential housing agreement if the additional beds are only a replacement of beds with rates in excess of the MSA equivalent rate which have been made available due to closure of a setting, a change of licensure or certification which removes the beds from group residential housing payment, or as a result of the downsizing of a group residential housing setting. The transfer of available beds from one county to another can only occur by the agreement of both counties.

 

Sec. 71. Minnesota Statutes 2006, section 256I.05, is amended by adding a subdivision to read:

 

Subd. 1h. Supplementary rate for certain facilities serving chemically dependent males. Notwithstanding subdivisions 1a and 1c, beginning July 1, 2007, a county agency shall negotiate a supplementary rate in addition to the rate specified in subdivision 1, not to exceed $737.87 per month, including any legislatively authorized inflationary adjustments, for a group residential housing provider that:

 

(1) is located in Ramsey County and has had a group residential housing contract with the county since 1982 and has been licensed as a board and lodge facility with special services since 1979; and

 

(2) serves recovering and chemically dependent males, providing 24-hour-a-day supervision.

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Sec. 72. Minnesota Statutes 2006, section 256I.05, is amended by adding a subdivision to read:

 

Subd. 1i. Supplementary rate for certain facilities; Hennepin County. Notwithstanding the provisions of subdivisions 1a and 1c, a county agency shall negotiate a supplementary rate in addition to the rate specified in subdivision 1, not to exceed $700 per month, including any legislatively authorized inflationary adjustments, for a facility located in Hennepin County with a capacity of up to 48 beds that has been licensed since 1978 as a board and lodging facility and that until August 1, 2007, operated as a licensed chemical dependency treatment program.

 

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

 

Sec. 73. Minnesota Statutes 2006, section 256I.05, is amended by adding a subdivision to read:

 

Subd. 1j. Supplementary rate for certain facilities; Crow Wing County. Notwithstanding the provisions of subdivisions 1a and 1c, beginning July 1, 2007, a county agency shall negotiate a supplementary rate in addition to the rate specified in subdivision 1, not to exceed $700 per month, including any legislatively authorized inflationary adjustments, for a new 65-bed facility in Crow Wing County that will serve chemically dependent persons operated by a group residential housing provider that currently operates a 304-bed facility in Minneapolis and a 44-bed facility in Duluth which opened in January of 2006.

 

Sec. 74. Minnesota Statutes 2006, section 256I.05, is amended by adding a subdivision to read:

 

Subd. 1k. Supplementary rate for certain facilities; Stearns County. Notwithstanding the provisions of this section, beginning July 1, 2007, a county agency shall negotiate a supplementary service rate in addition to the rate specified in subdivision 1, not to exceed $700 per month, including any legislatively authorized inflationary adjustments, for a group residential housing provider located in Stearns County that operates a 40-bed facility, that received financing through the Minnesota Housing Finance Agency Ending Long-Term Homelessness Initiative and serves chemically dependent clientele, providing 24-hour-a-day supervision.

 

Sec. 75. Minnesota Statutes 2006, section 256I.05, is amended by adding a subdivision to read:

 

Subd. 1l. Supplementary rate for certain facilities; St. Louis County. Notwithstanding the provisions of this section, beginning July 1, 2007, a county agency shall negotiate a supplementary service rate in addition to the rate specified in subdivision 1, not to exceed $700 per month, including any legislatively authorized inflationary adjustments, for a group residential housing provider located in St. Louis County that operates a 30-bed facility, that received financing through the Minnesota Housing Finance Agency Ending Long-Term Homelessness Initiative and serves chemically dependent clientele, providing 24-hour-a-day supervision.

 

Sec. 76. Minnesota Statutes 2006, section 256I.05, is amended by adding a subdivision to read:

 

Subd. 1m. Supplemental rate for certain facilities; Hennepin and Ramsey Counties. (a) Notwithstanding the provisions of this section, beginning July 1, 2007, a county agency shall negotiate a supplemental service rate in addition to the rate specified in subdivision 1, not to exceed $700 per month or the existing monthly rate, whichever is higher, including any legislatively authorized inflationary adjustments, for a group residential housing provider that operates two ten-bed facilities, one located in Hennepin County and one located in Ramsey County, which provide community support and serve the mental health needs of individuals who have chronically lived unsheltered, providing 24-hour per day supervision.

 

(b) An individual who has lived in one of the facilities under paragraph (a), who is being transitioned to independent living as part of the program plan continues to be eligible for group residential housing and the supplemental service rate negotiated with the county under paragraph (a).

 

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

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Sec. 77. Minnesota Statutes 2006, section 462A.05, is amended by adding a subdivision to read:

 

Subd. 42. Reverse mortgage incentive program. (a) The agency shall, within the limits of appropriations made available for this purpose, establish, in cooperation with the commissioner of human services, a program to encourage eligible persons to obtain reverse mortgages to pay for eligible costs of maintaining the person in the home as an alternative to a nursing facility placement.

 

(b) The incentive program shall be made available to a person who has been determined by the commissioner of human services or the commissioner's designated agent to meet all of the following criteria:

 

(1) is age 62 or older;

 

(2) would be eligible for medical assistance within 365 days of admission to a nursing home;

 

(3) is not a medical assistance recipient, is not eligible for medical assistance without a spenddown or waiver obligation, is not ineligible for the medical assistance program due to an asset transfer penalty, and does not have income greater than the maintenance needs allowance under section 256B.0915, subdivision 1d, but equal to or less than 120 percent of the federal poverty guidelines effective July 1 in the year for which program eligibility is established, who would be eligible for the elderly waiver with a waiver obligation;

 

(4) needs services that are not funded through other state or federal funding for which the person qualifies;

 

(5) obtains a reverse mortgage loan under section 47.58 on a home with an estimated market value not to exceed $156,000. This limit shall be adjusted annually on April 1 by the percentage change for the previous calendar year in the housing component of the United States Consumer Price Index - all urban consumers; and

 

(6) agrees to make expenditures of reverse mortgage payments according to a spending plan established under section 256B.0911, subdivision 3a, in which payments, services, and supports meet the following standards:

 

(i) payments received under the loan for a period of at least 24 months or in an amount of at least $15,000 are used for services and supports, including basic shelter needs, home maintenance, and modifications or adaptations, necessary to allow the person to remain in the home as an alternative to a nursing facility placement;

 

(ii) reimbursements for services, supplies, and equipment shall not exceed the market rate; and

 

(iii) if the person's spouse qualifies under section 256B.0913, subdivisions 1 to 14, the reverse mortgage payments may be used to pay client fees under that section.

 

(c) The incentives available under this program shall include:

 

(1) payment of the initial mortgage insurance premium for a reverse mortgage. The maximum payment under this clause shall be limited to $1,560. This limit shall be adjusted annually on April 1 by the percentage change for the previous calendar year in the housing component of the United States Consumer Price Index - all urban consumers;

 

(2) with federal approval, payments to reduce service fee set-asides, through an advance payment to the lender, an agreement to guarantee fee payments after 60 months if the set-aside is limited to 60 months, or through other mechanisms approved by the commissioner; and

 

(3) other incentives approved by the commissioner.

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(d) After calculating the adjusted maximum payment limits under paragraphs (b) and (c), the commissioner shall annually notify the Office of the Revisor of Statutes in writing, on or before May 1, of the adjusted limits. The revisor shall annually publish in the Minnesota Statutes the adjusted maximum payment limits under paragraph (b).

 

Sec. 78. Laws 2006, chapter 282, article 20, section 37, is amended to read:

 

Sec. 37. REPAYMENT DELAY.

 

(a) A county that overspent its allowed amounts in calendar year 2004 or 2005 under the waivered services program for persons with developmental disabilities shall not be required to pay back the amount of overspending until May 31, 2007. This section applies to Fillmore, Steele, and St. Louis Counties.

 

(b) Carver County is not required to pay back the amount of overspending under the waivered services program for persons with developmental disabilities for calendar years 2004 and 2005 until June 30, 2009.

 

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

 

Sec. 79. ASSISTIVE TECHNOLOGY RECOMMENDATIONS.

 

Subdivision 1. Review. During the biennium ending June 30, 2009, the Council on Disability shall facilitate a statewide review of the assistive technology needs of people with disabling conditions, and seniors. The council shall identify community-based service providers, state agencies, and other entities involved in providing assistive technology supports.

 

Subd. 2. Recommendations. The council shall present to the chairs of the house and senate committees having jurisdiction over human services, by January 1, 2009, recommendations, including proposed legislation creating a statewide comprehensive plan to meet the assistive technology needs of people with disabling conditions and seniors. The statewide plan must include steps to coordinate and streamline assistive technology services.

 

Sec. 80. PROVIDER RATE INCREASES.

 

(a) The commissioner of human services shall increase allocations, reimbursement rates, or rate limits, as applicable, by 3.00 percent beginning October 1, 2007, and by 3.00 percent beginning October 1, 2008, effective for services rendered on or after those dates. County contracts for services specified in this section must be amended to pass through these rate adjustments within 60 days of the effective date of the increase and must be retroactive from the effective date of the rate adjustment.

 

(b) The annual rate increases described in this section must be provided to:

 

(1) home and community-based waivered services for persons with developmental disabilities or related conditions, including consumer-directed community supports, under Minnesota Statutes, section 256B.501;

 

(2) home and community-based waivered services for the elderly, including consumer-directed community supports, under Minnesota Statutes, section 256B.0915;

 

(3) waivered services under community alternatives for disabled individuals, including consumer-directed community supports, under Minnesota Statutes, section 256B.49;

 

(4) community alternative care waivered services, including consumer-directed community supports, under Minnesota Statutes, section 256B.49;

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(5) traumatic brain injury waivered services, including consumer-directed community supports, under Minnesota Statutes, section 256B.49;

 

(6) nursing services and home health services under Minnesota Statutes, section 256B.0625, subdivision 6a;

 

(7) personal care services and qualified professional supervision of personal care services under Minnesota Statutes, section 256B.0625, subdivision 19a;

 

(8) private duty nursing services under Minnesota Statutes, section 256B.0625, subdivision 7;

 

(9) day training and habilitation services for adults with developmental disabilities or related conditions under Minnesota Statutes, sections 252.40 to 252.46, including the additional cost of rate adjustments on day training and habilitation services, provided as a social service under Minnesota Statutes, section 256M.60;

 

(10) alternative care services under Minnesota Statutes, section 256B.0913;

 

(11) adult residential program grants under Minnesota Statutes, section 245.73;

 

(12) children's community-based mental health services grants and adult community support and case management services grants under Minnesota Rules, parts 9535.1700 to 9535.1760;

 

(13) the group residential housing supplementary service rate under Minnesota Statutes, section 256I.05, subdivision 1a;

 

(14) adult mental health integrated fund grants under Minnesota Statutes, section 245.4661;

 

(15) semi-independent living services (SILS) under Minnesota Statutes, section 252.275, including SILS funding under county social services grants formerly funded under Minnesota Statutes, chapter 256I;

 

(16) community support services for deaf and hard-of-hearing adults with mental illness who use or wish to use sign language as their primary means of communication under Minnesota Statutes, section 256.01, subdivision 2; and deaf and hard-of-hearing grants under Minnesota Statutes, sections 256C.233 and 256C.25; Laws 1985, chapter 9, article 1; and Laws 1997, First Special Session chapter 5, section 20;

 

(17) living skills training programs for persons with intractable epilepsy who need assistance in the transition to independent living under Laws 1988, chapter 689;

 

(18) physical therapy services under sections 256B.0625, subdivision 8, and 256D.03, subdivision 4;

 

(19) occupational therapy services under sections 256B.0625, subdivision 8a, and 256D.03, subdivision 4;

 

(20) speech-language therapy services under section 256D.03, subdivision 4, and Minnesota Rules, part 9505.0390;

 

(21) respiratory therapy services under section 256D.03, subdivision 4, and Minnesota Rules, part 9505.0295;

 

(22) adult rehabilitative mental health services under section 256B.0623;

 

(23) children's therapeutic services and support services under section 256B.0943;

 

(24) tier I chemical health services under Minnesota Statutes, chapter 254B;

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(25) consumer support grants under Minnesota Statutes, section 256.476;

 

(26) family support grants under Minnesota Statutes, section 252.32;

 

(27) grants for case management services to persons with HIV or AIDS under Minnesota Statutes, section 256.01, subdivision 19; and

 

(28) aging grants under Minnesota Statutes, sections 256.975 to 256.977, 256B.0917, and 256B.0928.

 

(c) For services funded through Minnesota disability health options, the rate increases under this section apply to all medical assistance payments, including former group residential housing supplementary rates under Minnesota Statutes, chapter 256I.

 

(d) The commissioner may recoup payments made under this section from a provider that does not comply with paragraphs (f) and (g).

 

(e) A managed care plan receiving state payments for the services in this section must include these increases in their payments to providers on a prospective basis, effective on January 1 following the effective date of the rate increase.

 

(f) Providers that receive a rate increase under this section shall use 75 percent of the additional revenue to increase compensation-related costs for employees directly employed by the program on or after the effective date of the rate adjustments, except:

 

(1) the administrator;

 

(2) persons employed in the central office of a corporation or entity that has an ownership interest in the provider or exercises control over the provider; and

 

(3) persons paid by the provider under a management contract.

 

Compensation-related costs include: wages and salaries; FICA taxes, Medicare taxes, state and federal unemployment taxes, and workers' compensation; and the employer's share of health and dental insurance, life insurance, disability insurance, long-term care insurance, uniform allowance, and pensions.

 

(g) Two-thirds of the money available under paragraph (f) must be used for wage increases for all employees directly employed by the provider on or after the effective date of the rate adjustments, except those listed in paragraph (f), clauses (1) to (3). The wage adjustment that employees receive under this paragraph must be paid as an equal hourly percentage wage increase for all eligible employees. This paragraph shall not apply to:

 

(1) employees eligible for a Taft-Hartley insurance plan established under United States Code, title 29, section 186(c)(5); or

 

(2) public employees.

 

(h) For public employees, the increase for wages and benefits for certain staff is available and pay rates must be increased only to the extent that they comply with laws governing public employees collective bargaining. Money received by a provider for pay increases under this section may be used only for increases implemented on or after the first day of the rate period in which the increase is available and must not be used for increases implemented prior to that date.

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(i) The commissioner shall amend state grant contracts that include direct personnel-related grant expenditures to include the allocation for the portion of the contract that is employee compensation related. Grant contracts for compensation-related services must be amended to pass through these adjustments within 60 days of the effective date of the increase and must be retroactive to the effective date of the rate adjustment.

 

(j) The Board on Aging and its Area Agencies on Aging shall amend their grants that include direct personnel-related grant expenditures to include the rate adjustment for the portion of the grant that is employee compensation related. Grants for compensation-related services must be amended to pass through these adjustments within 60 days of the effective date of the increase and must be retroactive to the effective date of the rate adjustment.

 

(k) The calendar year 2008 rate for vendors reimbursed under Minnesota Statutes, chapter 254B, shall be at least 3.0 percent above the rate in effect on January 1, 2007. The calendar year 2009 rate shall be at least 3.0 percent above the rate in effect on January 1, 2008.

 

(l) Providers that receive a rate adjustment under paragraph (a) that is subject to paragraphs (f) and (g) shall provide to the commissioner, and those counties with whom they have a contract, within six months after the effective date of each rate adjustment, a letter, in a format specified by the commissioner, that provides assurances that the provider has developed and implemented a compensation plan and complied with paragraphs (f) and (g). The provider shall keep on file, and produce for the commissioner or county upon request, its plan, which must specify:

 

(1) an estimate of the amounts of money that must be used as specified in paragraphs (f) and (g); and

 

(2) a detailed distribution plan specifying the allowable compensation-related and wage increases the provider will implement to use the funds available in clause (1).

 

(m) Within six months after the effective date of each rate adjustment, the provider shall post this plan, excluding the information required in paragraph (l), clause (1), for a period of at least six weeks in an area of the provider's operation to which all eligible employees have access and provide instructions for employees who believe they have not received the wage and other compensation-related increases specified in paragraph (l), clause (2). Instructions must include a mailing address, e-mail address, and the telephone number that may be used by the employee to contact the commissioner or the commissioner's representative. Providers shall also make assurances to the commissioner and counties with whom they have a contract that they have complied with the requirement in this paragraph.

 

Sec. 81. MINNESOTA RULES.

 

The Department of Administration shall publish adopted rules in the State Register making the terminology changes specified in section 84 in Minnesota Rules. Upon publication in the State Register, the terminology changes for Minnesota Rules are adopted without further administrative action.

 

Sec. 82. HOUSING WITH SERVICES AND HOME CARE PROVIDERS STUDY; REPORT.

 

The commissioner of human services shall conduct a study of housing with services establishments and their arranged home care providers to assess the impact that spending down to eligibility for public programs by residents who are age 65 or older has on public expenditures. The preliminary results of this study shall be reported to the house and senate committees with jurisdiction over health and human services policy and finance issues by February 15, 2008, with a final report completed by December 15, 2008. Housing with services establishments and home care providers shall provide information upon request of the commissioner in order to achieve study outcomes, including:

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(1) length of stay of residents in the housing with services establishment;

 

(2) housing and services provided and related charges, payments, and payment sources;

 

(3) housing and services included in base rates charged to all residents;

 

(4) reasons for termination of services;

 

(5) reasons for termination of leases;

 

(6) copies of contracts, agreements, and leases;

 

(7) resident demographics; and

 

(8) other information as requested by the commissioner.

 

Sec. 83. PROVIDER RATE INCREASE.

 

Effective July 1, 2007, a day training and habilitation provider in St. Louis County providing services for up to 80 individuals shall have a reimbursement rate that equals 94 percent of 125 percent of the statewide median per diem.

 

Sec. 84. REVISOR'S INSTRUCTION.

 

The revisor of statutes shall change the terms in column A to the terms in column B wherever they appear in Minnesota Statutes:

 

                                                 Column A                                                                            Column B

 

              "Office of Ombudsman for Older Minnesotans and"                             "Office of Ombudsman

              "Office of the Ombudsman for Older Minnesotans"                              for Long-Term Care"

 

              "ombudsman for older Minnesotans"                                                      "ombudsman for long-term care"

 

Sec. 85. REPEALER.

 

Minnesota Statutes 2006, sections 252.21; 252.22; 252.23; 252.24; 252.25; 252.261; 252.275, subdivision 5; 256.9743; 256B.0913, subdivisions 5b, 5c, 5d, 5e, 5f, 5g, and 5h; and 256B.441, subdivisions 12, 16, 21, 26, 28, 42, and 45, are repealed.

 

ARTICLE 8

 

MENTAL HEALTH

 

Section 1. [16C.155] JANITORIAL CONTRACTS FOR REHABILITATION PROGRAMS AND EXTENDED EMPLOYMENT PROVIDERS.

 

The commissioner of administration shall ensure that a portion of all janitorial services contracts be awarded by the state to rehabilitation programs and extended employment providers listed under section 16C.15. The total value of the contracts under this section must exceed 19 percent of the total value of janitorial services contracts entered into in the previous fiscal year. The amount of each contract awarded under this section may exceed the estimated fair market price for the same goods and services by up to five percent.

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Sec. 2. Minnesota Statutes 2006, section 148C.11, subdivision 1, is amended to read:

 

Subdivision 1. Other professionals. (a) Nothing in this chapter prevents members of other professions or occupations from performing functions for which they are qualified or licensed. This exception includes, but is not limited to: licensed physicians; registered nurses; licensed practical nurses; licensed psychological practitioners; members of the clergy; American Indian medicine men and women; licensed attorneys; probation officers; licensed marriage and family therapists; licensed social workers; social workers employed by city, county, or state agencies; licensed professional counselors; licensed school counselors; registered occupational therapists or occupational therapy assistants; city, county, or state employees when providing assessments or case management under Minnesota Rules, chapter 9530; and until July 1, 2007 2009, individuals providing integrated dual-diagnosis treatment in adult mental health rehabilitative programs certified by the Department of Human Services under section 256B.0622 or 256B.0623.

 

(b) Nothing in this chapter prohibits technicians and resident managers in programs licensed by the Department of Human Services from discharging their duties as provided in Minnesota Rules, chapter 9530.

 

(c) Any person who is exempt under this subdivision but who elects to obtain a license under this chapter is subject to this chapter to the same extent as other licensees. The board shall issue a license without examination to an applicant who is licensed or registered in a profession identified in paragraph (a) if the applicant:

 

(1) shows evidence of current licensure or registration; and

 

(2) has submitted to the board a plan for supervision during the first 2,000 hours of professional practice or has submitted proof of supervised professional practice that is acceptable to the board.

 

(d) Any person who is exempt from licensure under this section must not use a title incorporating the words "alcohol and drug counselor" or "licensed alcohol and drug counselor" or otherwise hold themselves out to the public by any title or description stating or implying that they are engaged in the practice of alcohol and drug counseling, or that they are licensed to engage in the practice of alcohol and drug counseling unless that person is also licensed as an alcohol and drug counselor. Persons engaged in the practice of alcohol and drug counseling are not exempt from the board's jurisdiction solely by the use of one of the above titles.

 

Sec. 3. Minnesota Statutes 2006, section 245.462, subdivision 20, is amended to read:

 

Subd. 20. Mental illness. (a) "Mental illness" means an organic disorder of the brain or a clinically significant disorder of thought, mood, perception, orientation, memory, or behavior that is listed in the clinical manual of the International Classification of Diseases (ICD-9-CM), current edition, code range 290.0 to 302.99 or 306.0 to 316.0 or the corresponding code in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-MD), current edition, Axes I, II, or III, and that seriously limits a person's capacity to function in primary aspects of daily living such as personal relations, living arrangements, work, and recreation.

 

(b) An "adult with acute mental illness" means an adult who has a mental illness that is serious enough to require prompt intervention.

 

(c) For purposes of case management and community support services, a "person with serious and persistent mental illness" means an adult who has a mental illness and meets at least one of the following criteria:

 

(1) the adult has undergone two or more episodes of inpatient care for a mental illness within the preceding 24 months;

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(2) the adult has experienced a continuous psychiatric hospitalization or residential treatment exceeding six months' duration within the preceding 12 months;

 

(3) the adult has been treated by a crisis team two or more times within the preceding 24 months;

 

(4) the adult:

 

(i) has a diagnosis of schizophrenia, bipolar disorder, major depression, or borderline personality disorder;

 

(ii) indicates a significant impairment in functioning; and

 

(iii) has a written opinion from a mental health professional, in the last three years, stating that the adult is reasonably likely to have future episodes requiring inpatient or residential treatment, of a frequency described in clause (1) or (2), unless ongoing case management or community support services are provided;

 

(4) (5) the adult has, in the last three years, been committed by a court as a person who is mentally ill under chapter 253B, or the adult's commitment has been stayed or continued; or

 

(5) (6) the adult (i) was eligible under clauses (1) to (4) (5), but the specified time period has expired or the adult was eligible as a child under section 245.4871, subdivision 6; and (ii) has a written opinion from a mental health professional, in the last three years, stating that the adult is reasonably likely to have future episodes requiring inpatient or residential treatment, of a frequency described in clause (1) or (2), unless ongoing case management or community support services are provided.

 

Sec. 4. Minnesota Statutes 2006, section 245.465, is amended by adding a subdivision to read:

 

Subd. 3. Responsibility not duplicated. For individuals who have health care coverage, the county board is not responsible for providing mental health services which are within the limits of the individual's health care coverage.

 

Sec. 5. [245.4682] MENTAL HEALTH SERVICE DELIVERY AND FINANCE REFORM.

 

Subdivision 1. Policy. The commissioner of human services shall undertake a series of reforms to address the underlying structural, financial, and organizational problems in Minnesota's mental health system with the goal of improving the availability, quality, and accountability of mental health care within the state.

 

Subd. 2. General provisions. (a) In the design and implementation of reforms to the mental health system, the commissioner shall:

 

(1) consult with consumers, families, counties, tribes, advocates, providers, and other stakeholders;

 

(2) bring to the legislature, and the State Advisory Council on Mental Health, by January 15, 2008, recommendations for legislation to update the role of counties and to clarify the case management roles, functions, and decision-making authority of health plans and counties, and to clarify county retention of the responsibility for the delivery of social services as required under subdivision 3, paragraph (a);

 

(3) withhold implementation of any recommended changes in case management roles, functions, and decision-making authority until after the release of the report due January 15, 2008;

 

(4) ensure continuity of care for persons affected by these reforms including ensuring client choice of provider by requiring broad provider networks and developing mechanisms to facilitate a smooth transition of service responsibilities;

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(5) provide accountability for the efficient and effective use of public and private resources in achieving positive outcomes for consumers;

 

(6) ensure client access to applicable protections and appeals; and

 

(7) make budget transfers necessary to implement the reallocation of services and client responsibilities between counties and health care programs that do not increase the state and county costs and efficiently allocate state funds.

 

(b) When making transfers under paragraph (a) necessary to implement movement of responsibility for clients and services between counties and health care programs, the commissioner, in consultation with counties, shall ensure that any transfer of state grants to health care programs, including the value of case management transfer grants under section 256B.0625, subdivision 20, does not exceed the value of the services being transferred for the latest 12-month period for which data is available. The commissioner may make quarterly adjustments based on the availability of additional data during the first four quarters after the transfers first occur. If case management transfer grants under section 256B.0625, subdivision 20, are repealed and the value, based on the last year prior to repeal, exceeds the value of the services being transferred, the difference becomes an ongoing part of each county's adult and children's mental health grants under sections 245.4661, 245.4889, and 256E.12.

 

(c) This appropriation is not authorized to be expended after December 31, 2010, unless approved by the legislature.

 

Subd. 3. Projects for coordination of care. (a) Consistent with section 256B.69 and chapters 256D and 256L, the commissioner is authorized to solicit, approve, and implement up to three projects to demonstrate the integration of physical and mental health services within prepaid health plans and their coordination with social services. The commissioner shall require that each project be based on locally defined partnerships that include at least one health maintenance organization, community integrated service network, or accountable provider network authorized and operating under chapter 62D, 62N, or 62T, or county-based purchasing entity under section 256B.692 that is eligible to contract with the commissioner as a prepaid health plan, and the county or counties within the service area. Counties shall retain responsibility and authority for social services in these locally defined partnerships.

 

(b) The commissioner, in consultation with consumers, families, and their representatives, shall:

 

(1) determine criteria for approving the projects and use those criteria to solicit proposals for preferred integrated networks. The commissioner must develop criteria to evaluate the partnership proposed by the county and prepaid health plan to coordinate access and delivery of services. The proposal must at a minimum address how the partnership will coordinate the provision of:

 

(i) client outreach and identification of health and social service needs paired with expedited access to appropriate resources;

 

(ii) activities to maintain continuity of health care coverage;

 

(iii) children's residential mental health treatment and treatment foster care;

 

(iv) court-ordered assessments and treatments;

 

(v) prepetition screening and commitments under chapter 253B;

 

(vi) assessment and treatment of children identified through mental health screening of child welfare and juvenile corrections cases;

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(vii) home and community-based waiver services;

 

(viii) assistance with finding and maintaining employment;

 

(ix) housing; and

 

(x) transportation;

 

(2) determine specifications for contracts with prepaid health plans to improve the plan's ability to serve persons with mental health conditions, including specifications addressing:

 

(i) early identification and intervention of physical and behavioral health problems;

 

(ii) communication between the enrollee and the health plan;

 

(iii) facilitation of enrollment for persons who are also eligible for a Medicare special needs plan offered by the health plan;

 

(iv) risk screening procedures;

 

(v) health care coordination;

 

(vi) member services and access to applicable protections and appeal processes;

 

(vii) specialty provider networks;

 

(viii) transportation services;

 

(ix) treatment planning; and

 

(x) administrative simplification for providers;

 

(3) begin implementation of the projects no earlier than January 1, 2009, with not more than 40 percent of the statewide population included during calendar year 2009 and additional counties included in subsequent years;

 

(4) waive any administrative rule not consistent with the implementation of the projects;

 

(5) allow potential bidders at least 90 days to respond to the request for proposals; and

 

(6) conduct an independent evaluation to determine if mental health outcomes have improved in that county or counties according to measurable standards designed in consultation with the advisory body established under this subdivision and reviewed by the State Advisory Council on Mental Health.

 

(c) Notwithstanding any statute or administrative rule to the contrary, the commissioner may enroll all persons eligible for medical assistance with serious mental illness or emotional disturbance in the prepaid plan of their choice within the project service area unless:

 

(1) the individual is eligible for home and community-based services for persons with developmental disabilities and related conditions under section 256B.092; or

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(2) the individual has a basis for exclusion from the prepaid plan under section 256B.69, subdivision 4, other than disability, mental illness, or emotional disturbance.

 

(d) The commissioner shall involve organizations representing persons with mental illness and their families in the development and distribution of information used to educate potential enrollees regarding their options for health care and mental health service delivery under this subdivision.

 

(e) If the person described in paragraph (c) does not elect to remain in fee-for-service medical assistance, or declines to choose a plan, the commissioner may preferentially assign that person to the prepaid plan participating in the preferred integrated network. The commissioner shall implement the enrollment changes within a project's service area on the timeline specified in that project's approved application.

 

(f) A person enrolled in a prepaid health plan under paragraphs (c) and (d) may disenroll from the plan at any time.

 

(g) The commissioner, in consultation with consumers, families, and their representatives, shall evaluate the projects begun in 2009, and shall refine the design of the service integration projects before expanding the projects. The commissioner shall report to the chairs of the legislative committees with jurisdiction over mental health services by March 1, 2008, on plans for evaluation of preferred integrated networks established under this subdivision.

 

(h) The commissioner shall apply for any federal waivers necessary to implement these changes.

 

(i) Payment for Medicaid service providers under this subdivision for the months of May and June will be made no earlier than July 1 of the same calendar year.

 

Sec. 6. Minnesota Statutes 2006, section 245.4712, subdivision 1, is amended to read:

 

Subdivision 1. Availability of community support services. (a) County boards must provide or contract for sufficient community support services within the county to meet the needs of adults with serious and persistent mental illness who are residents of the county. Adults may be required to pay a fee according to section 245.481. The community support services program must be designed to improve the ability of adults with serious and persistent mental illness to:

 

(1) work in a regular or supported work environment;

 

(2) handle basic activities of daily living;

 

(3) participate in leisure time activities;

 

(4) set goals and plans; and

 

(5) obtain and maintain appropriate living arrangements.

 

The community support services program must also be designed to reduce the need for and use of more intensive, costly, or restrictive placements both in number of admissions and length of stay.

 

(b) Community support services are those services that are supportive in nature and not necessarily treatment oriented, and include:

 

(1) conducting outreach activities such as home visits, health and wellness checks, and problem solving;

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(2) connecting people to resources to meet their basic needs;

 

(3) finding, securing, and supporting people in their housing;

 

(4) attaining and maintaining health insurance benefits;

 

(5) assisting with job applications, finding and maintaining employment, and securing a stable financial situation;

 

(6) fostering social support, including support groups, mentoring, peer support, and other efforts to prevent isolation and promote recovery; and

 

(7) educating about mental illness, treatment, and recovery.

 

(c) Community support services shall use all available funding streams. The county shall maintain the level of expenditures for this program, as required under section 245.4835. County boards must continue to provide funds for those services not covered by other funding streams and to maintain an infrastructure to carry out these services.

 

(d) The commissioner shall collect data on community support services programs, including, but not limited to, demographic information such as age, sex, race, the number of people served, and information related to housing, employment, hospitalization, symptoms, and satisfaction with services.

 

Sec. 7. Minnesota Statutes 2006, section 245.4874, is amended to read:

 

245.4874 DUTIES OF COUNTY BOARD.

 

Subdivision 1. Duties of the county board. (a) The county board must:

 

(1) develop a system of affordable and locally available children's mental health services according to sections 245.487 to 245.4887;

 

(2) establish a mechanism providing for interagency coordination as specified in section 245.4875, subdivision 6;

 

(3) consider the assessment of unmet needs in the county as reported by the local children's mental health advisory council under section 245.4875, subdivision 5, paragraph (b), clause (3). The county shall provide, upon request of the local children's mental health advisory council, readily available data to assist in the determination of unmet needs;

 

(4) assure that parents and providers in the county receive information about how to gain access to services provided according to sections 245.487 to 245.4887;

 

(5) coordinate the delivery of children's mental health services with services provided by social services, education, corrections, health, and vocational agencies to improve the availability of mental health services to children and the cost-effectiveness of their delivery;

 

(6) assure that mental health services delivered according to sections 245.487 to 245.4887 are delivered expeditiously and are appropriate to the child's diagnostic assessment and individual treatment plan;

 

(7) provide the community with information about predictors and symptoms of emotional disturbances and how to access children's mental health services according to sections 245.4877 and 245.4878;

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(8) provide for case management services to each child with severe emotional disturbance according to sections 245.486; 245.4871, subdivisions 3 and 4; and 245.4881, subdivisions 1, 3, and 5;

 

(9) provide for screening of each child under section 245.4885 upon admission to a residential treatment facility, acute care hospital inpatient treatment, or informal admission to a regional treatment center;

 

(10) prudently administer grants and purchase-of-service contracts that the county board determines are necessary to fulfill its responsibilities under sections 245.487 to 245.4887;

 

(11) assure that mental health professionals, mental health practitioners, and case managers employed by or under contract to the county to provide mental health services are qualified under section 245.4871;

 

(12) assure that children's mental health services are coordinated with adult mental health services specified in sections 245.461 to 245.486 so that a continuum of mental health services is available to serve persons with mental illness, regardless of the person's age;

 

(13) assure that culturally informed competent mental health consultants are used as necessary to assist the county board in assessing and providing appropriate treatment for children of cultural or racial minority heritage; and

 

(14) consistent with section 245.486, arrange for or provide a children's mental health screening to a child receiving child protective services or a child in out-of-home placement, a child for whom parental rights have been terminated, a child found to be delinquent, and a child found to have committed a juvenile petty offense for the third or subsequent time, unless a screening has been performed within the previous 180 days, or the child is currently under the care of a mental health professional. The court or county agency must notify a parent or guardian whose parental rights have not been terminated of the potential mental health screening and the option to prevent the screening by notifying the court or county agency in writing. The screening shall be conducted with a screening instrument approved by the commissioner of human services according to criteria that are updated and issued annually to ensure that approved screening instruments are valid and useful for child welfare and juvenile justice populations, and shall be conducted by a mental health practitioner as defined in section 245.4871, subdivision 26, or a probation officer or local social services agency staff person who is trained in the use of the screening instrument. Training in the use of the instrument shall include training in the administration of the instrument, the interpretation of its validity given the child's current circumstances, the state and federal data practices laws and confidentiality standards, the parental consent requirement, and providing respect for families and cultural values. If the screen indicates a need for assessment, the child's family, or if the family lacks mental health insurance, the local social services agency, in consultation with the child's family, shall have conducted a diagnostic assessment, including a functional assessment, as defined in section 245.4871. The administration of the screening shall safeguard the privacy of children receiving the screening and their families and shall comply with the Minnesota Government Data Practices Act, chapter 13, and the federal Health Insurance Portability and Accountability Act of 1996, Public Law 104-191. Screening results shall be considered private data and the commissioner shall not collect individual screening results.

 

(b) When the county board refers clients to providers of children's therapeutic services and supports under section 256B.0943, the county board must clearly identify the desired services components not covered under section 256B.0943 and identify the reimbursement source for those requested services, the method of payment, and the payment rate to the provider.

 

Subd. 2. Responsibility not duplicated. For individuals who have health care coverage, the county board is not responsible for providing mental health services which are within the limits of the individual's health care coverage.

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Sec. 8. [245.4889] CHILDREN'S MENTAL HEALTH GRANTS.

 

Subdivision 1. Establishment and authority. (a) The commissioner is authorized to make grants from available appropriations to assist:

 

(1) counties;

 

(2) Indian tribes;

 

(3) children's collaboratives under section 124D.23 or 245.493; or

 

(4) mental health service providers

 

for providing services to children with emotional disturbances as defined in section 245.4871, subdivision 15, and their families. The commissioner may also authorize grants to young adults meeting the criteria for transition services in section 245.4875, subdivision 8, and their families.

 

(b) Services under paragraph (a) must be designed to help each child to function and remain with the child's family in the community and delivered consistent with the child's treatment plan. Transition services to eligible young adults under paragraph (a) must be designed to foster independent living in the community.

 

Subd. 2. Grant application and reporting requirements. To apply for a grant, an applicant organization shall submit an application and budget for the use of the money in the form specified by the commissioner. The commissioner shall make grants only to entities whose applications and budgets are approved by the commissioner. In awarding grants, the commissioner shall give priority to applications that indicate plans to collaborate in the development, funding, and delivery of services with other agencies in the local system of care. The commissioner shall specify requirements for reports, including quarterly fiscal reports under section 256.01, subdivision 2, paragraph (q). The commissioner shall require collection of data and periodic reports that the commissioner deems necessary to demonstrate the effectiveness of each service.

 

Sec. 9. Minnesota Statutes 2006, section 245.50, subdivision 5, is amended to read:

 

Subd. 5. Special contracts; bordering states. (a) An individual who is detained, committed, or placed on an involuntary basis under chapter 253B may be confined or treated in a bordering state pursuant to a contract under this section. An individual who is detained, committed, or placed on an involuntary basis under the civil law of a bordering state may be confined or treated in Minnesota pursuant to a contract under this section. A peace or health officer who is acting under the authority of the sending state may transport an individual to a receiving agency that provides services pursuant to a contract under this section and may transport the individual back to the sending state under the laws of the sending state. Court orders valid under the law of the sending state are granted recognition and reciprocity in the receiving state for individuals covered by a contract under this section to the extent that the court orders relate to confinement for treatment or care of mental illness or chemical dependency. Such treatment or care may address other conditions that may be co-occurring with the mental illness or chemical dependency. These court orders are not subject to legal challenge in the courts of the receiving state. Individuals who are detained, committed, or placed under the law of a sending state and who are transferred to a receiving state under this section continue to be in the legal custody of the authority responsible for them under the law of the sending state. Except in emergencies, those individuals may not be transferred, removed, or furloughed from a receiving agency without the specific approval of the authority responsible for them under the law of the sending state.

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(b) While in the receiving state pursuant to a contract under this section, an individual shall be subject to the sending state's laws and rules relating to length of confinement, reexaminations, and extensions of confinement. No individual may be sent to another state pursuant to a contract under this section until the receiving state has enacted a law recognizing the validity and applicability of this section.

 

(c) If an individual receiving services pursuant to a contract under this section leaves the receiving agency without permission and the individual is subject to involuntary confinement under the law of the sending state, the receiving agency shall use all reasonable means to return the individual to the receiving agency. The receiving agency shall immediately report the absence to the sending agency. The receiving state has the primary responsibility for, and the authority to direct, the return of these individuals within its borders and is liable for the cost of the action to the extent that it would be liable for costs of its own resident.

 

(d) Responsibility for payment for the cost of care remains with the sending agency.

 

(e) This subdivision also applies to county contracts under subdivision 2 which include emergency care and treatment provided to a county resident in a bordering state.

 

(f) If a Minnesota resident is admitted to a facility in a bordering state under this chapter, a physician, licensed psychologist who has a doctoral degree in psychology, or an advance practice registered nurse certified in mental health, who is licensed in the bordering state, may act as an examiner under sections 253B.07, 253B.08, 253B.092, 253B.12, and 253B.17 subject to the same requirements and limitations in section 253B.02, subdivision 7.

 

Sec. 10. Minnesota Statutes 2006, section 245.98, subdivision 2, is amended to read:

 

Subd. 2. Program. The commissioner of human services shall establish a program for the treatment of compulsive gamblers. The commissioner may contract with an entity with expertise regarding the treatment of compulsive gambling to operate the program. The program may include the establishment of a statewide toll-free number, resource library, public education programs; regional in-service training programs and conferences for health care professionals, educators, treatment providers, employee assistance programs, and criminal justice representatives; and the establishment of certification standards for programs and service providers. The commissioner may enter into agreements with other entities and may employ or contract with consultants to facilitate the provision of these services or the training of individuals to qualify them to provide these services. The program may also include inpatient and outpatient treatment and rehabilitation services and for residents in different settings, including a temporary or permanent residential setting for mental health or chemical dependency, and individuals in jails or correctional facilities. The program may also include research studies. The research studies must include baseline and prevalence studies for adolescents and adults to identify those at the highest risk. The program must be approved by the commissioner before it is established.

 

Sec. 11. [245A.175] MENTAL HEALTH TRAINING REQUIREMENT.

 

Prior to nonemergency placement of a child in a foster care home, the child foster care provider, licensed after July 1, 2007, must complete two hours of training that addresses the causes, symptoms, and key warning signs of mental health disorders; cultural considerations; and effective approaches for dealing with a child's behaviors. At least one hour of the annual 12-hour training requirement for foster parents must be on children's mental health issues and treatment. Training curriculum shall be approved by the commissioner of human services.

 

Sec. 12. Minnesota Statutes 2006, section 246.54, subdivision 1, is amended to read:

 

Subdivision 1. County portion for cost of care. (a) Except for chemical dependency services provided under sections 254B.01 to 254B.09, the client's county shall pay to the state of Minnesota a portion of the cost of care provided in a regional treatment center or a state nursing facility to a client legally settled in that county. A county's

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payment shall be made from the county's own sources of revenue and payments shall be paid as follows: payments to the state from the county shall equal 20 percent a percentage of the cost of care, as determined by the commissioner, for each day, or the portion thereof, that the client spends at a regional treatment center or a state nursing facility. according to the following schedule:

 

(1) zero percent for the first 30 days;

 

(2) 20 percent for days 31 to 60; and

 

(3) 50 percent for any days over 60.

 

(b) The increase in the county portion for cost of care under paragraph (a), clause (3), shall be imposed when the treatment facility has determined that it is clinically appropriate for the client to be discharged.

 

(c) If payments received by the state under sections 246.50 to 246.53 exceed 80 percent of the cost of care for days 31 to 60, or 50 percent for days over 60, the county shall be responsible for paying the state only the remaining amount. The county shall not be entitled to reimbursement from the client, the client's estate, or from the client's relatives, except as provided in section 246.53. No such payments shall be made for any client who was last committed prior to July 1, 1947.

 

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

 

Sec. 13. Minnesota Statutes 2006, section 246.54, subdivision 2, is amended to read:

 

Subd. 2. Exceptions. (a) Subdivision 1 does not apply to services provided at the Minnesota Security Hospital, the Minnesota sex offender program, or the Minnesota extended treatment options program. For services at these facilities, a county's payment shall be made from the county's own sources of revenue and payments shall be paid as follows: payments to the state from the county shall equal ten percent of the cost of care, as determined by the commissioner, for each day, or the portion thereof, that the client spends at the facility. If payments received by the state under sections 246.50 to 246.53 exceed 90 percent of the cost of care, the county shall be responsible for paying the state only the remaining amount. The county shall not be entitled to reimbursement from the client, the client's estate, or from the client's relatives, except as provided in section 246.53.

 

(b) Regardless of the facility to which the client is committed, subdivision 1 does not apply to the following individuals:

 

(1) clients who are committed as mentally ill and dangerous under section 253B.02, subdivision 17;

 

(2) clients who are committed as sexual psychopathic personalities under section 253B.02, subdivision 18b; and

 

(3) clients who are committed as sexually dangerous persons under section 253B.02, subdivision 18c.

 

For each of the individuals in clauses (1) to (3), the payment by the county to the state shall equal ten percent of the cost of care for each day as determined by the commissioner.

 

Sec. 14. Minnesota Statutes 2006, section 253B.185, is amended by adding a subdivision to read:

 

Subd. 8. Petition and report required. (a) Within 120 days of receipt of a preliminary determination from a court under section 609.1351, or a referral from the commissioner of corrections pursuant to section 244.05, subdivision 7, a county attorney shall determine whether good cause under this section exists to file a petition, and if good cause exists, the county attorney or designee shall file the petition with the court.

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(b) Failure to meet the requirements of paragraph (a) does not bar filing a petition under subdivision 1 any time the county attorney determines pursuant to subdivision 1 that good cause for such a petition exists.

 

(c) By February 1 of each year, the commissioner of human services shall annually report to the respective chairs of the divisions or committees of the senate and house of representatives that oversee human services finance regarding compliance with this subdivision.

 

Sec. 15. [254A.25] DUTIES OF COMMISSIONER RELATED TO CHEMICAL HEALTH.

 

The commissioner shall:

 

(1) annually distribute information to chemical health assessors on best practices in assessments, including model instruments for adults and adolescents;

 

(2) monitor the compliance of local agencies with assessment and referral rules;

 

(3) develop a directory that identifies key characteristics of each licensed chemical dependency treatment program;

 

(4) work with the commissioner of health to develop guidelines and training materials for health care organizations on the use of brief interventions for alcohol and chemical substance abuse;

 

(5) provide local agencies with examples of best practices for addressing needs of persons being considered for repeat placements into publicly funded treatment;

 

(6) identify best practices to help local agencies monitor the progress of clients placed in treatment;

 

(7) periodically provide local agencies with statewide information on treatment outcomes; and

 

(8) post copies of state licensing reviews at an online location where they may be reviewed by agencies that make client placements.

 

Sec. 16. [256B.0615] MENTAL HEALTH CERTIFIED PEER SPECIALIST.

 

Subdivision 1. Scope. Medical assistance covers mental health certified peers specialists services, as established in subdivision 2, subject to federal approval, if provided to recipients who are eligible for services under sections 256B.0622 and 256B.0623, and are provided by a certified peer specialist who has completed the training under subdivision 5.

 

Subd. 2. Establishment. The commissioner of human services shall establish a certified peer specialists program model, which:

 

(1) provides nonclinical peer support counseling by certified peer specialists;

 

(2) provides a part of a wraparound continuum of services in conjunction with other community mental health services;

 

(3) is individualized to the consumer; and

 

(4) promotes socialization, recovery, self-sufficiency, self-advocacy, development of natural supports, and maintenance of skills learned in other support services.

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Subd. 3. Eligibility. Peer support services may be made available to consumers of the intensive rehabilitative mental health services under section 256B.0622 and adult rehabilitative mental health services under section 256B.0623.

 

Subd. 4. Peer support specialist program providers. The commissioner shall develop a process to certify peer support specialist programs, in accordance with the federal guidelines, in order for the program to bill for reimbursable services. Peer support programs may be freestanding or within existing mental health community provider centers.

 

Subd. 5. Certified peer specialist training and certification. The commissioner of human services shall develop a training and certification process for certified peer specialists, who must be at least 21 years of age and have a high school diploma or its equivalent. The candidates must have had a primary diagnosis of mental illness, be a current or former consumer of mental health services, and must demonstrate leadership and advocacy skills and a strong dedication to recovery. The training curriculum must teach participating consumers specific skills relevant to providing peer support to other consumers. In addition to initial training and certification, the commissioner shall develop ongoing continuing educational workshops on pertinent issues related to peer support counseling.

 

Sec. 17. Minnesota Statutes 2006, section 256B.0622, subdivision 2, is amended to read:

 

Subd. 2. Definitions. For purposes of this section, the following terms have the meanings given them.

 

(a) "Intensive nonresidential rehabilitative mental health services" means adult rehabilitative mental health services as defined in section 256B.0623, subdivision 2, paragraph (a), except that these services are provided by a multidisciplinary staff using a total team approach consistent with assertive community treatment, the Fairweather Lodge treatment model, as defined by the standards established by the National Coalition for Community Living, and other evidence-based practices, and directed to recipients with a serious mental illness who require intensive services.

 

(b) "Intensive residential rehabilitative mental health services" means short-term, time-limited services provided in a residential setting to recipients who are in need of more restrictive settings and are at risk of significant functional deterioration if they do not receive these services. Services are designed to develop and enhance psychiatric stability, personal and emotional adjustment, self-sufficiency, and skills to live in a more independent setting. Services must be directed toward a targeted discharge date with specified client outcomes and must be consistent with the Fairweather Lodge treatment model as defined in paragraph (a), and other evidence-based practices.

 

(c) "Evidence-based practices" are nationally recognized mental health services that are proven by substantial research to be effective in helping individuals with serious mental illness obtain specific treatment goals.

 

(d) "Overnight staff" means a member of the intensive residential rehabilitative mental health treatment team who is responsible during hours when recipients are typically asleep.

 

(e) "Treatment team" means all staff who provide services under this section to recipients. At a minimum, this includes the clinical supervisor, mental health professionals, as defined in section 245.462, subdivision 18, clauses (1) to (5); mental health practitioners, and as defined in section 245.462, subdivision 17; mental health rehabilitation workers under section 256B.0623, subdivision 5, clause (3); and certified peer specialists under section 256B.0615.

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Sec. 18. Minnesota Statutes 2006, section 256B.0623, subdivision 5, is amended to read:

 

Subd. 5. Qualifications of provider staff. Adult rehabilitative mental health services must be provided by qualified individual provider staff of a certified provider entity. Individual provider staff must be qualified under one of the following criteria:

 

(1) a mental health professional as defined in section 245.462, subdivision 18, clauses (1) to (5). If the recipient has a current diagnostic assessment by a licensed mental health professional as defined in section 245.462, subdivision 18, clauses (1) to (5), recommending receipt of adult mental health rehabilitative services, the definition of mental health professional for purposes of this section includes a person who is qualified under section 245.462, subdivision 18, clause (6), and who holds a current and valid national certification as a certified rehabilitation counselor or certified psychosocial rehabilitation practitioner;

 

(2) a mental health practitioner as defined in section 245.462, subdivision 17. The mental health practitioner must work under the clinical supervision of a mental health professional; or

 

(3) a certified peer specialist under section 256B.0615. The certified peer specialist must work under the clinical supervision of a mental health professional; or

 

(3) (4) a mental health rehabilitation worker. A mental health rehabilitation worker means a staff person working under the direction of a mental health practitioner or mental health professional and under the clinical supervision of a mental health professional in the implementation of rehabilitative mental health services as identified in the recipient's individual treatment plan who:

 

(i) is at least 21 years of age;

 

(ii) has a high school diploma or equivalent;

 

(iii) has successfully completed 30 hours of training during the past two years in all of the following areas: recipient rights, recipient-centered individual treatment planning, behavioral terminology, mental illness, co‑occurring mental illness and substance abuse, psychotropic medications and side effects, functional assessment, local community resources, adult vulnerability, recipient confidentiality; and

 

(iv) meets the qualifications in subitem (A) or (B):

 

(A) has an associate of arts degree in one of the behavioral sciences or human services, or is a registered nurse without a bachelor's degree, or who within the previous ten years has:

 

(1) three years of personal life experience with serious and persistent mental illness;

 

(2) three years of life experience as a primary caregiver to an adult with a serious mental illness or traumatic brain injury; or

 

(3) 4,000 hours of supervised paid work experience in the delivery of mental health services to adults with a serious mental illness or traumatic brain injury; or

 

(B)(1) is fluent in the non-English language or competent in the culture of the ethnic group to which at least 20 percent of the mental health rehabilitation worker's clients belong;

 

(2) receives during the first 2,000 hours of work, monthly documented individual clinical supervision by a mental health professional;

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(3) has 18 hours of documented field supervision by a mental health professional or practitioner during the first 160 hours of contact work with recipients, and at least six hours of field supervision quarterly during the following year;

 

(4) has review and cosignature of charting of recipient contacts during field supervision by a mental health professional or practitioner; and

 

(5) has 40 hours of additional continuing education on mental health topics during the first year of employment.

 

Sec. 19. Minnesota Statutes 2006, section 256B.0625, is amended by adding a subdivision to read:

 

Subd. 5l. Intensive mental health outpatient treatment. Medical assistance covers intensive mental health outpatient treatment for dialectical behavioral therapy for adults. The commissioner shall establish:

 

(1) certification procedures to ensure that providers of these services are qualified; and

 

(2) treatment protocols including required service components and criteria for admission, continued treatment, and discharge.

 

EFFECTIVE DATE. This section is effective July 1, 2008, and subject to federal approval. The commissioner shall notify the revisor of statutes when federal approval is obtained.

 

Sec. 20. Minnesota Statutes 2006, section 256B.0625, subdivision 20, is amended to read:

 

Subd. 20. Mental health case management. (a) To the extent authorized by rule of the state agency, medical assistance covers case management services to persons with serious and persistent mental illness and children with severe emotional disturbance. Services provided under this section must meet the relevant standards in sections 245.461 to 245.4887, the Comprehensive Adult and Children's Mental Health Acts, Minnesota Rules, parts 9520.0900 to 9520.0926, and 9505.0322, excluding subpart 10.

 

(b) Entities meeting program standards set out in rules governing family community support services as defined in section 245.4871, subdivision 17, are eligible for medical assistance reimbursement for case management services for children with severe emotional disturbance when these services meet the program standards in Minnesota Rules, parts 9520.0900 to 9520.0926 and 9505.0322, excluding subparts 6 and 10.

 

(c) Medical assistance and MinnesotaCare payment for mental health case management shall be made on a monthly basis. In order to receive payment for an eligible child, the provider must document at least a face-to-face contact with the child, the child's parents, or the child's legal representative. To receive payment for an eligible adult, the provider must document:

 

(1) at least a face-to-face contact with the adult or the adult's legal representative; or

 

(2) at least a telephone contact with the adult or the adult's legal representative and document a face-to-face contact with the adult or the adult's legal representative within the preceding two months.

 

(d) Payment for mental health case management provided by county or state staff shall be based on the monthly rate methodology under section 256B.094, subdivision 6, paragraph (b), with separate rates calculated for child welfare and mental health, and within mental health, separate rates for children and adults.

 

(e) Payment for mental health case management provided by Indian health services or by agencies operated by Indian tribes may be made according to this section or other relevant federally approved rate setting methodology.

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(f) Payment for mental health case management provided by vendors who contract with a county or Indian tribe shall be based on a monthly rate negotiated by the host county or tribe. The negotiated rate must not exceed the rate charged by the vendor for the same service to other payers. If the service is provided by a team of contracted vendors, the county or tribe may negotiate a team rate with a vendor who is a member of the team. The team shall determine how to distribute the rate among its members. No reimbursement received by contracted vendors shall be returned to the county or tribe, except to reimburse the county or tribe for advance funding provided by the county or tribe to the vendor.

 

(g) If the service is provided by a team which includes contracted vendors, tribal staff, and county or state staff, the costs for county or state staff participation in the team shall be included in the rate for county-provided services. In this case, the contracted vendor, the tribal agency, and the county may each receive separate payment for services provided by each entity in the same month. In order to prevent duplication of services, each entity must document, in the recipient's file, the need for team case management and a description of the roles of the team members.

 

(h) The commissioner shall calculate the nonfederal share of actual medical assistance and general assistance medical care payments for each county, based on the higher of calendar year 1995 or 1996, by service date, project that amount forward to 1999, and transfer one-half of the result from medical assistance and general assistance medical care to each county's mental health grants under section 256E.12 for calendar year 1999. The annualized minimum amount added to each county's mental health grant shall be $3,000 per year for children and $5,000 per year for adults. The commissioner may reduce the statewide growth factor in order to fund these minimums. The annualized total amount transferred shall become part of the base for future mental health grants for each county.

 

(i) (h) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of costs for mental health case management shall be provided by the recipient's county of responsibility, as defined in sections 256G.01 to 256G.12, from sources other than federal funds or funds used to match other federal funds. If the service is provided by a tribal agency, the nonfederal share, if any, shall be provided by the recipient's tribe. When this service is paid by the state without a federal share through fee-for-service, 50 percent of the cost shall be provided by the recipient's county of responsibility.

 

(i) Notwithstanding any administrative rule to the contrary, prepaid medical assistance, general assistance medical care, and MinnesotaCare include mental health case management. When the service is provided through prepaid capitation, the nonfederal share is paid by the state and the county pays no share.

 

(j) The commissioner may suspend, reduce, or terminate the reimbursement to a provider that does not meet the reporting or other requirements of this section. The county of responsibility, as defined in sections 256G.01 to 256G.12, or, if applicable, the tribal agency, is responsible for any federal disallowances. The county or tribe may share this responsibility with its contracted vendors.

 

(k) The commissioner shall set aside a portion of the federal funds earned for county expenditures under this section to repay the special revenue maximization account under section 256.01, subdivision 2, clause (15). The repayment is limited to:

 

(1) the costs of developing and implementing this section; and

 

(2) programming the information systems.

 

(l) Payments to counties and tribal agencies for case management expenditures under this section shall only be made from federal earnings from services provided under this section. When this service is paid by the state without a federal share through fee-for-service, 50 percent of the cost shall be provided by the state. Payments to county-contracted vendors shall include both the federal earnings, the state share, and the county share.

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(m) Notwithstanding section 256B.041, county payments for the cost of mental health case management services provided by county or state staff shall not be made to the commissioner of finance. For the purposes of mental health case management services provided by county or state staff under this section, the centralized disbursement of payments to counties under section 256B.041 consists only of federal earnings from services provided under this section.

 

(n) (m) Case management services under this subdivision do not include therapy, treatment, legal, or outreach services.

 

(o) (n) If the recipient is a resident of a nursing facility, intermediate care facility, or hospital, and the recipient's institutional care is paid by medical assistance, payment for case management services under this subdivision is limited to the last 180 days of the recipient's residency in that facility and may not exceed more than six months in a calendar year.

 

(p) (o) Payment for case management services under this subdivision shall not duplicate payments made under other program authorities for the same purpose.

 

(q) By July 1, 2000, the commissioner shall evaluate the effectiveness of the changes required by this section, including changes in number of persons receiving mental health case management, changes in hours of service per person, and changes in caseload size.

 

(r) For each calendar year beginning with the calendar year 2001, the annualized amount of state funds for each county determined under paragraph (h) shall be adjusted by the county's percentage change in the average number of clients per month who received case management under this section during the fiscal year that ended six months prior to the calendar year in question, in comparison to the prior fiscal year.

 

(s) For counties receiving the minimum allocation of $3,000 or $5,000 described in paragraph (h), the adjustment in paragraph (s) shall be determined so that the county receives the higher of the following amounts:

 

(1) a continuation of the minimum allocation in paragraph (h); or

 

(2) an amount based on that county's average number of clients per month who received case management under this section during the fiscal year that ended six months prior to the calendar year in question, times the average statewide grant per person per month for counties not receiving the minimum allocation.

 

(t) The adjustments in paragraphs (s) and (t) shall be calculated separately for children and adults.

 

EFFECTIVE DATE. This section is effective January 1, 2009, except the amendments to paragraphs (h), (r), (s), and (t) are effective January 1, 2008.

 

Sec. 21. Minnesota Statutes 2006, section 256B.0625, subdivision 47, is amended to read:

 

Subd. 47. Treatment foster care services. Effective July 1, 2006 2009, and subject to federal approval, medical assistance covers treatment foster care services according to section 256B.0946.

 

Sec. 22. Minnesota Statutes 2006, section 256B.0943, subdivision 8, is amended to read:

 

Subd. 8. Required preservice and continuing education. (a) A provider entity shall establish a plan to provide preservice and continuing education for staff. The plan must clearly describe the type of training necessary to maintain current skills and obtain new skills and that relates to the provider entity's goals and objectives for services offered.

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(b) A provider that employs a mental health behavioral aide under this section must require the mental health behavioral aide to complete 30 hours of preservice training. The preservice training must include topics specified in Minnesota Rules, part 9535.4068, subparts 1 and 2, and parent team training. The preservice training must include 15 hours of in-person training of a mental health behavioral aide in mental health services delivery and eight hours of parent team training. Curricula for parent team training must be approved in advance by the commissioner. Components of parent team training include:

 

(1) partnering with parents;

 

(2) fundamentals of family support;

 

(3) fundamentals of policy and decision making;

 

(4) defining equal partnership;

 

(5) complexities of the parent and service provider partnership in multiple service delivery systems due to system strengths and weaknesses;

 

(6) sibling impacts;

 

(7) support networks; and

 

(8) community resources.

 

(c) A provider entity that employs a mental health practitioner and a mental health behavioral aide to provide children's therapeutic services and supports under this section must require the mental health practitioner and mental health behavioral aide to complete 20 hours of continuing education every two calendar years. The continuing education must be related to serving the needs of a child with emotional disturbance in the child's home environment and the child's family. The topics covered in orientation and training must conform to Minnesota Rules, part 9535.4068.

 

(d) The provider entity must document the mental health practitioner's or mental health behavioral aide's annual completion of the required continuing education. The documentation must include the date, subject, and number of hours of the continuing education, and attendance records, as verified by the staff member's signature, job title, and the instructor's name. The provider entity must keep documentation for each employee, including records of attendance at professional workshops and conferences, at a central location and in the employee's personnel file.

 

Sec. 23. Minnesota Statutes 2006, section 256B.0945, subdivision 4, is amended to read:

 

Subd. 4. Payment rates. (a) Notwithstanding sections 256B.19 and 256B.041, payments to counties for residential services provided by a residential facility shall only be made of federal earnings for services provided under this section, and the nonfederal share of costs for services provided under this section shall be paid by the county from sources other than federal funds or funds used to match other federal funds. Payment to counties for services provided according to this section shall be a proportion of the per day contract rate that relates to rehabilitative mental health services and shall not include payment for costs or services that are billed to the IV-E program as room and board.

 

(b) Per diem rates paid to providers under this section by prepaid plans shall be the proportion of the per-day contract rate that relates to rehabilitative mental health services and shall not include payment for group foster care costs or services that are billed to the county of financial responsibility.

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(c) The commissioner shall set aside a portion not to exceed five percent of the federal funds earned for county expenditures under this section to cover the state costs of administering this section. Any unexpended funds from the set-aside shall be distributed to the counties in proportion to their earnings under this section.

 

EFFECTIVE DATE. This section is effective January 1, 2009.

 

Sec. 24. Minnesota Statutes 2006, section 256B.69, subdivision 4, is amended to read:

 

Subd. 4. Limitation of choice. (a) The commissioner shall develop criteria to determine when limitation of choice may be implemented in the experimental counties. The criteria shall ensure that all eligible individuals in the county have continuing access to the full range of medical assistance services as specified in subdivision 6.

 

(b) The commissioner shall exempt the following persons from participation in the project, in addition to those who do not meet the criteria for limitation of choice:

 

(1) persons eligible for medical assistance according to section 256B.055, subdivision 1;

 

(2) persons eligible for medical assistance due to blindness or disability as determined by the Social Security Administration or the state medical review team, unless:

 

(i) they are 65 years of age or older; or

 

(ii) they reside in Itasca County or they reside in a county in which the commissioner conducts a pilot project under a waiver granted pursuant to section 1115 of the Social Security Act;

 

(3) recipients who currently have private coverage through a health maintenance organization;

 

(4) recipients who are eligible for medical assistance by spending down excess income for medical expenses other than the nursing facility per diem expense;

 

(5) recipients who receive benefits under the Refugee Assistance Program, established under United States Code, title 8, section 1522(e);

 

(6) children who are both determined to be severely emotionally disturbed and receiving case management services according to section 256B.0625, subdivision 20, except children who are eligible for and who decline enrollment in an approved preferred integrated network under section 245.4682;

 

(7) adults who are both determined to be seriously and persistently mentally ill and received case management services according to section 256B.0625, subdivision 20;

 

(8) persons eligible for medical assistance according to section 256B.057, subdivision 10; and

 

(9) persons with access to cost-effective employer-sponsored private health insurance or persons enrolled in a non-Medicare individual health plan determined to be cost-effective according to section 256B.0625, subdivision 15.

 

Children under age 21 who are in foster placement may enroll in the project on an elective basis. Individuals excluded under clauses (1), (6), and (7) may choose to enroll on an elective basis. The commissioner may enroll recipients in the prepaid medical assistance program for seniors who are (1) age 65 and over, and (2) eligible for medical assistance by spending down excess income.

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(c) The commissioner may allow persons with a one-month spenddown who are otherwise eligible to enroll to voluntarily enroll or remain enrolled, if they elect to prepay their monthly spenddown to the state.

 

(d) The commissioner may require those individuals to enroll in the prepaid medical assistance program who otherwise would have been excluded under paragraph (b), clauses (1), (3), and (8), and under Minnesota Rules, part 9500.1452, subpart 2, items H, K, and L.

 

(e) Before limitation of choice is implemented, eligible individuals shall be notified and after notification, shall be allowed to choose only among demonstration providers. The commissioner may assign an individual with private coverage through a health maintenance organization, to the same health maintenance organization for medical assistance coverage, if the health maintenance organization is under contract for medical assistance in the individual's county of residence. After initially choosing a provider, the recipient is allowed to change that choice only at specified times as allowed by the commissioner. If a demonstration provider ends participation in the project for any reason, a recipient enrolled with that provider must select a new provider but may change providers without cause once more within the first 60 days after enrollment with the second provider.

 

(f) An infant born to a woman who is eligible for and receiving medical assistance and who is enrolled in the prepaid medical assistance program shall be retroactively enrolled to the month of birth in the same managed care plan as the mother once the child is enrolled in medical assistance unless the child is determined to be excluded from enrollment in a prepaid plan under this section.

 

EFFECTIVE DATE. This section is effective January 1, 2009.

 

Sec. 25. Minnesota Statutes 2006, section 256B.69, subdivision 5g, is amended to read:

 

Subd. 5g. Payment for covered services. For services rendered on or after January 1, 2003, the total payment made to managed care plans for providing covered services under the medical assistance and general assistance medical care programs is reduced by .5 percent from their current statutory rates. This provision excludes payments for nursing home services, home and community-based waivers, and payments to demonstration projects for persons with disabilities, and mental health services added as covered benefits after December 31, 2007.

 

Sec. 26. Minnesota Statutes 2006, section 256B.69, subdivision 5h, is amended to read:

 

Subd. 5h. Payment reduction. In addition to the reduction in subdivision 5g, the total payment made to managed care plans under the medical assistance program is reduced 1.0 percent for services provided on or after October 1, 2003, and an additional 1.0 percent for services provided on or after January 1, 2004. This provision excludes payments for nursing home services, home and community-based waivers, and payments to demonstration projects for persons with disabilities, and mental health services added as covered benefits after December 31, 2007.

 

Sec. 27. Minnesota Statutes 2006, section 256B.763, is amended to read:

 

256B.763 CRITICAL ACCESS MENTAL HEALTH RATE INCREASE.

 

(a) For services defined in paragraph (b) and rendered on or after July 1, 2007, payment rates shall be increased by 23.7 percent over the rates in effect on January 1, 2006, for:

 

(1) psychiatrists and advanced practice registered nurses with a psychiatric specialty;

 

(2) community mental health centers under section 256B.0625, subdivision 5; and

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(3) mental health clinics and centers certified under Minnesota Rules, parts 9520.0750 to 9520.0870, or hospital outpatient psychiatric departments that are designated as essential community providers under section 62Q.19.

 

(b) This increase applies to group skills training when provided as a component of children's therapeutic services and support, psychotherapy, medication management, evaluation and management, diagnostic assessment, explanation of findings, psychological testing, neuropsychological services, direction of behavioral aides, and inpatient consultation.

 

(c) This increase does not apply to rates that are governed by section 256B.0625, subdivision 30, or 256B.761, paragraph (b), other cost-based rates, rates that are negotiated with the county, rates that are established by the federal government, or rates that increased between January 1, 2004, and January 1, 2005.

 

(d) The commissioner shall adjust rates paid to prepaid health plans under contract with the commissioner to reflect the rate increases provided in paragraph paragraphs (a), (e), and (f). The prepaid health plan must pass this rate increase to the providers identified in paragraph paragraphs (a), (e), (f), and (g).

 

(e) Payment rates shall be increased by 23.7 percent over the rates in effect on January 1, 2006, for:

 

(1) medication education services provided on or after January 1, 2008, by adult rehabilitative mental health services providers certified under section 256B.0623; and

 

(2) mental health behavioral aide services provided on or after January 1, 2008, by children's therapeutic services and support providers certified under section 256B.0943.

 

(f) For services defined in paragraph (b) and rendered on or after January 1, 2008, by children's therapeutic services and support providers certified under section 256B.0943 and not already included in paragraph (a), payment rates shall be increased by 23.7 percent over the rates in effect on January 1, 2006.

 

(g) Payment rates shall be increased by 2.3 percent over the rates in effect on December 31, 2007, for individual and family skills training provided on or after January 1, 2008, by children's therapeutic services and support providers certified under section 256B.0943.

 

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

 

Sec. 28. Minnesota Statutes 2006, section 256D.03, subdivision 4, is amended to read:

 

Subd. 4. General assistance medical care; services. (a)(i) For a person who is eligible under subdivision 3, paragraph (a), clause (2), item (i), general assistance medical care covers, except as provided in paragraph (c):

 

(1) inpatient hospital services;

 

(2) outpatient hospital services;

 

(3) services provided by Medicare certified rehabilitation agencies;

 

(4) prescription drugs and other products recommended through the process established in section 256B.0625, subdivision 13;

 

(5) equipment necessary to administer insulin and diagnostic supplies and equipment for diabetics to monitor blood sugar level;

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(6) eyeglasses and eye examinations provided by a physician or optometrist;

 

(7) hearing aids;

 

(8) prosthetic devices;

 

(9) laboratory and X-ray services;

 

(10) physician's services;

 

(11) medical transportation except special transportation;

 

(12) chiropractic services as covered under the medical assistance program;

 

(13) podiatric services;

 

(14) dental services as covered under the medical assistance program;

 

(15) outpatient services provided by a mental health center or clinic that is under contract with the county board and is established under section 245.62 mental health services covered under chapter 256B;

 

(16) day treatment services for mental illness provided under contract with the county board;

 

(17) (16) prescribed medications for persons who have been diagnosed as mentally ill as necessary to prevent more restrictive institutionalization;

 

(18) psychological services, (17) medical supplies and equipment, and Medicare premiums, coinsurance and deductible payments;

 

(19) (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;

 

(20) (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;

 

(21) (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; and

 

(22) (21) telemedicine consultations, to the extent they are covered under section 256B.0625, subdivision 3b; and.

 

(23) mental health telemedicine and psychiatric consultation as covered under section 256B.0625, subdivisions 46 and 48.

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(ii) Effective October 1, 2003, for a person who is eligible under subdivision 3, paragraph (a), clause (2), item (ii), general assistance medical care coverage is limited to inpatient hospital services, including physician services provided during the inpatient hospital stay. A $1,000 deductible is required for each inpatient hospitalization.

 

(b) Effective August 1, 2005, sex reassignment surgery is not covered under this subdivision.

 

(c) In order to contain costs, the commissioner of human services shall select vendors of medical care who can provide the most economical care consistent with high medical standards and shall where possible contract with organizations on a prepaid capitation basis to provide these services. The commissioner shall consider proposals by counties and vendors for prepaid health plans, competitive bidding programs, block grants, or other vendor payment mechanisms designed to provide services in an economical manner or to control utilization, with safeguards to ensure that necessary services are provided. Before implementing prepaid programs in counties with a county operated or affiliated public teaching hospital or a hospital or clinic operated by the University of Minnesota, the commissioner shall consider the risks the prepaid program creates for the hospital and allow the county or hospital the opportunity to participate in the program in a manner that reflects the risk of adverse selection and the nature of the patients served by the hospital, provided the terms of participation in the program are competitive with the terms of other participants considering the nature of the population served. Payment for services provided pursuant to this subdivision shall be as provided to medical assistance vendors of these services under sections 256B.02, subdivision 8, and 256B.0625. For payments made during fiscal year 1990 and later years, the commissioner shall consult with an independent actuary in establishing prepayment rates, but shall retain final control over the rate methodology.

 

(d) Recipients eligible under subdivision 3, paragraph (a), shall pay the following co-payments for services provided on or after October 1, 2003:

 

(1) $25 for eyeglasses;

 

(2) $25 for nonemergency visits to a hospital-based emergency room;

 

(3) $3 per brand-name drug prescription and $1 per generic drug prescription, subject to a $12 per month maximum for prescription drug co-payments. No co-payments shall apply to antipsychotic drugs when used for the treatment of mental illness; and

 

(4) 50 percent coinsurance on restorative dental services.

 

(e) Co-payments shall be limited to one per day per provider for nonpreventive visits, eyeglasses, and nonemergency visits to a hospital-based emergency room. Recipients of general assistance medical care are responsible for all co-payments in this subdivision. The general assistance medical care reimbursement to the provider shall be reduced by the amount of the co-payment, except that reimbursement for prescription drugs shall not be reduced once a recipient has reached the $12 per month maximum for prescription drug co-payments. The provider collects the co-payment from the recipient. Providers may not deny services to recipients who are unable to pay the co-payment, except as provided in paragraph (f).

 

(f) If it is the routine business practice of a provider to refuse service to an individual with uncollected debt, the provider may include uncollected co-payments under this section. A provider must give advance notice to a recipient with uncollected debt before services can be denied.

 

(g) Any county may, from its own resources, provide medical payments for which state payments are not made.

 

(h) Chemical dependency services that are reimbursed under chapter 254B must not be reimbursed under general assistance medical care.

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(i) The maximum payment for new vendors enrolled in the general assistance medical care program after the base year shall be determined from the average usual and customary charge of the same vendor type enrolled in the base year.

 

(j) The conditions of payment for services under this subdivision are the same as the conditions specified in rules adopted under chapter 256B governing the medical assistance program, unless otherwise provided by statute or rule.

 

(k) Inpatient and outpatient payments shall be reduced by five percent, effective July 1, 2003. This reduction is in addition to the five percent reduction effective July 1, 2003, and incorporated by reference in paragraph (i).

 

(l) Payments for all other health services except inpatient, outpatient, and pharmacy services shall be reduced by five percent, effective July 1, 2003.

 

(m) Payments to managed care plans shall be reduced by five percent for services provided on or after October 1, 2003.

 

(n) A hospital receiving a reduced payment as a result of this section may apply the unpaid balance toward satisfaction of the hospital's bad debts.

 

(o) Fee-for-service payments for nonpreventive visits shall be reduced by $3 for services provided on or after January 1, 2006. For purposes of this subdivision, a visit means an episode of service which is required because of a recipient's symptoms, diagnosis, or established illness, and which is delivered in an ambulatory setting by a physician or physician ancillary, chiropractor, podiatrist, advance practice nurse, audiologist, optician, or optometrist.

 

(p) Payments to managed care plans shall not be increased as a result of the removal of the $3 nonpreventive visit co-payment effective January 1, 2006.

 

(q) Payments for mental health services added as covered benefits after December 31, 2007, are not subject to the reductions in paragraphs (i), (k), (l), and (m).

 

EFFECTIVE DATE. This section is effective January 1, 2008, except mental health case management under paragraph (a), clause (i), item (15), is effective January 1, 2009.

 

Sec. 29. Minnesota Statutes 2006, section 256L.03, subdivision 1, is amended to read:

 

Subdivision 1. Covered health services. For individuals under section 256L.04, subdivision 7, with income no greater than 75 percent of the federal poverty guidelines or for families with children under section 256L.04, subdivision 1, all subdivisions of this section apply. "Covered health services" means the health services reimbursed under chapter 256B, with the exception of inpatient hospital services, special education services, private duty nursing services, adult dental care services other than services covered under section 256B.0625, subdivision 9, orthodontic services, nonemergency medical transportation services, personal care assistant and case management services, nursing home or intermediate care facilities services, inpatient mental health services, and chemical dependency services. Outpatient mental health services covered under the MinnesotaCare program are limited to diagnostic assessments, psychological testing, explanation of findings, mental health telemedicine, psychiatric consultation, medication management by a physician, day treatment, partial hospitalization, and individual, family, and group psychotherapy.

 

No public funds shall be used for coverage of abortion under MinnesotaCare except where the life of the female would be endangered or substantial and irreversible impairment of a major bodily function would result if the fetus were carried to term; or where the pregnancy is the result of rape or incest.

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Covered health services shall be expanded as provided in this section.

 

EFFECTIVE DATE. This section is effective January 1, 2008, except coverage for mental health case management under subdivision 1 is effective January 1, 2009.

 

Sec. 30. Minnesota Statutes 2006, section 256L.03, subdivision 5, is amended to read:

 

Subd. 5. Co-payments and coinsurance. (a) Except as provided in paragraphs (b) and (c), the MinnesotaCare benefit plan shall include the following co-payments and coinsurance requirements for all enrollees:

 

(1) ten percent of the paid charges for inpatient hospital services for adult enrollees, subject to an annual inpatient out-of-pocket maximum of $1,000 per individual and $3,000 per family;

 

(2) $3 per prescription for adult enrollees;

 

(3) $25 for eyeglasses for adult enrollees;

 

(4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an episode of service which is required because of a recipient's symptoms, diagnosis, or established illness, and which is delivered in an ambulatory setting by a physician or physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse, audiologist, optician, or optometrist; and

 

(5) $6 for nonemergency visits to a hospital-based emergency room.

 

(b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of children under the age of 21 in households with family income equal to or less than 175 percent of the federal poverty guidelines. Paragraph (a), clause (1), does not apply to parents and relative caretakers of children under the age of 21 in households with family income greater than 175 percent of the federal poverty guidelines for inpatient hospital admissions occurring on or after January 1, 2001.

 

(c) Paragraph (a), clauses (1) to (4), do not apply to pregnant women and children under the age of 21.

 

(d) Paragraph (a), clause (4), does not apply to mental health services.

 

(e) Adult enrollees with family gross income that exceeds 175 percent of the federal poverty guidelines and who are not pregnant shall be financially responsible for the coinsurance amount, if applicable, and amounts which exceed the $10,000 inpatient hospital benefit limit.

 

(e) (f) When a MinnesotaCare enrollee becomes a member of a prepaid health plan, or changes from one prepaid health plan to another during a calendar year, any charges submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket expenses incurred by the enrollee for inpatient services, that were submitted or incurred prior to enrollment, or prior to the change in health plans, shall be disregarded.

 

Sec. 31. Minnesota Statutes 2006, section 256L.12, subdivision 9a, is amended to read:

 

Subd. 9a. Rate setting; ratable reduction. For services rendered on or after October 1, 2003, the total payment made to managed care plans under the MinnesotaCare program is reduced 1.0 percent. This provision excludes payments for mental health services added as covered benefits after December 31, 2007.

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Sec. 32. Minnesota Statutes 2006, section 609.115, subdivision 9, is amended to read:

 

Subd. 9. Compulsive gambling assessment required. (a) If a person is convicted of theft under section 609.52, embezzlement of public funds under section 609.54, or forgery under section 609.625, 609.63, or 609.631, the probation officer shall determine in the report prepared under subdivision 1 whether or not compulsive gambling contributed to the commission of the offense. If so, the report shall contain the results of a compulsive gambling assessment conducted in accordance with this subdivision. The probation officer shall make an appointment for the offender to undergo the assessment if so indicated.

 

(b) The compulsive gambling assessment report must include a recommended level of treatment for the offender if the assessor concludes that the offender is in need of compulsive gambling treatment. The assessment must be conducted by an assessor qualified either under section 245.98, subdivision 2a Minnesota Rules, part 9585.0040, subpart 1, item C, or qualifications determined to be equivalent by the commissioner, to perform these assessments or to provide compulsive gambling treatment. An assessor providing a compulsive gambling assessment may not have any direct or shared financial interest or referral relationship resulting in shared financial gain with a treatment provider. If an independent assessor is not available, the probation officer may use the services of an assessor with a financial interest or referral relationship as authorized under rules adopted by the commissioner of human services under section 245.98, subdivision 2a.

 

(c) The commissioner of human services shall reimburse the assessor for the costs associated with a each compulsive gambling assessment at a rate established by the commissioner up to a maximum of $100 for each assessment. To the extent practicable, the commissioner shall standardize reimbursement rates for assessments. The commissioner shall reimburse these costs the assessor after receiving written verification from the probation officer that the assessment was performed and found acceptable.

 

Sec. 33. REPORT.

 

The commissioner shall make a report to the legislature by January 15, 2008, regarding the transfer of funds to counties for state registered nurses employed in community mental health pilot projects as part of the assertive community treatment teams under Minnesota Statutes, section 245.4661. The report shall address the impact of the nursing shortage on replacing these positions, continuity of patient care if these positions cannot be filled, and ways to maintain state registered nurses in these positions until the nurse retires or leaves employment. No funds for state registered nurse positions referenced in this section may be transferred before the report date. This section does not apply to positions vacated by routine attrition.

 

Sec. 34. CASE MANAGEMENT; BEST PRACTICES.

 

The commissioner of human services, in consultation with consumers, families, counties, and other interested stakeholders, will develop recommendations for changes in the adult mental health act related to case management, consistent with evidence-based and best practices.

 

Sec. 35. REGIONAL CHILDREN'S MENTAL HEALTH INITIATIVE.

 

Subdivision 1. Pilot project authorized; purpose. A two-year Regional Children's Mental Health Initiative pilot project is established to improve children's mental health service coordination, communication, and processes in Blue Earth, Brown, Faribault, Freeborn, Le Sueur, Martin, Nicollet, Rice, Sibley, Waseca, and Watonwan Counties. The purpose of the Regional Children's Mental Health Initiative will be to plan and develop new programs and services related to children's mental health in south central Minnesota.

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Subd. 2. Goals. To accomplish its purpose, the Regional Children's Mental Health Initiative shall have the following goals:

 

(1) work to streamline delivery and regional access to services;

 

(2) share strategies and resources for the management of out-of-home placements;

 

(3) establish standard protocols and operating procedures for functions that are performed across all counties;

 

(4) share information to improve resource allocation and service delivery across counties;

 

(5) evaluate outcomes of various treatment alternatives;

 

(6) create a network for and provide support to service delivery groups;

 

(7) establish a regional process to match children in need of out-of-home placement with foster homes that can meet their needs; and

 

(8) recruit and retain foster homes.

 

Subd. 3. Director's Council. The Director's Council shall govern the operations of the Regional Children's Mental Health Initiative. Members of the Director's Council shall represent each of the 11 counties participating in the pilot project.

 

Subd. 4. Regional Children's Mental Health Initiative Team. The members of the Regional Children's Mental Health Initiative Team shall conduct planning and development of new and modified children's mental health programs and services in the region. Members of the team shall reflect the cultural, demographic, and geographic diversity of the region and shall be composed of representatives from each of the following:

 

(1) the medical community;

 

(2) human services;

 

(3) corrections;

 

(4) education;

 

(5) mental health providers and vendors;

 

(6) advocacy organizations;

 

(7) parents; and

 

(8) children and youth.

 

Subd. 5. Authority. The regional children's mental health initiative shall have the authority to develop and implement the following programs:

 

(1) Flexible funding payments. This program will make funds available to respond to the unique and unpredictable needs of children with mental health issues such as the need for prescription drugs, transportation, clothing, and assessments not otherwise available.

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(2) Transition to self-sufficiency. This program will help youths between the ages of 14 and 21 establish professional relationships, find jobs, build financial foundations, and learn to fulfill their roles as productive citizens.

 

(3) Crisis response. This program will establish public and private partnerships to offer a range of options to meet the needs of children in crisis. Methods to meet these needs may include accessible local services, holistic assessments, urgent care and stabilization services, and telehealth for specialized diagnosis and therapeutic sessions.

 

(4) Integrated services for complex conditions. This program will design, develop, and implement packages of integrated services to meet the needs of children with specific, complex conditions.

 

Subd. 6. Evaluation and report. The regional children's mental health initiative shall develop a method for evaluating the effectiveness of this pilot project focusing on identifiable goals and outcomes. An interim report on the pilot project's effectiveness shall be submitted to the house and senate finance committees having jurisdiction over mental health, the commissioner of human services, and the Minnesota Association of County Social Service Administrators no later than December 31, 2008. A final report is due no later than December 31, 2009.

 

Sec. 36. MINNESOTA FAMILY INVESTMENT PROGRAM AND CHILDREN'S MENTAL HEALTH PILOT PROJECT.

 

Subdivision 1. Pilot project authorized. The commissioner of human services shall fund a three-year pilot project to measure the effect of children's identified mental health needs, including social and emotional needs, on Minnesota family investment program (MFIP) participants' ability to obtain and retain employment. The project shall also measure the effect on work activity of MFIP participants' needs to address their children's identified mental health needs.

 

Subd. 2. Provider and agency proposals. (a) Interested MFIP providers and agencies shall:

 

(1) submit proposals defining how they will identify participants whose children have mental health needs that hinder the employment process;

 

(2) connect families with appropriate developmental, social, and emotional screenings and services; and

 

(3) incorporate those services into the participant's employment plan.

 

Each proposal under this paragraph must include an evaluation component.

 

(b) Interested MFIP providers and agencies shall develop a protocol to inform MFIP participants of the following:

 

(1) the availability of developmental, social, and emotional screening tools for children and youth;

 

(2) the purpose of the screenings;

 

(3) how the information will be used to assist the participants in identifying and addressing potential barriers to employment; and

 

(4) that their employment plan may be modified based on the screening results.

 

Subd. 3. Program components. (a) MFIP providers shall obtain the participant's written consent for participation in the pilot project, including consent for developmental, social, and emotional screening.

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(b) MFIP providers shall coordinate with county social service agencies and health plans to assist recipients in arranging referrals indicated by the screening results.

 

(c) Tools used for developmental, social, and emotional screenings shall be approved by the commissioner of human services.

 

Subd. 4. Program evaluation. The commissioner of human services shall conduct an evaluation of the pilot project to determine:

 

(1) the number of participants who took part in the screening;

 

(2) the number of children who were screened and what screening tools were used;

 

(3) the number of children who were identified in the screening who needed referral or follow-up services;

 

(4) the number of children who received services, what agency provided the services, and what type of services were provided;

 

(5) the number of employment plans that were adjusted to include the activities recommended in the screenings;

 

(6) the changes in work participation rates;

 

(7) the changes in earned income;

 

(8) the changes in sanction rates; and

 

(9) the participants' report of program effectiveness.

 

Subd. 5. Work activity. Participant involvement in screenings and subsequent referral and follow-up services shall count as work activity under Minnesota Statutes, section 256J.49, subdivision 13.

 

Subd. 6. Evaluation. Of the amounts appropriated, the commissioner may use up to $100,000 for evaluation of this pilot.

 

Sec. 37. SOCIAL AND ECONOMIC COSTS OF GAMBLING.

 

Subdivision 1. Report. The commissioner of human services, in consultation with the state affiliate of the National Council on Problem Gambling, stakeholders, and licensed vendors, shall prepare a report that provides a process and funding mechanism to study the issues in subdivisions 2 and 3. The commissioner, in consultation with the state affiliate of the National Council on Problem Gambling, stakeholders, and licensed vendors, shall include in the report potential financial commitments made by stakeholders and others in order to fund the study. The report is due to the legislative committees having jurisdiction over compulsive gambling issues by December 1, 2007.

 

Subd. 2. Issues to be addressed. The study must address:

 

(1) state, local, and tribal government policies and practices in Minnesota to legalize or prohibit gambling;

 

(2) the relationship between gambling and crime in Minnesota, including: (i) the relationship between gambling and overall crime rates; (ii) the relationship between gambling and crimes rates for specific crimes, such as forgery, domestic abuse, child neglect and abuse, alcohol and drug offenses, and youth crime; and (iii) enforcement and regulation practices that are intended to address the relationship between gambling and levels of crime;

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(3) the relationship between expanded gambling and increased rates of problem gambling in Minnesota, including the impact of pathological or problem gambling on individuals, families, businesses, social institutions, and the economy;

 

(4) the social impact of gambling on individuals, families, businesses, and social institutions in Minnesota, including an analysis of the relationship between gambling and depression, abuse, divorce, homelessness, suicide, and bankruptcy;

 

(5) the economic impact of gambling on state, local, and tribal economies in Minnesota; and

 

(6) any other issues deemed necessary in assessing the social and economic impact of gambling in Minnesota.

 

Subd. 3. Quantification of social and economic impact. The study shall quantify the social and economic impact on both (1) state, local, and tribal governments in Minnesota, and (2) Minnesota's communities and social institutions, including individuals, families, and businesses within those communities and institutions.

 

Sec. 38. REVISOR'S INSTRUCTION.

 

(a) The revisor of statutes shall change the references to sections "245.487 to 245.4887" wherever it appears in statutes or rules to sections "245.487 to 245.4889."

 

(b) The revisor of statutes shall correct all internal references that are necessary from the relettering in section 20.

 

Sec. 39. REPEALER.

 

Minnesota Rules, part 9585.0030, is repealed.

 

ARTICLE 9

 

DEPARTMENT OF HEALTH POLICY

 

Section 1. Minnesota Statutes 2006, section 62J.17, subdivision 2, is amended to read:

 

Subd. 2. Definitions. For purposes of this section, the terms defined in this subdivision have the meanings given.

 

(a) "Access" means the financial, temporal, and geographic availability of health care to individuals who need it.

 

(b) (a) "Capital expenditure" means an expenditure which, under generally accepted accounting principles, is not properly chargeable as an expense of operation and maintenance.

 

(c) "Cost" means the amount paid by consumers or third party payers for health care services or products.

 

(d) "Date of the major spending commitment" means the date the provider formally obligated itself to the major spending commitment. The obligation may be incurred by entering into a contract, making a down payment, issuing bonds or entering a loan agreement to provide financing for the major spending commitment, or taking some other formal, tangible action evidencing the provider's intention to make the major spending commitment.

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(e) (b) "Health care service" means:

 

(1) a service or item that would be covered by the medical assistance program under chapter 256B if provided in accordance with medical assistance requirements to an eligible medical assistance recipient; and

 

(2) a service or item that would be covered by medical assistance except that it is characterized as experimental, cosmetic, or voluntary.

 

"Health care service" does not include retail, over-the-counter sales of nonprescription drugs and other retail sales of health-related products that are not generally paid for by medical assistance and other third-party coverage.

 

(f) (c) "Major spending commitment" means an expenditure in excess of $1,000,000 for:

 

(1) acquisition of a unit of medical equipment;

 

(2) a capital expenditure for a single project for the purposes of providing health care services, other than for the acquisition of medical equipment;

 

(3) offering a new specialized service not offered before;

 

(4) planning for an activity that would qualify as a major spending commitment under this paragraph; or

 

(5) a project involving a combination of two or more of the activities in clauses (1) to (4).

 

The cost of acquisition of medical equipment, and the amount of a capital expenditure, is the total cost to the provider regardless of whether the cost is distributed over time through a lease arrangement or other financing or payment mechanism.

 

(g) (d) "Medical equipment" means fixed and movable equipment that is used by a provider in the provision of a health care service. "Medical equipment" includes, but is not limited to, the following:

 

(1) an extracorporeal shock wave lithotripter;

 

(2) a computerized axial tomography (CAT) scanner;

 

(3) a magnetic resonance imaging (MRI) unit;

 

(4) a positron emission tomography (PET) scanner; and

 

(5) emergency and nonemergency medical transportation equipment and vehicles.

 

(h) (e) "New specialized service" means a specialized health care procedure or treatment regimen offered by a provider that was not previously offered by the provider, including, but not limited to:

 

(1) cardiac catheterization services involving high-risk patients as defined in the Guidelines for Coronary Angiography established by the American Heart Association and the American College of Cardiology;

 

(2) heart, heart-lung, liver, kidney, bowel, or pancreas transplantation service, or any other service for transplantation of any other organ;

 

(3) megavoltage radiation therapy;

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(4) open heart surgery;

 

(5) neonatal intensive care services; and

 

(6) any new medical technology for which premarket approval has been granted by the United States Food and Drug Administration, excluding implantable and wearable devices.

 

(f) "Specialty care" includes but is not limited to cardiac, neurology, orthopedic, obstetrics, mental health, chemical dependency, and emergency services.

 

Sec. 2. Minnesota Statutes 2006, section 62J.17, subdivision 4a, is amended to read:

 

Subd. 4a. Expenditure reporting. (a) A provider making a major spending commitment after April 1, 1992, shall submit notification of the expenditure to the commissioner and provide the commissioner with any relevant background information.

 

(b) Notification must include a report, submitted within 60 days after the date of the major spending commitment, using terms conforming to the definitions in section 62J.03 and this section. Each report is subject to retrospective review and must contain:

 

(1) a detailed description of the major spending commitment, including the specific dollar amount of each expenditure, and its purpose;

 

(2) the date of the major spending commitment;

 

(3) a statement of the expected impact that the major spending commitment will have on charges by the provider to patients and third party payers;

 

(4) a statement of the expected impact on the clinical effectiveness or quality of care received by the patients that the provider expects to serve;

 

(5) a statement of the extent to which equivalent services or technology are already available to the provider's actual and potential patient population;

 

(6) a statement of the distance from which the nearest equivalent services or technology are already available to the provider's actual and potential population;

 

(7) a statement describing the pursuit of any lawful collaborative arrangements; and

 

(8) a statement of assurance that the provider will not use, purchase, or perform health care technologies and procedures that are not clinically effective and cost-effective, unless the technology is used for experimental or research purposes to determine whether a technology or procedure is clinically effective and cost-effective.

 

The provider may submit any additional information that it deems relevant.

 

(c) The commissioner may request additional information from a provider for the purpose of review of a report submitted by that provider, and may consider relevant information from other sources. A provider shall provide any information requested by the commissioner within the time period stated in the request, or within 30 days after the date of the request if the request does not state a time.

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(d) If the provider fails to submit a complete and timely expenditure report, including any additional information requested by the commissioner, the commissioner may make the provider's subsequent major spending commitments subject to the procedures of prospective review and approval under subdivision 6a.

 

Each hospital, outpatient surgical center, diagnostic imaging center, and physician clinic shall report annually to the commissioner on all major spending commitments, in the form and manner specified by the commissioner. The report shall include the following information:

 

(a) a description of major spending commitments made during the previous year, including the total dollar amount of major spending commitments and purpose of the expenditures;

 

(b) the cost of land acquisition, construction of new facilities, and renovation of existing facilities;

 

(c) the cost of purchased or leased medical equipment, by type of equipment;

 

(d) expenditures by type for specialty care and new specialized services;

 

(e) information on the amount and types of added capacity for diagnostic imaging services, outpatient surgical services, and new specialized services; and

 

(f) information on investments in electronic medical records systems.

 

For hospitals and outpatient surgical centers, this information shall be included in reports to the commissioner that are required under section 144.698. For diagnostic imaging centers, this information shall be included in reports to the commissioner that are required under section 144.565. For physician clinics, this information shall be included in reports to the commissioner that are required under section 62J.41. For all other health care providers that are subject to this reporting requirement, reports must be submitted to the commissioner by March 1 each year for the preceding calendar year.

 

Sec. 3. Minnesota Statutes 2006, section 62J.17, subdivision 6a, is amended to read:

 

Subd. 6a. Prospective review and approval. (a) No health care provider subject to prospective review under this subdivision shall make a major spending commitment unless:

 

(1) the provider has filed an application with the commissioner to proceed with the major spending commitment and has provided all supporting documentation and evidence requested by the commissioner; and

 

(2) the commissioner determines, based upon this documentation and evidence, that the major spending commitment is appropriate under the criteria provided in subdivision 5a in light of the alternatives available to the provider.

 

(b) A provider subject to prospective review and approval shall submit an application to the commissioner before proceeding with any major spending commitment. The application must address each item listed in subdivision 4a, paragraph (a), and must also include documentation to support the response to each item. The provider may submit information, with supporting documentation, regarding why the major spending commitment should be excepted from prospective review under subdivision 7. The submission may be made either in addition to or instead of the submission of information relating to the items listed in subdivision 4a, paragraph (a).

 

(c) The commissioner shall determine, based upon the information submitted, whether the major spending commitment is appropriate under the criteria provided in subdivision 5a, or whether it should be excepted from prospective review under subdivision 7. In making this determination, the commissioner may also consider relevant

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information from other sources. At the request of the commissioner, the health technology advisory committee shall convene an expert review panel made up of persons with knowledge and expertise regarding medical equipment, specialized services, health care expenditures, and capital expenditures to review applications and make recommendations to the commissioner. The commissioner shall make a decision on the application within 60 days after an application is received.

 

(d) The commissioner of health has the authority to issue fines, seek injunctions, and pursue other remedies as provided by law.

 

Sec. 4. Minnesota Statutes 2006, section 62J.17, subdivision 7, is amended to read:

 

Subd. 7. Exceptions. (a) The retrospective review process as described in subdivision 5a and the prospective review and approval process as described in subdivision 6a reporting requirement in subdivision 4a do does not apply to:

 

(1) a major spending commitment to replace existing equipment with comparable equipment used for direct patient care, upgrades of equipment beyond the current model, or comparable model must be reported;

 

(2) (1) a major spending commitment made by a research and teaching institution for purposes of conducting medical education, medical research supported or sponsored by a medical school, or by a federal or foundation grant or clinical trials;

 

(3) a major spending commitment to repair, remodel, or replace existing buildings or fixtures if, in the judgment of the commissioner, the project does not involve a substantial expansion of service capacity or a substantial change in the nature of health care services provided;

 

(4) (2) a major spending commitment for building maintenance including heating, water, electricity, and other maintenance-related expenditures; and

 

(5) (3) a major spending commitment for activities, not directly related to the delivery of patient care services, including food service, laundry, housekeeping, and other service-related activities; and.

 

(6) a major spending commitment for computer equipment or data systems not directly related to the delivery of patient care services, including computer equipment or data systems related to medical record automation.

 

(b) In addition to the exceptions listed in paragraph (a), the prospective review and approval process described in subdivision 6a reporting requirement in subdivision 4a does not apply to mergers, acquisitions, and other changes in ownership or control that, in the judgment of the commissioner, do not involve a substantial expansion of service capacity or a substantial change in the nature of health care services provided.

 

Sec. 5. Minnesota Statutes 2006, section 62J.41, subdivision 1, is amended to read:

 

Subdivision 1. Cost containment data to be collected from providers. The commissioner shall require health care providers to collect and provide both patient specific information and descriptive and financial aggregate data on:

 

(1) the total number of patients served;

 

(2) the total number of patients served by state of residence and Minnesota county;

 

(3) the site or sites where the health care provider provides services;

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(4) the number of individuals employed, by type of employee, by the health care provider;

 

(5) the services and their costs for which no payment was received;

 

(6) total revenue by type of payer or by groups of payers, including but not limited to, revenue from Medicare, medical assistance, MinnesotaCare, nonprofit health service plan corporations, commercial insurers, health maintenance organizations, and individual patients;

 

(7) revenue from research activities;

 

(8) revenue from educational activities;

 

(9) revenue from out-of-pocket payments by patients;

 

(10) revenue from donations; and

 

(11) a report on health care capital expenditures during the previous year, as required by section 62J.17; and

 

(11) (12) any other data required by the commissioner, including data in unaggregated form, for the purposes of developing spending estimates, setting spending limits, monitoring actual spending, and monitoring costs.

 

The commissioner may, by rule, modify the data submission categories listed above if the commissioner determines that this will reduce the reporting burden on providers without having a significant negative effect on necessary data collection efforts.

 

Sec. 6. Minnesota Statutes 2006, section 62J.52, subdivision 1, is amended to read:

 

Subdivision 1. Uniform billing form CMS 1450. (a) On and after January 1, 1996, all institutional inpatient hospital services, ancillary services, institutionally owned or operated outpatient services rendered by providers in Minnesota, and institutional or noninstitutional home health services that are not being billed using an equivalent electronic billing format, must be billed using the uniform billing form CMS 1450, except as provided in subdivision 5.

 

(b) The instructions and definitions for the use of the uniform billing form CMS 1450 shall be in accordance with the uniform billing form manual specified by the commissioner. In promulgating these instructions, the commissioner may utilize the manual developed by the National Uniform Billing Committee, as adopted and finalized by the Minnesota Uniform Billing Committee.

 

(c) Services to be billed using the uniform billing form CMS 1450 include: institutional inpatient hospital services and distinct units in the hospital such as psychiatric unit services, physical therapy unit services, swing bed (SNF) services, inpatient state psychiatric hospital services, inpatient skilled nursing facility services, home health services (Medicare part A), and hospice services; ancillary services, where benefits are exhausted or patient has no Medicare part A, from hospitals, state psychiatric hospitals, skilled nursing facilities, and home health (Medicare part B); institutional owned or operated outpatient services such as waivered services, hospital outpatient services, including ambulatory surgical center services, hospital referred laboratory services, hospital-based ambulance services, and other hospital outpatient services, skilled nursing facilities, home health, freestanding renal dialysis centers, comprehensive outpatient rehabilitation facilities (CORF), outpatient rehabilitation facilities (ORF), rural health clinics, and community mental health centers; home health services such as home health intravenous therapy providers, waivered services, personal care attendants, and hospice; and any other health care provider certified by the Medicare program to use this form.

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(d) On and after January 1, 1996, a mother and newborn child must be billed separately, and must not be combined on one claim form.

 

(e) Services provided by Medicare Critical Access Hospitals electing Method II billing will be allowed an exception to this provision to allow the inclusion of the professional fees on the CMS 1450.

 

Sec. 7. Minnesota Statutes 2006, section 62J.52, subdivision 2, is amended to read:

 

Subd. 2. Uniform billing form CMS 1500. (a) On and after January 1, 1996, all noninstitutional health care services rendered by providers in Minnesota except dental or pharmacy providers, that are not currently being billed using an equivalent electronic billing format, must be billed using the health insurance claim form CMS 1500, except as provided in subdivision 5.

 

(b) The instructions and definitions for the use of the uniform billing form CMS 1500 shall be in accordance with the manual developed by the Administrative Uniformity Committee entitled standards for the use of the CMS 1500 form, dated February 1994, as further defined by the commissioner.

 

(c) Services to be billed using the uniform billing form CMS 1500 include physician services and supplies, durable medical equipment, noninstitutional ambulance services, independent ancillary services including occupational therapy, physical therapy, speech therapy and audiology, home infusion therapy, podiatry services, optometry services, mental health licensed professional services, substance abuse licensed professional services, nursing practitioner professional services, certified registered nurse anesthetists, chiropractors, physician assistants, laboratories, medical suppliers, and other health care providers such as day activity centers and freestanding ambulatory surgical centers.

 

(d) Services provided by Medicare Critical Access Hospitals electing Method II billing will be allowed an exception to this provision to allow the inclusion of the professional fees on the CMS 1450.

 

Sec. 8. Minnesota Statutes 2006, section 62J.60, subdivision 2, is amended to read:

 

Subd. 2. General characteristics. (a) The Minnesota uniform health care identification card must be a preprinted card constructed of plastic, paper, or any other medium that conforms with ANSI and ISO 7810 physical characteristics standards. The card dimensions must also conform to ANSI and ISO 7810 physical characteristics standard. The use of a signature panel is optional. The uniform prescription drug information contained on the card must conform with the format adopted by the NCPDP and, except as provided in subdivision 3, paragraph (a), clause (2), must include all of the fields required to submit a claim in conformance with the most recent pharmacy identification card implementation guide produced by the NCPDP. All information required to submit a prescription drug claim, exclusive of information provided on a prescription that is required by law, must be included on the card in a clear, readable, and understandable manner. If a health benefit plan requires a conditional or situational field, as defined by the NCPDP, the conditional or situational field must conform to the most recent pharmacy information card implementation guide produced by the NCPDP.

 

(b) The Minnesota uniform health care identification card must have an essential information window on the front side with the following data elements: card issuer name, electronic transaction routing information, card issuer identification number, cardholder (insured) identification number, and cardholder (insured) identification name. No optional data may be interspersed between these data elements.

 

(c) Standardized labels are required next to human readable data elements and must come before the human data elements.

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Sec. 9. Minnesota Statutes 2006, section 62J.60, subdivision 3, is amended to read:

 

Subd. 3. Human readable data elements. (a) The following are the minimum human readable data elements that must be present on the front side of the Minnesota uniform health care identification card:

 

(1) card issuer name or logo, which is the name or logo that identifies the card issuer. The card issuer name or logo may be located at the top of the card. No standard label is required for this data element;

 

(2) complete electronic transaction routing information including, at a minimum, the international identification number. The standardized label of this data element is "RxBIN." Processor control numbers and group numbers are required if needed to electronically process a prescription drug claim. The standardized label for the process control numbers data element is "RxPCN" and the standardized label for the group numbers data element is "RxGrp," except that if the group number data element is a universal element to be used by all health care providers, the standardized label may be "Grp." To conserve vertical space on the card, the international identification number and the processor control number may be printed on the same line;

 

(3) cardholder (insured) identification number, which is the unique identification number of the individual card holder established and defined under this section. The standardized label for the data element is "ID";

 

(4) cardholder (insured) identification name, which is the name of the individual card holder. The identification name must be formatted as follows: first name, space, optional middle initial, space, last name, optional space and name suffix. The standardized label for this data element is "Name";

 

(5) care type, which is the description of the group purchaser's plan product under which the beneficiary is covered. The description shall include the health plan company name and the plan or product name. The standardized label for this data element is "Care Type";

 

(6) service type, which is the description of coverage provided such as hospital, dental, vision, prescription, or mental health. The standard label for this data element is "Svc Type"; and

 

(7) provider/clinic name, which is the name of the primary care clinic the card holder is assigned to by the health plan company. The standard label for this field is "PCP." This information is mandatory only if the health plan company assigns a specific primary care provider to the card holder.

 

(b) The following human readable data elements shall be present on the back side of the Minnesota uniform health care identification card. These elements must be left justified, and no optional data elements may be interspersed between them:

 

(1) claims submission names and addresses, which are the names and addresses of the entity or entities to which claims should be submitted. If different destinations are required for different types of claims, this must be labeled;

 

(2) telephone numbers and names that pharmacies and other health care providers may call for assistance. These telephone numbers and names are required on the back side of the card only if one of the contacts listed in clause (3) cannot provide pharmacies or other providers with assistance or with the telephone numbers and names of contacts for assistance; and

 

(3) telephone numbers and names; which are the telephone numbers and names of the following contacts with a standardized label describing the service function as applicable:

 

(i) eligibility and benefit information;

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(ii) utilization review;

 

(iii) precertification; or

 

(iv) customer services.

 

(c) The following human readable data elements are mandatory on the back side of the Minnesota uniform health care identification card for health maintenance organizations:

 

(1) emergency care authorization telephone number or instruction on how to receive authorization for emergency care. There is no standard label required for this information; and

 

(2) one of the following:

 

(i) telephone number to call to appeal to or file a complaint with the commissioner of health; or

 

(ii) for persons enrolled under section 256B.69, 256D.03, or 256L.12, the telephone number to call to file a complaint with the ombudsperson designated by the commissioner of human services under section 256B.69 and the address to appeal to the commissioner of human services. There is no standard label required for this information.

 

(d) All human readable data elements not required under paragraphs (a) to (c) are optional and may be used at the issuer's discretion.

 

Sec. 10. Minnesota Statutes 2006, section 62Q.80, subdivision 3, is amended to read:

 

Subd. 3. Approval. (a) Prior to the operation of a community-based health care coverage program, a community-based health initiative shall submit to the commissioner of health for approval the community-based health care coverage program developed by the initiative. The commissioner shall only approve a program that has been awarded a community access program grant from the United States Department of Health and Human Services. The commissioner shall ensure that the program meets the federal grant requirements and any requirements described in this section and is actuarially sound based on a review of appropriate records and methods utilized by the community-based health initiative in establishing premium rates for the community-based health care coverage program.

 

(b) Prior to approval, the commissioner shall also ensure that:

 

(1) the benefits offered comply with subdivision 8 and that there are adequate numbers of health care providers participating in the community-based health network to deliver the benefits offered under the program;

 

(2) the activities of the program are limited to activities that are exempt under this section or otherwise from regulation by the commissioner of commerce;

 

(3) the complaint resolution process meets the requirements of subdivision 10; and

 

(4) the data privacy policies and procedures comply with state and federal law.

 

Sec. 11. Minnesota Statutes 2006, section 62Q.80, subdivision 4, is amended to read:

 

Subd. 4. Establishment. (a) The initiative shall establish and operate upon approval by the commissioner of health a community-based health care coverage program. The operational structure established by the initiative shall include, but is not limited to:

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(1) establishing a process for enrolling eligible individuals and their dependents;

 

(2) collecting and coordinating premiums from enrollees and employers of enrollees;

 

(3) providing payment to participating providers;

 

(4) establishing a benefit set according to subdivision 8 and establishing premium rates and cost-sharing requirements;

 

(5) creating incentives to encourage primary care and wellness services; and

 

(6) initiating disease management services, as appropriate.

 

(b) The payments collected under paragraph (a), clause (2), may be used to capture available federal funds.

 

Sec. 12. Minnesota Statutes 2006, section 62Q.80, subdivision 13, is amended to read:

 

Subd. 13. Report. (a) The initiative shall submit quarterly status reports to the commissioner of health on January 15, April 15, July 15, and October 15 of each year, with the first report due January 15, 2007 2008. The status report shall include:

 

(1) the financial status of the program, including the premium rates, cost per member per month, claims paid out, premiums received, and administrative expenses;

 

(2) a description of the health care benefits offered and the services utilized;

 

(3) the number of employers participating, the number of employees and dependents covered under the program, and the number of health care providers participating;

 

(4) a description of the health outcomes to be achieved by the program and a status report on the performance measurements to be used and collected; and

 

(5) any other information requested by the commissioner of health or commerce or the legislature.

 

(b) The initiative shall contract with an independent entity to conduct an evaluation of the program to be submitted to the commissioners of health and commerce and the legislature by January 15, 2009 2010. The evaluation shall include:

 

(1) an analysis of the health outcomes established by the initiative and the performance measurements to determine whether the outcomes are being achieved;

 

(2) an analysis of the financial status of the program, including the claims to premiums loss ratio and utilization and cost experience;

 

(3) the demographics of the enrollees, including their age, gender, family income, and the number of dependents;

 

(4) the number of employers and employees who have been denied access to the program and the basis for the denial;

 

(5) specific analysis on enrollees who have aggregate medical claims totaling over $5,000 per year, including data on the enrollee's main diagnosis and whether all the medical claims were covered by the program;

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(6) number of enrollees referred to state public assistance programs;

 

(7) a comparison of employer-subsidized health coverage provided in a comparable geographic area to the designated community-based geographic area served by the program, including, to the extent available:

 

(i) the difference in the number of employers with 50 or fewer employees offering employer-subsidized health coverage;

 

(ii) the difference in uncompensated care being provided in each area; and

 

(iii) a comparison of health care outcomes and measurements established by the initiative; and

 

(8) any other information requested by the commissioner of health or commerce.

 

Sec. 13. Minnesota Statutes 2006, section 62Q.80, subdivision 14, is amended to read:

 

Subd. 14. Sunset. This section expires December 31, 2011 2012.

 

Sec. 14. Minnesota Statutes 2006, section 144.565, is amended to read:

 

144.565 DIAGNOSTIC IMAGING FACILITIES.

 

Subdivision 1. Utilization and services data; economic and financial interests. The commissioner shall require diagnostic imaging facilities and providers of diagnostic imaging services in Minnesota to annually report by March 1 each year for the preceding fiscal year to the commissioner, in the form and manner specified by the commissioner:

 

(1) utilization data for each health plan company and each public program, including workers' compensation, as follows: of diagnostic imaging services as defined in subdivision 4, paragraph (b);

 

(i) the number of computerized tomography (CT) procedures performed;

 

(ii) the number of magnetic resonance imaging (MRI) procedures performed; and

 

(iii) the number of positron emission tomography (PET) procedures performed; and

 

(2) the names of all physicians with any financial or economic interest and all other individuals with a ten percent or greater financial or economic interest in the facility.;

 

(3) the location where procedures were performed;

 

(4) the number of units of each type of fixed, portable, and mobile scanner used at each location;

 

(5) the average number of hours per month each mobile scanner was operated at each location;

 

(6) the number of hours per month each scanner was leased, if applicable;

 

(7) the total number of diagnostic imaging procedures billed for by the provider at each location, by type of diagnostic imaging service as defined in subdivision 4, paragraph (b); and

 

(8) a report on major health care capital expenditures during the previous year, as required by section 62J.17.

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Subd. 2. Commissioner's right to inspect records. If the report is not filed or the commissioner of health has reason to believe the report is incomplete or false, the commissioner shall have the right to inspect diagnostic imaging facility books, audits, and records.

 

Subd. 3. Separate reports. For a diagnostic imaging facility that is not attached or not contiguous to a hospital or a hospital affiliate, the commissioner shall require the information in subdivision 1 be reported separately for each detached diagnostic imaging facility as part of the report required under section 144.702. If any entity owns more than one diagnostic imaging facility, that entity must report by individual facility. Reports must include only services that were billed by the provider of diagnostic imaging services submitting the report. If a diagnostic imaging facility leases capacity, technical services, or professional services to one or more other providers of diagnostic imaging services, each provider must submit a separate annual report to the commissioner for all diagnostic imaging services that it provided and billed. The owner of the leased capacity must provide a report listing the names and addresses of providers to whom the diagnostic imaging services and equipment were leased.

 

Subd. 4. Definitions. For purposes of this section, the following terms have the meanings given:

 

(a) "Diagnostic imaging facility" means a health care facility that provides is not a hospital or location licensed as a hospital which offers diagnostic imaging services through the use of ionizing radiation or other imaging technique including, but not limited to magnetic resonance imaging (MRI) or computerized tomography (CT) scan on a freestanding or mobile basis in Minnesota, regardless of whether the equipment used to provide the service is owned or leased. For the purposes of this section, diagnostic imaging facility includes, but is not limited to, facilities such as a physician's office, clinic, mobile transport vehicle, outpatient imaging center, or surgical center.

 

(b) "Diagnostic imaging service" means the use of ionizing radiation or other imaging technique on a human patient including, but not limited to, magnetic resonance imaging (MRI) or computerized tomography (CT), positron emission tomography (PET), or single photon emission computerized tomography (SPECT) scans using fixed, portable, or mobile equipment.

 

(b) (c) "Financial or economic interest" means a direct or indirect:

 

(1) equity or debt security issued by an entity, including, but not limited to, shares of stock in a corporation, membership in a limited liability company, beneficial interest in a trust, units or other interests in a partnership, bonds, debentures, notes or other equity interests or debt instruments, or any contractual arrangements;

 

(2) membership, proprietary interest, or co-ownership with an individual, group, or organization to which patients, clients, or customers are referred to; or

 

(3) employer-employee or independent contractor relationship, including, but not limited to, those that may occur in a limited partnership, profit-sharing arrangement, or other similar arrangement with any facility to which patients are referred, including any compensation between a facility and a health care provider, the group practice of which the provider is a member or employee or a related party with respect to any of them.

 

(c) (d) "Freestanding Fixed equipment" means a stationary diagnostic imaging facility that is not located within a: machine installed in a permanent location.

 

(1) hospital;

 

(2) location licensed as a hospital; or

 

(3) physician's office or clinic where the professional practice of medicine by licensed physicians is the primary purpose and not the provision of ancillary services such as diagnostic imaging.

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(d) (e) "Mobile equipment" means a diagnostic imaging facility that is transported to various sites not including movement within a hospital or a physician's office or clinic machine in a self-contained transport vehicle designed to be brought to a temporary offsite location to perform diagnostic imaging services.

 

(f) "Portable equipment" means a diagnostic imaging machine designed to be temporarily transported within a permanent location to perform diagnostic imaging services.

 

(g) "Provider of diagnostic imaging services" means a diagnostic imaging facility or an entity that offers and bills for diagnostic imaging services at a facility owned or leased by the entity.

 

Subd. 5. Reports open to public inspection. All reports filed pursuant to this section shall be open to public inspection.

 

Sec. 15. [144.585] METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS CONTROL PROGRAMS.

 

In order to improve the prevention of hospital-associated infections due to methicillin-resistant Staphylococcus aureus ("MRSA"), every hospital shall establish an MRSA control program that meets Minnesota Department of Health MRSA recommendations as published January 15, 2008. In developing the MRSA recommendations, the Department of Health shall consider the following infection control practices:

 

(1) identification of MRSA-colonized patients in all intensive care units, or other at-risk patients identified by the hospital;

 

(2) isolation of identified MRSA-colonized or MRSA-infected patients in an appropriate manner;

 

(3) adherence to hand hygiene requirements; and

 

(4) monitor trends in the incidence of MRSA in the hospital over time and modify interventions if MRSA infection rates do not decrease.

 

The Department of Health shall review the MRSA recommendations on an annual basis and revise the recommendations as necessary, in accordance with available scientific data.

 

Sec. 16. Minnesota Statutes 2006, section 144.651, subdivision 9, is amended to read:

 

Subd. 9. Information about treatment. Patients and residents shall be given by their physicians complete and current information concerning their diagnosis, treatment, alternatives, risks, and prognosis as required by the physician's legal duty to disclose. This information shall be in terms and language the patients or residents can reasonably be expected to understand. Patients and residents may be accompanied by a family member or other chosen representative, or both. This information shall include the likely medical or major psychological results of the treatment and its alternatives. In cases where it is medically inadvisable, as documented by the attending physician in a patient's or resident's medical record, the information shall be given to the patient's or resident's guardian or other person designated by the patient or resident as a representative. Individuals have the right to refuse this information.

 

Every patient or resident suffering from any form of breast cancer shall be fully informed, prior to or at the time of admission and during her stay, of all alternative effective methods of treatment of which the treating physician is knowledgeable, including surgical, radiological, or chemotherapeutic treatments or combinations of treatments and the risks associated with each of those methods.

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Sec. 17. Minnesota Statutes 2006, section 144.651, subdivision 10, is amended to read:

 

Subd. 10. Participation in planning treatment; notification of family members. (a) Patients and residents shall have the right to participate in the planning of their health care. This right includes the opportunity to discuss treatment and alternatives with individual caregivers, the opportunity to request and participate in formal care conferences, and the right to include a family member or other chosen representative, or both. In the event that the patient or resident cannot be present, a family member or other representative chosen by the patient or resident may be included in such conferences. A chosen representative may include a doula of the patient's choice.

 

(b) If a patient or resident who enters a facility is unconscious or comatose or is unable to communicate, the facility shall make reasonable efforts as required under paragraph (c) to notify either a family member or a person designated in writing by the patient as the person to contact in an emergency that the patient or resident has been admitted to the facility. The facility shall allow the family member to participate in treatment planning, unless the facility knows or has reason to believe the patient or resident has an effective advance directive to the contrary or knows the patient or resident has specified in writing that they do not want a family member included in treatment planning. After notifying a family member but prior to allowing a family member to participate in treatment planning, the facility must make reasonable efforts, consistent with reasonable medical practice, to determine if the patient or resident has executed an advance directive relative to the patient or resident's health care decisions. For purposes of this paragraph, "reasonable efforts" include:

 

(1) examining the personal effects of the patient or resident;

 

(2) examining the medical records of the patient or resident in the possession of the facility;

 

(3) inquiring of any emergency contact or family member contacted under this section whether the patient or resident has executed an advance directive and whether the patient or resident has a physician to whom the patient or resident normally goes for care; and

 

(4) inquiring of the physician to whom the patient or resident normally goes for care, if known, whether the patient or resident has executed an advance directive. If a facility notifies a family member or designated emergency contact or allows a family member to participate in treatment planning in accordance with this paragraph, the facility is not liable to the patient or resident for damages on the grounds that the notification of the family member or emergency contact or the participation of the family member was improper or violated the patient's privacy rights.

 

(c) In making reasonable efforts to notify a family member or designated emergency contact, the facility shall attempt to identify family members or a designated emergency contact by examining the personal effects of the patient or resident and the medical records of the patient or resident in the possession of the facility. If the facility is unable to notify a family member or designated emergency contact within 24 hours after the admission, the facility shall notify the county social service agency or local law enforcement agency that the patient or resident has been admitted and the facility has been unable to notify a family member or designated emergency contact. The county social service agency and local law enforcement agency shall assist the facility in identifying and notifying a family member or designated emergency contact. A county social service agency or local law enforcement agency that assists a facility in implementing this subdivision is not liable to the patient or resident for damages on the grounds that the notification of the family member or emergency contact or the participation of the family member was improper or violated the patient's privacy rights.

 

Sec. 18. Minnesota Statutes 2006, section 144.651, subdivision 26, is amended to read:

 

Subd. 26. Right to associate. (a) Residents may meet with and receive visitors and participate in activities of commercial, religious, political, as defined in section 203B.11 and community groups without interference at their discretion if the activities do not infringe on the right to privacy of other residents or are not programmatically contraindicated. This includes:

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(1) the right to join with other individuals within and outside the facility to work for improvements in long-term care;

 

(2) the right to visitation by an individual the patient has appointed as the patient's health care agent under chapter 145C;

 

(3) the right to visitation and health care decision making by an individual designated by the patient under paragraph (c).

 

(b) Upon admission to a facility where federal law prohibits unauthorized disclosure of patient or resident identifying information to callers and visitors, the patient or resident, or the legal guardian or conservator of the patient or resident, shall be given the opportunity to authorize disclosure of the patient's or resident's presence in the facility to callers and visitors who may seek to communicate with the patient or resident. To the extent possible, the legal guardian or conservator of a patient or resident shall consider the opinions of the patient or resident regarding the disclosure of the patient's or resident's presence in the facility.

 

(c) Upon admission to a facility, the patient or resident, or the legal guardian or conservator of the patient or resident, must be given the opportunity to designate a person who is not related who will have the status of the patient's next of kin with respect to visitation and making a health care decision. A designation must be included in the patient's health record. With respect to making a health care decision, a health care directive or appointment of a health care agent under chapter 145C prevails over a designation made under this paragraph. The unrelated person may also be identified as such by the patient or by the patient's family.

 

Sec. 19. Minnesota Statutes 2006, section 145C.05, is amended to read:

 

145C.05 SUGGESTED FORM; PROVISIONS THAT MAY BE INCLUDED.

 

Subdivision 1. Content. A health care directive executed pursuant to this chapter may, but need not, be in the form contained in section 145C.16.

 

Subd. 2. Provisions that may be included. (a) A health care directive may include provisions consistent with this chapter, including, but not limited to:

 

(1) the designation of one or more alternate health care agents to act if the named health care agent is not reasonably available to serve;

 

(2) directions to joint health care agents regarding the process or standards by which the health care agents are to reach a health care decision for the principal, and a statement whether joint health care agents may act independently of one another;

 

(3) limitations, if any, on the right of the health care agent or any alternate health care agents to receive, review, obtain copies of, and consent to the disclosure of the principal's medical records or to visit the principal when the principal is a patient in a health care facility;

 

(4) limitations, if any, on the nomination of the health care agent as guardian for purposes of sections 524.5-202, 524.5-211, 524.5-302, and 524.5-303;

 

(5) a document of gift for the purpose of making an anatomical gift, as set forth in sections 525.921 to 525.9224, or an amendment to, revocation of, or refusal to make an anatomical gift;

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(6) a declaration regarding intrusive mental health treatment under section 253B.03, subdivision 6d, or a statement that the health care agent is authorized to give consent for the principal under section 253B.04, subdivision 1a;

 

(7) a funeral directive as provided in section 149A.80, subdivision 2;

 

(8) limitations, if any, to the effect of dissolution or annulment of marriage or termination of domestic partnership on the appointment of a health care agent under section 145C.09, subdivision 2;

 

(9) specific reasons why a principal wants a health care provider or an employee of a health care provider attending the principal to be eligible to act as the principal's health care agent;

 

(10) health care instructions by a woman of child bearing age regarding how she would like her pregnancy, if any, to affect health care decisions made on her behalf; and

 

(11) health care instructions regarding artificially administered nutrition or hydration.

 

(b) A health care directive may include a statement of the circumstances under which the directive becomes effective other than upon the judgment of the principal's attending physician in the following situations:

 

(1) a principal who in good faith generally selects and depends upon spiritual means or prayer for the treatment or care of disease or remedial care and does not have an attending physician, may include a statement appointing an individual who may determine the principal's decision-making capacity; and

 

(2) a principal who in good faith does not generally select a physician or a health care facility for the principal's health care needs may include a statement appointing an individual who may determine the principal's decision-making capacity, provided that if the need to determine the principal's capacity arises when the principal is receiving care under the direction of an attending physician in a health care facility, the determination must be made by an attending physician after consultation with the appointed individual.

 

If a person appointed under clause (1) or (2) is not reasonably available and the principal is receiving care under the direction of an attending physician in a health care facility, an attending physician shall determine the principal's decision-making capacity.

 

(c) A health care directive may authorize a health care agent to make health care decisions for a principal even though the principal retains decision-making capacity.

 

Sec. 20. Minnesota Statutes 2006, section 145C.07, is amended by adding a subdivision to read:

 

Subd. 5. Visitation. A health care agent may visit the principal when the principal is a patient in a health care facility regardless of whether the principal retains decision-making capacity, unless:

 

(1) the principal has otherwise specified in the health care directive;

 

(2) a principal who retains decision-making capacity indicates otherwise; or

 

(3) a health care provider reasonably determines that the principal must be isolated from all visitors or that the presence of the health care agent would endanger the health or safety of the principal, other patients, or the facility in which the care is being provided.

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Sec. 21. Minnesota Statutes 2006, section 148.6445, subdivision 1, is amended to read:

 

Subdivision 1. Initial licensure fee. The initial licensure fee for occupational therapists is $180 $145. The initial licensure fee for occupational therapy assistants is $100 $80. The commissioner shall prorate fees based on the number of quarters remaining in the biennial licensure period.

 

Sec. 22. Minnesota Statutes 2006, section 148.6445, subdivision 2, is amended to read:

 

Subd. 2. Licensure renewal fee. The biennial licensure renewal fee for occupational therapists is $180 $145. The biennial licensure renewal fee for occupational therapy assistants is $100 $80.

 

Sec. 23. [148.785] FEES.

 

The fees charged by the board are fixed at the following rates:

 

(1) application fee for physical therapists and physical therapist assistants, $100;

 

(2) annual licensure for physical therapists and physical therapist assistants, $60;

 

(3) licensure renewal late fee, $20;

 

(4) temporary permit, $25;

 

(5) duplicate license or registration, $20;

 

(6) certification letter, $25;

 

(7) education or training program approval, $100;

 

(8) report creation and generation, $60 per hour billed in quarter-hour increments with a quarter-hour minimum; and

 

(9) examination administration:

 

(i) half day, $50; and

 

(ii) full day, $80.

 

Sec. 24. [148.995] DEFINITIONS.

 

Subdivision 1. Applicability. The definitions in this section apply to sections 148.995 to 148.997.

 

Subd. 2. Certified doula. "Certified doula" means an individual who has received a certification to perform doula services from the International Childbirth Education Association, the Doulas of North America (DONA), the Association of Labor Assistants and Childbirth Educators (ALACE), Birthworks, Childbirth and Postpartum Professional Association (CAPPA), or Childbirth International.

 

Subd. 3. Commissioner. "Commissioner" means the commissioner of health.

 

Subd. 4. Doula services. "Doula services" means emotional and physical support during pregnancy, labor, birth, and postpartum.

 

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

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Sec. 25. [148.996] REGISTRY.

 

Subdivision 1. Establishment. The commissioner of health shall maintain a registry of certified doulas who have met the requirements listed in subdivision 2.

 

Subd. 2. Qualifications. The commissioner shall include on the registry any individual who:

 

(1) submits an application on a form provided by the commissioner. The form must include the applicant's name, address, and contact information;

 

(2) maintains a current certification from one of the organizations listed in section 146B.01, subdivision 2; and

 

(3) pays the fees required under section 148.997.

 

Subd. 3. Criminal background check. The commissioner shall conduct a criminal background check by reviewing the Bureau of Criminal Apprehension's Web site. If the review indicates that an applicant has been engaged in criminal behavior, the commissioner shall indicate this on the registry and provide a link to the Bureau of Criminal Apprehension's Web site.

 

Subd. 4. Renewal. Inclusion on the registry maintained by the commissioner is valid for three years. At the end of the three-year period, the certified doula may submit a new application to remain on the doula registry by meeting the requirements described in subdivision 2.

 

Subd. 5. Public access. The commissioner shall provide a link to the registry on the Department of Health's Web site.

 

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

 

Sec. 26. [148.997] FEES.

 

Subdivision 1. Fees. (a) The application fee is $130.

 

(b) The criminal background check fee is $6.

 

Subd. 2. Nonrefundable fees. The fees in this section are nonrefundable.

 

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

 

Sec. 27. Minnesota Statutes 2006, section 148B.53, subdivision 3, is amended to read:

 

Subd. 3. Fee. Nonrefundable fees are as follows:

 

(1) initial license application fee for licensed professional counseling (LPC) - $250 $150;

 

(2) initial license fee for LPC - $250;

 

(3) annual active license renewal fee for LPC - $200 $250 or equivalent;

 

(3) (4) annual inactive license renewal fee for LPC - $100 $125;

 

(5) initial license application fee for licensed professional clinical counseling (LPCC) - $150;

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(6) initial license fee for LPCC - $250;

 

(7) annual active license renewal fee for LPCC - $250 or equivalent;

 

(8) annual inactive license renewal fee for LPCC - $125;

 

(4) (9) license renewal late fee - $100 per month or portion thereof;

 

(5) (10) copy of board order or stipulation - $10;

 

(6) (11) certificate of good standing or license verification - $10 $25;

 

(7) (12) duplicate certificate fee - $10 $25;

 

(8) (13) professional firm renewal fee - $25;

 

(9) (14) sponsor application for approval of a continuing education course - $60;

 

(15) initial registration fee - $50; and

 

(10) (16) annual registration renewal fee - $25; and

 

(17) approved supervisor application processing fee - $30.

 

Sec. 28. Minnesota Statutes 2006, section 149A.52, subdivision 3, is amended to read:

 

Subd. 3. Application procedure; documentation; initial inspection. An applicant for a license to operate a crematory shall submit to the commissioner a completed application. A completed application includes:

 

(1) a completed application form, as provided by the commissioner;

 

(2) proof of business form and ownership; and

 

(3) proof of liability insurance coverage or other financial documentation, as determined by the commissioner, that demonstrates the applicant's ability to respond in damages for liability arising from the ownership, maintenance, management, or operation of a crematory.

 

Upon receipt of the application and appropriate fee, the commissioner shall review and verify all information. Upon completion of the verification process and resolution of any deficiencies in the application information, the commissioner shall conduct an initial inspection of the premises to be licensed. After the inspection and resolution of any deficiencies found and any reinspections as may be necessary, the commissioner shall make a determination, based on all the information available, to grant or deny licensure. If the commissioner's determination is to grant the license, the applicant shall be notified and the license shall issue and remain valid for a period prescribed on the license, but not to exceed one calendar year from the date of issuance of the license. If the commissioner's determination is to deny the license, the commissioner must notify the applicant, in writing, of the denial and provide the specific reason for denial.

 

Sec. 29. [149A.65] FEES.

 

Subdivision 1. Generally. This section establishes the fees for registrations, examinations, initial and renewal licenses, and late fees authorized under the provisions of this chapter.

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Subd. 2. Mortuary science fees. Fees for mortuary science are:

 

(1) $50 for the initial and renewal registration of a mortuary science intern;

 

(2) $100 for the mortuary science examination;

 

(3) $125 for issuance of initial and renewal mortuary science licenses;

 

(4) $25 late fee charge for a license renewal; and

 

(5) $200 for issuing a mortuary science license by endorsement.

 

Subd. 3. Funeral directors. The license renewal fee for funeral directors is $125. The late fee charge for a license renewal is $25.

 

Subd. 4. Funeral establishments. The initial and renewal fee for funeral establishments is $300. The late fee charge for a license renewal is $25.

 

Subd. 5. Crematories. The initial and renewal fee for a crematory is $300. The late fee charge for a license renewal is $25.

 

Sec. 30. Minnesota Statutes 2006, section 149A.97, subdivision 7, is amended to read:

 

Subd. 7. Reports to commissioner. Every funeral provider lawfully doing business in Minnesota that accepts funds under subdivision 2 must make a complete annual report to the commissioner. The reports may be on forms provided by the commissioner or substantially similar forms containing, at least, identification and the state of each trust account, including all transactions involving principal and accrued interest, and must be filed by March 31 of the calendar year following the reporting year along with a filing fee of $15 $25 for each report. Fees shall be paid to the commissioner of finance, state of Minnesota, for deposit in the state government special revenue fund in the state treasury. Reports must be signed by an authorized representative of the funeral provider and notarized under oath. All reports to the commissioner shall be reviewed for account inaccuracies or possible violations of this section. If the commissioner has a reasonable belief to suspect that there are account irregularities or possible violations of this section, the commissioner shall report that belief, in a timely manner, to the state auditor. The commissioner shall also file an annual letter with the state auditor disclosing whether or not any irregularities or possible violations were detected in review of the annual trust fund reports filed by the funeral providers. This letter shall be filed with the state auditor by May 31 of the calendar year following the reporting year.

 

Sec. 31. Minnesota Statutes 2006, section 157.16, subdivision 1, is amended to read:

 

Subdivision 1. License required annually. A license is required annually for every person, firm, or corporation engaged in the business of conducting a food and beverage service establishment, hotel, motel, lodging establishment, or resort. Any person wishing to operate a place of business licensed in this section shall first make application, pay the required fee specified in this section, and receive approval for operation, including plan review approval. Seasonal and temporary food stands and special event food stands are not required to submit plans. Nonprofit organizations operating a special event food stand with multiple locations at an annual one-day event shall be issued only one license. Application shall be made on forms provided by the commissioner and shall require the applicant to state the full name and address of the owner of the building, structure, or enclosure, the lessee and manager of the food and beverage service establishment, hotel, motel, lodging establishment, or resort; the name under which the business is to be conducted; and any other information as may be required by the commissioner to complete the application for license.

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Sec. 32. INJUNCTIVE RELIEF REPORT.

 

The commissioner of health shall present to the 2008 legislature, by December 15, 2007, recommendations to fund the cost of bringing actions for injunctive relief under Minnesota Statutes, section 144G.02, subdivision 2, paragraph (b).

 

Sec. 33. HEARING AID DISPENSER FEES.

 

Fees relating to hearing aid dispensers, as provided in Minnesota Statutes, section 153A.17, may not be increased until after the Department of Health provides a report to the legislature regarding the need and reasons for fee increases.

 

Sec. 34. REPEALER.

 

Minnesota Rules, part 4610.2800, is repealed.

 

ARTICLE 10

 

DEPARTMENT OF HEALTH

 

Section 1. Minnesota Statutes 2006, section 62Q.80, is amended by adding a subdivision to read:

 

Subd. 1a. Demonstration project. The commissioner of health shall award a demonstration project grant to a community-based health care initiative to develop and operate a community-based health care coverage program to operate within Carlton, Cook, Lake, and St. Louis County. The demonstration project shall extend for five years and must comply with the requirements of this section.

 

Sec. 2. [144.291] MINNESOTA HEALTH RECORDS ACT.

 

Subdivision 1. Short title. Sections 144.291 to 144.298 may be cited as the Minnesota Health Records Act.

 

Subd. 2. Definitions. For the purposes of sections 144.291 to 144.298, the following terms have the meanings given.

 

(a) Group purchaser. "Group purchaser" has the meaning given in section 62J.03, subdivision 6.

 

(b) Health information exchange. "Health information exchange" means a legal arrangement between health care providers and group purchasers to enable and oversee the business and legal issues involved in the electronic exchange of health records between the entities for the delivery of patient care.

 

(c) Health record. "Health record" means any information, whether oral or recorded in any form or medium, that relates to the past, present, or future physical or mental health or condition of a patient; the provision of health care to a patient; or the past, present, or future payment for the provision of health care to a patient.

 

(d) Identifying information. "Identifying information" means the patient's name, address, date of birth, gender, parent's or guardian's name regardless of the age of the patient, and other nonclinical data which can be used to uniquely identify a patient.

 

(e) Individually identifiable form. "Individually identifiable form" means a form in which the patient is or can be identified as the subject of the health records.

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(f) Medical emergency. "Medical emergency" means medically necessary care which is immediately needed to preserve life, prevent serious impairment to bodily functions, organs, or parts, or prevent placing the physical or mental health of the patient in serious jeopardy.

 

(g) Patient. "Patient" means a natural person who has received health care services from a provider for treatment or examination of a medical, psychiatric, or mental condition, the surviving spouse and parents of a deceased patient, or a person the patient appoints in writing as a representative, including a health care agent acting according to chapter 145C, unless the authority of the agent has been limited by the principal in the principal's health care directive. Except for minors who have received health care services under sections 144.341 to 144.347, in the case of a minor, patient includes a parent or guardian, or a person acting as a parent or guardian in the absence of a parent or guardian.

 

(h) Provider. "Provider" means:

 

(1) any person who furnishes health care services and is regulated to furnish the services under chapter 147, 147A, 147B, 147C, 147D, 148, 148B, 148C, 148D, 150A, 151, 153, or 153A;

 

(2) a home care provider licensed under section 144A.46;

 

(3) a health care facility licensed under this chapter or chapter 144A;

 

(4) a physician assistant registered under chapter 147A; and

 

(5) an unlicensed mental health practitioner regulated under sections 148B.60 to 148B.71.

 

(i) Record locator service. "Record locator service" means an electronic index of patient identifying information that directs providers in a health information exchange to the location of patient health records held by providers and group purchasers.

 

(j) Related health care entity. "Related health care entity" means an affiliate, as defined in section 144.6521, subdivision 3, paragraph (b), of the provider releasing the health records.

 

Sec. 3. [144.292] PATIENT RIGHTS.

 

Subdivision 1. Scope. Patients have the rights specified in this section regarding the treatment the patient receives and the patient's health record.

 

Subd. 2. Patient access. Upon request, a provider shall supply to a patient complete and current information possessed by that provider concerning any diagnosis, treatment, and prognosis of the patient in terms and language the patient can reasonably be expected to understand.

 

Subd. 3. Additional patient rights. A patient's right specified in this section and sections 144.293 to 144.298 are in addition to the rights specified in sections 144.651 and 144.652 and any other provision of law relating to the access of a patient to the patient's health records.

 

Subd. 4. Notice of rights; information on release. A provider shall provide to patients, in a clear and conspicuous manner, a written notice concerning practices and rights with respect to access to health records. The notice must include an explanation of:

 

(1) disclosures of health records that may be made without the written consent of the patient, including the type of records and to whom the records may be disclosed; and

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(2) the right of the patient to have access to and obtain copies of the patient's health records and other information about the patient that is maintained by the provider.

 

The notice requirements of this subdivision are satisfied if the notice is included with the notice and copy of the patient and resident bill of rights under section 144.652 or if it is displayed prominently in the provider's place of business. The commissioner of health shall develop the notice required in this subdivision and publish it in the State Register.

 

Subd. 5. Copies of health records to patients. Except as provided in section 144.296, upon a patient's written request, a provider, at a reasonable cost to the patient, shall promptly furnish to the patient:

 

(1) copies of the patient's health record, including but not limited to laboratory reports, x-rays, prescriptions, and other technical information used in assessing the patient's health conditions; or

 

(2) the pertinent portion of the record relating to a condition specified by the patient.

 

With the consent of the patient, the provider may instead furnish only a summary of the record. The provider may exclude from the health record written speculations about the patient's health condition, except that all information necessary for the patient's informed consent must be provided.

 

Subd. 6. Cost. (a) When a patient requests a copy of the patient's record for purposes of reviewing current medical care, the provider must not charge a fee.

 

(b) When a provider or its representative makes copies of patient records upon a patient's request under this section, the provider or its representative may charge the patient or the patient's representative no more than 75 cents per page, plus $10 for time spent retrieving and copying the records, unless other law or a rule or contract provide for a lower maximum charge. This limitation does not apply to x-rays. The provider may charge a patient no more than the actual cost of reproducing x-rays, plus no more than $10 for the time spent retrieving and copying the x‑rays.

 

(c) The respective maximum charges of 75 cents per page and $10 for time provided in this subdivision are in effect for calendar year 1992 and may be adjusted annually each calendar year as provided in this subdivision. The permissible maximum charges shall change each year by an amount that reflects the change, as compared to the previous year, in the Consumer Price Index for all Urban Consumers, Minneapolis-St. Paul (CPI-U), published by the Department of Labor.

 

(d) A provider or its representative must not charge a fee to provide copies of records requested by a patient or the patient's authorized representative if the request for copies of records is for purposes of appealing a denial of Social Security disability income or Social Security disability benefits under title II or title XVI of the Social Security Act. For the purpose of further appeals, a patient may receive no more than two medical record updates without charge, but only for medical record information previously not provided. For purposes of this paragraph, a patient's authorized representative does not include units of state government engaged in the adjudication of Social Security disability claims.

 

Subd. 7. Withholding health records from patient. (a) If a provider, as defined in section 144.291, subdivision 2, paragraph (h), clause (1), reasonably determines that the information is detrimental to the physical or mental health of the patient, or is likely to cause the patient to inflict self harm, or to harm another, the provider may withhold the information from the patient and may supply the information to an appropriate third party or to another provider, as defined in section 144.291, subdivision 2, paragraph (h), clause (1). The other provider or third party may release the information to the patient.

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(b) A provider, as defined in section 144.291, subdivision 2, paragraph (h), clause (3), shall release information upon written request unless, prior to the request, a provider, as defined in section 144.291, subdivision 2, paragraph (h), clause (1), has designated and described a specific basis for withholding the information as authorized by paragraph (a).

 

Subd. 8. Form. By January 1, 2008, the Department of Health must develop a form that may be used by a patient to request access to health records under this section. A form developed by the commissioner must be accepted by a provider as a legally enforceable request under this section.

 

Sec. 4. [144.293] RELEASE OR DISCLOSURE OF HEALTH RECORDS.

 

Subdivision 1. Release or disclosure of health records. Health records can be released or disclosed as specified in subdivisions 2 to 9 and sections 144.294 and 144.295.

 

Subd. 2. Patient consent to release of records. A provider, or a person who receives health records from a provider, may not release a patient's health records to a person without:

 

(1) a signed and dated consent from the patient or the patient's legally authorized representative authorizing the release;

 

(2) specific authorization in law; or

 

(3) a representation from a provider that holds a signed and dated consent from the patient authorizing the release.

 

Subd. 3. Release from one provider to another. A patient's health record, including, but not limited to, laboratory reports, x-rays, prescriptions, and other technical information used in assessing the patient's condition, or the pertinent portion of the record relating to a specific condition, or a summary of the record, shall promptly be furnished to another provider upon the written request of the patient. The written request shall specify the name of the provider to whom the health record is to be furnished. The provider who furnishes the health record or summary may retain a copy of the materials furnished. The patient shall be responsible for the reasonable costs of furnishing the information.

 

Subd. 4. Duration of consent. Except as provided in this section, a consent is valid for one year or for a lesser period specified in the consent or for a different period provided by law.

 

Subd. 5. Exceptions to consent requirement. This section does not prohibit the release of health records:

 

(1) for a medical emergency when the provider is unable to obtain the patient's consent due to the patient's condition or the nature of the medical emergency;

 

(2) to other providers within related health care entities when necessary for the current treatment of the patient; or

 

(3) to a health care facility licensed by this chapter, chapter 144A, or to the same types of health care facilities licensed by this chapter and chapter 144A that are licensed in another state when a patient:

 

(i) is returning to the health care facility and unable to provide consent; or

 

(ii) who resides in the health care facility, has services provided by an outside resource under Code of Federal Regulations, title 42, section 483.75(h), and is unable to provide consent.

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Subd. 6. Consent does not expire. Notwithstanding subdivision 4, if a patient explicitly gives informed consent to the release of health records for the purposes and restrictions in clauses (1) and (2), the consent does not expire after one year for:

 

(1) the release of health records to a provider who is being advised or consulted with in connection with the releasing provider's current treatment of the patient;

 

(2) the release of health records to an accident and health insurer, health service plan corporation, health maintenance organization, or third-party administrator for purposes of payment of claims, fraud investigation, or quality of care review and studies, provided that:

 

(i) the use or release of the records complies with sections 72A.49 to 72A.505;

 

(ii) further use or release of the records in individually identifiable form to a person other than the patient without the patient's consent is prohibited; and

 

(iii) the recipient establishes adequate safeguards to protect the records from unauthorized disclosure, including a procedure for removal or destruction of information that identifies the patient.

 

Subd. 7. Exception to consent. Subdivision 2 does not apply to the release of health records to the commissioner of health or the Health Data Institute under chapter 62J, provided that the commissioner encrypts the patient identifier upon receipt of the data.

 

Subd. 8. Record locator service. (a) A provider or group purchaser may release patient identifying information and information about the location of the patient's health records to a record locator service without consent from the patient, unless the patient has elected to be excluded from the service under paragraph (d). The Department of Health may not access the record locator service or receive data from the record locator service. Only a provider may have access to patient identifying information in a record locator service. Except in the case of a medical emergency, a provider participating in a health information exchange using a record locator service does not have access to patient identifying information and information about the location of the patient's health records unless the patient specifically consents to the access. A consent does not expire but may be revoked by the patient at any time by providing written notice of the revocation to the provider.

 

(b) A health information exchange maintaining a record locator service must maintain an audit log of providers accessing information in a record locator service that at least contains information on:

 

(1) the identity of the provider accessing the information;

 

(2) the identity of the patient whose information was accessed by the provider; and

 

(3) the date the information was accessed.

 

(c) No group purchaser may in any way require a provider to participate in a record locator service as a condition of payment or participation.

 

(d) A provider or an entity operating a record locator service must provide a mechanism under which patients may exclude their identifying information and information about the location of their health records from a record locator service. At a minimum, a consent form that permits a provider to access a record locator service must include a conspicuous check-box option that allows a patient to exclude all of the patient's information from the record locator service. A provider participating in a health information exchange with a record locator service who receives a patient's request to exclude all of the patient's information from the record locator service or to have a specific provider contact excluded from the record locator service is responsible for removing that information from the record locator service.

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Subd. 9. Documentation of release. (a) In cases where a provider releases health records without patient consent as authorized by law, the release must be documented in the patient's health record. In the case of a release under section 144.294, subdivision 2, the documentation must include the date and circumstances under which the release was made, the person or agency to whom the release was made, and the records that were released.

 

(b) When a health record is released using a representation from a provider that holds a consent from the patient, the releasing provider shall document:

 

(1) the provider requesting the health records;

 

(2) the identity of the patient;

 

(3) the health records requested; and

 

(4) the date the health records were requested.

 

Subd. 10. Warranties regarding consents, requests, and disclosures. (a) When requesting health records using consent, a person warrants that the consent:

 

(1) contains no information known to the person to be false; and

 

(2) accurately states the patient's desire to have health records disclosed or that there is specific authorization in law.

 

(b) When requesting health records using consent, a provider warrants that the request:

 

(1) contains no information known to the provider to be false;

 

(2) accurately states the patient's desire to have health records disclosed or that there is specific authorization in law; and

 

(3) does not exceed any limits imposed by the patient in the consent.

 

(c) When disclosing health records, a person releasing health records warrants that the person:

 

(1) has complied with the requirements of this section regarding disclosure of health records;

 

(2) knows of no information related to the request that is false; and

 

(3) has complied with the limits set by the patient in the consent.

 

Sec. 5. [144.294] RECORDS RELATING TO MENTAL HEALTH.

 

Subdivision 1. Provider inquiry. Upon the written request of a spouse, parent, child, or sibling of a patient being evaluated for or diagnosed with mental illness, a provider shall inquire of a patient whether the patient wishes to authorize a specific individual to receive information regarding the patient's current and proposed course of treatment. If the patient so authorizes, the provider shall communicate to the designated individual the patient's current and proposed course of treatment. Section 144.293, subdivisions 2 and 4, apply to consents given under this subdivision.

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Subd. 2. Disclosure to law enforcement agency. Notwithstanding section 144.293, subdivisions 2 and 4, a provider must disclose health records relating to a patient's mental health to a law enforcement agency if the law enforcement agency provides the name of the patient and communicates that the:

 

(1) patient is currently involved in an emergency interaction with the law enforcement agency; and

 

(2) disclosure of the records is necessary to protect the health or safety of the patient or of another person.

 

The scope of disclosure under this subdivision is limited to the minimum necessary for law enforcement to respond to the emergency. A law enforcement agency that obtains health records under this subdivision shall maintain a record of the requestor, the provider of the information, and the patient's name. Health records obtained by a law enforcement agency under this subdivision are private data on individuals as defined in section 13.02, subdivision 12, and must not be used by law enforcement for any other purpose.

 

Subd. 3. Records release for family and caretaker; mental health care. (a) Notwithstanding section 144.293, a provider providing mental health care and treatment may disclose health record information described in paragraph (b) about a patient to a family member of the patient or other person who requests the information if:

 

(1) the request for information is in writing;

 

(2) the family member or other person lives with, provides care for, or is directly involved in monitoring the treatment of the patient;

 

(3) the involvement under clause (2) is verified by the patient's mental health care provider, the patient's attending physician, or a person other than the person requesting the information, and is documented in the patient's medical record;

 

(4) before the disclosure, the patient is informed in writing of the request, the name of the person requesting the information, the reason for the request, and the specific information being requested;

 

(5) the patient agrees to the disclosure, does not object to the disclosure, or is unable to consent or object, and the patient's decision or inability to make a decision is documented in the patient's medical record; and

 

(6) the disclosure is necessary to assist in the provision of care or monitoring of the patient's treatment.

 

(b) The information disclosed under this paragraph is limited to diagnosis, admission to or discharge from treatment, the name and dosage of the medications prescribed, side effects of the medication, consequences of failure of the patient to take the prescribed medication, and a summary of the discharge plan.

 

(c) If a provider reasonably determines that providing information under this subdivision would be detrimental to the physical or mental health of the patient or is likely to cause the patient to inflict self harm or to harm another, the provider must not disclose the information.

 

(d) This subdivision does not apply to disclosures for a medical emergency or to family members as authorized or required under subdivision 1 or section 144.293, subdivision 5, clause (1).

 

Sec. 6. [144.295] DISCLOSURE OF HEALTH RECORDS FOR EXTERNAL RESEARCH.

 

Subdivision 1. Methods of release. (a) Notwithstanding section 144.293, subdivisions 2 and 4, health records may be released to an external researcher solely for purposes of medical or scientific research only as follows:

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(1) health records generated before January 1, 1997, may be released if the patient has not objected or does not elect to object after that date;

 

(2) for health records generated on or after January 1, 1997, the provider must:

 

(i) disclose in writing to patients currently being treated by the provider that health records, regardless of when generated, may be released and that the patient may object, in which case the records will not be released; and

 

(ii) use reasonable efforts to obtain the patient's written general authorization that describes the release of records in item (i), which does not expire but may be revoked or limited in writing at any time by the patient or the patient's authorized representative;

 

(3) the provider must advise the patient of the rights specified in clause (4); and

 

(4) the provider must, at the request of the patient, provide information on how the patient may contact an external researcher to whom the health record was released and the date it was released.

 

(b) Authorization may be established if an authorization is mailed at least two times to the patient's last known address with a postage prepaid return envelope and a conspicuous notice that the patient's medical records may be released if the patient does not object, and at least 60 days have expired since the second notice was sent.

 

Subd. 2. Duties of researcher. In making a release for research purposes, the provider shall make a reasonable effort to determine that:

 

(1) the use or disclosure does not violate any limitations under which the record was collected;

 

(2) the use or disclosure in individually identifiable form is necessary to accomplish the research or statistical purpose for which the use or disclosure is to be made;

 

(3) the recipient has established and maintains adequate safeguards to protect the records from unauthorized disclosure, including a procedure for removal or destruction of information that identifies the patient; and

 

(4) further use or release of the records in individually identifiable form to a person other than the patient without the patient's consent is prohibited.

 

Sec. 7. [144.296] COPIES OF VIDEOTAPES.

 

A provider may not release a copy of a videotape of a child victim or alleged victim of physical or sexual abuse without a court order under section 13.03, subdivision 6, or as provided in section 611A.90. This section does not limit the right of a patient to view the videotape.

 

Sec. 8. [144.297] INDEPENDENT MEDICAL EXAMINATION.

 

Sections 144.291 to 144.298 apply to the subject and provider of an independent medical examination requested by or paid for by a third party. Notwithstanding section 144.293, a provider may release health records created as part of an independent medical examination to the third party who requested or paid for the examination.

 

Sec. 9. [144.298] PENALTIES.

 

Subdivision 1. Licensing action. A violation of sections 144.291 to 144.298 may be grounds for disciplinary action against a provider by the appropriate licensing board or agency.

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Subd. 2. Liability of provider or other person. A person who does any of the following is liable to the patient for compensatory damages caused by an unauthorized release, plus costs and reasonable attorney fees:

 

(1) negligently or intentionally requests or releases a health record in violation of sections 144.291 to 144.297;

 

(2) forges a signature on a consent form or materially alters the consent form of another person without the person's consent; or

 

(3) obtains a consent form or the health records of another person under false pretenses.

 

Subd. 3. Liability for record locator service. A patient is entitled to receive compensatory damages plus costs and reasonable attorney fees if a health information exchange maintaining a record locator service, or an entity maintaining a record locator service for a health information exchange, negligently or intentionally violates the provisions of section 144.293, subdivision 8.

 

Sec. 10. Minnesota Statutes 2006, section 144.3345, is amended to read:

 

144.3345 INTERCONNECTED ELECTRONIC HEALTH RECORD GRANTS.

 

Subdivision 1. Definitions. The following definitions are used for the purposes of this section.

 

(a) "Eligible community e-health collaborative" means an existing or newly established collaborative to support the adoption and use of interoperable electronic health records. A collaborative must consist of at least three two or more eligible health care entities in at least two of the categories listed in paragraph (b) and have a focus on interconnecting the members of the collaborative for secure and interoperable exchange of health care information.

 

(b) "Eligible health care entity" means one of the following:

 

(1) community clinics, as defined under section 145.9268;

 

(2) hospitals eligible for rural hospital capital improvement grants, as defined in section 144.148;

 

(3) physician clinics located in a community with a population of less than 50,000 according to United States Census Bureau statistics and outside the seven-county metropolitan area;

 

(4) nursing facilities licensed under sections 144A.01 to 144A.27;

 

(5) community health boards or boards of health as established under chapter 145A;

 

(6) nonprofit entities with a purpose to provide health information exchange coordination governed by a representative, multi-stakeholder board of directors; and

 

(7) other providers of health or health care services approved by the commissioner for which interoperable electronic health record capability would improve quality of care, patient safety, or community health.

 

Subd. 2. Grants authorized. The commissioner of health shall award grants to:

 

(a) eligible community e-health collaborative projects to improve the implementation and use of interoperable electronic health records including but not limited to the following projects:

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(1) collaborative efforts to host and support fully functional interoperable electronic health records in multiple care settings;

 

(2) electronic medication history and electronic patient registration medical history information;

 

(3) electronic personal health records for persons with chronic diseases and for prevention services;

 

(4) rural and underserved community models for electronic prescribing; and

 

(5) enabling modernize local public health information systems to rapidly and electronically exchange information needed to participate in community e-health collaboratives or for public health emergency preparedness and response.; and

 

(6) implement regional or community-based health information exchange organizations;

 

(b) community clinics, as defined under section 145.9268, to implement and use interoperable electronic health records, including but not limited to the following projects:

 

(1) efforts to plan for and implement fully functional, standards-based interoperable electronic health records; and

 

(2) purchases and implementation of computer hardware, software, and technology to fully implement interoperable electronic health records;

 

(c) regional or community-based health information exchange organizations to connect and facilitate the exchange of health information between eligible health care entities, including but not limited to the development, testing, and implementation of:

 

(1) data exchange standards, including data, vocabulary, and messaging standards, for the exchange of health information, provided that such standards are consistent with state and national standards;

 

(2) security standards necessary to ensure the confidentiality and integrity of health records;

 

(3) computer interfaces and mechanisms for standardizing health information exchanged between eligible health care entities;

 

(4) a record locator service for identifying the location of patient health records; or

 

(5) interfaces and mechanisms for implementing patient consent requirements; and

 

(d) community health boards and boards of health as established under chapter 145A to modernize local public health information systems to be standards-based and interoperable with other electronic health records and information systems, or for enhanced public health emergency preparedness and response.

 

Grant funds may not be used for construction of health care or other buildings or facilities.

 

Subd. 3. Allocation of grants. (a) To receive a grant under this section, an eligible community e-health collaborative, community clinic, regional or community-based health information exchange, or community health boards and boards of health must submit an application to the commissioner of health by the deadline established by the commissioner. A grant may be awarded upon the signing of a grant contract. In awarding grants, the commissioner shall give preference to projects benefiting providers located in rural and underserved areas of

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Minnesota which the commissioner has determined have an unmet need for the development and funding of electronic health records. Applicants may apply for and the commissioner may award grants for one-year, two-year, or three-year periods.

 

(b) An application must be on a form and contain information as specified by the commissioner but at a minimum must contain:

 

(1) a description of the purpose or project for which grant funds will be used;

 

(2) a description of the problem or problems the grant funds will be used to address, including an assessment of the likelihood of the project occurring absent grant funding;

 

(3) a description of achievable objectives, a workplan, budget, budget narrative, a project communications plan, a timeline for implementation and completion of processes or projects enabled by the grant, and an assessment of privacy and security issues and a proposed approach to address these issues;

 

(4) a description of the health care entities and other groups participating in the project, including identification of the lead entity responsible for applying for and receiving grant funds;

 

(5) a plan for how patients and consumers will be involved in development of policies and procedures related to the access to and interchange of information;

 

(6) evidence of consensus and commitment among the health care entities and others who developed the proposal and are responsible for its implementation; and

 

(7) a plan for documenting and evaluating results of the grant. ; and

 

(8) a plan for use of data exchange standards, including data and vocabulary.

 

(c) The commissioner shall review each application to determine whether the application is complete and whether the applicant and the project are eligible for a grant. In evaluating applications, the commissioner shall take into consideration factors, including but not limited to, the following:

 

(1) the degree to which the proposal interconnects the various providers of care with other health care entities in the applicant's geographic community;

 

(2) the degree to which the project provides for the interoperability of electronic health records or related health information technology between the members of the collaborative, and presence and scope of a description of how the project intends to interconnect with other providers not part of the project into the future;

 

(3) the degree to which the project addresses current unmet needs pertaining to interoperable electronic health records in a geographic area of Minnesota and the likelihood that the needs would not be met absent grant funds;

 

(4) the applicant's thoroughness and clarity in describing the project, how the project will improve patient safety, quality of care, and consumer empowerment, and the role of the various collaborative members;

 

(5) the recommendations of the Health Information and Technology Infrastructure Advisory Committee; and

 

(6) other factors that the commissioner deems relevant.

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(d) Grant funds shall be awarded on a three-to-one match basis. Applicants shall be required to provide $1 in the form of cash or in-kind staff or services for each $3 provided under the grant program.

 

(e) Grants shall not exceed $900,000 per grant. The commissioner has discretion over the size and number of grants awarded.

 

Subd. 4. Evaluation and report. The commissioner of health shall evaluate the overall effectiveness of the grant program. The commissioner shall collect progress and expenditure reports to evaluate the grant program from the eligible community collaboratives receiving grants.

 

Sec. 11. Minnesota Statutes 2006, section 144D.03, subdivision 1, is amended to read:

 

Subdivision 1. Registration procedures. The commissioner shall establish forms and procedures for annual registration of housing with services establishments. The commissioner shall charge an annual registration fee of $35 $155. No fee shall be refunded. A registered establishment shall notify the commissioner within 30 days of the date it is no longer required to be registered under this chapter or of any change in the business name or address of the establishment, the name or mailing address of the owner or owners, or the name or mailing address of the managing agent. There shall be no fee for submission of the notice.

 

Sec. 12. [145.9269] FEDERALLY QUALIFIED HEALTH CENTERS.

 

Subdivision 1. Definitions. For purposes of this section, "federally qualified health center" means an entity that is receiving a grant under United States Code, title 42, section 254b, or, based on the recommendation of the Health Resources and Services Administration within the Public Health Service, is determined by the secretary to meet the requirements for receiving such a grant.

 

Subd. 2. Allocation of subsidies. The commissioner of health shall distribute subsidies to federally qualified health centers operating in Minnesota to continue, expand, and improve federally qualified health center services to low-income populations. The commissioner shall distribute the funds appropriated under this section to federally qualified health centers operating in Minnesota as of January 1, 2007. The amount of each subsidy shall be in proportion to each federally qualified health center's amount of discounts granted to patients during calendar year 2006 as reported on the federal Uniform Data System report in conformance with the Bureau of Primary Health Care Program Expectations Policy Information Notice 98-23, except that each eligible federally qualified health center shall receive at least two percent but no more than 30 percent of the total amount of money available under this section.

 

Sec. 13. HEALTH PROMOTION PROGRAM.

 

The commissioner of health, in consultation with the State Community Health Services Advisory Committee established in Minnesota Statutes, section 145A.10, subdivision 10, shall develop a plan to fund and implement an ongoing comprehensive health promotion program that can effect change more effectively and at lower cost at a community level rather than through individual counseling and change promotion. The program shall use proven public health strategies to promote healthy lifestyles and behaviors in order to establish a sustainable, long-term approach to reducing preventable disability, chronic health conditions, and disease. The focus shall be on community based initiatives that address childhood and adult obesity, tobacco and substance abuse, improved activity levels among senior citizens, and other lifestyle issues that impact health and healthcare costs. Because of its population health focus, funding shall be related to the size of the population to be served. The plan shall be completed by October 1, 2007, and shared with the Legislative Health Care Access Commission.

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Sec. 14. CERVICAL CANCER PREVENTION AND HUMAN PAPILLOMA VIRUS VACCINE STUDY.

 

The commissioner of health shall reconvene the cervical cancer elimination study required under Laws 2005, First Special Session chapter 4, article 6, section 52, to conduct a study, in collaboration with the Minnesota Immunization Practices Advisory Committee, on the human papilloma virus vaccine, including, but not limited to, the following:

 

(1) the risks and benefits of the human papilloma virus vaccine;

 

(2) the availability and effectiveness of the vaccine;

 

(3) the extent to which health plan companies cover the cost of this vaccination; and

 

(4) ways to cover the cost of vaccination for persons without coverage.

 

The commissioner shall submit a report to the legislature by February 1, 2008, on the findings of the study and recommendations as to whether the human papilloma virus vaccine should be made mandatory statewide.

 

Sec. 15. REVISOR'S INSTRUCTION.

 

In Minnesota Statutes and Minnesota Rules, the revisor shall change the references in column A with the references in column B.

 

                                     Column A                                                                                      Column B

 

                 section 144.335                                                                                 sections 144.291 to 144.298

          section 144.335, subdivision 1                                                       section 144.291, subdivision 2

                 section 144.335, subdivision 1, paragraph (b)                             section 144.291, subdivision 2, paragraph (h)

                 section 144.335, subdivision 2, paragraphs (a) and (b)              section 144.292, subdivisions 2 and 5

                 section 144.335, subdivision 2                                                       section 144.292

                 section 144.335, subdivision 3a                                                     section 144.294, subdivision 2

                 section 144.335, subdivision 3a, paragraph (d)                           section 144.295

                 section 144.335, subdivision 3a, paragraph (f)                            section 144.294

                 section 144.335, subdivision 3b                                                     section 144.293, subdivision 7

 

Sec. 16. REPEALER.

 

Minnesota Statutes 2006, section 144.335, and Laws 2006, chapter 249, section 6, are repealed.

 

ARTICLE 11

 

MISCELLANEOUS POLICY

 

Section 1. Minnesota Statutes 2006, section 13.381, is amended by adding a subdivision to read:

 

Subd. 16a. Prescription electronic reporting system. Access to data in the prescription electronic reporting system is governed by section 152.126.

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Sec. 2. Minnesota Statutes 2006, section 148.235, is amended by adding a subdivision to read:

 

Subd. 11. Dispensing by protocol. A registered nurse in a family planning agency as defined in Minnesota Rules, part 9505.0280, subpart 3, may dispense oral contraceptives prescribed by a licensed practitioner as defined in section 151.01, subdivision 23, pursuant to a dispensing protocol established by the agency's medical director or under the direction of a physician. The dispensing protocol must address the requirements of sections 151.01, subdivision 30, and 151.212, subdivision 1.

 

Sec. 3. Minnesota Statutes 2006, section 151.19, subdivision 2, is amended to read:

 

Subd. 2. Nonresident pharmacies. The board shall require and provide for an annual nonresident special pharmacy registration for all pharmacies located outside of this state that regularly dispense medications for Minnesota residents and mail, ship, or deliver prescription medications into this state. Nonresident special pharmacy registration shall be granted by the board upon the disclosure and certification by a pharmacy:

 

(1) that it is licensed in the state in which the dispensing facility is located and from which the drugs are dispensed;

 

(2) the location, names, and titles of all principal corporate officers and all pharmacists who are dispensing drugs to residents of this state;

 

(3) that it complies with all lawful directions and requests for information from the Board of Pharmacy of all states in which it is licensed or registered, except that it shall respond directly to all communications from the board concerning emergency circumstances arising from the dispensing of drugs to residents of this state;

 

(4) that it maintains its records of drugs dispensed to residents of this state so that the records are readily retrievable from the records of other drugs dispensed;

 

(5) that it cooperates with the board in providing information to the Board of Pharmacy of the state in which it is licensed concerning matters related to the dispensing of drugs to residents of this state; and

 

(6) that during its regular hours of operation, but not less than six days per week, for a minimum of 40 hours per week, a toll-free telephone service is provided to facilitate communication between patients in this state and a pharmacist at the pharmacy who has access to the patients' records; the toll-free number must be disclosed on the label affixed to each container of drugs dispensed to residents of this state.; and

 

(7) that, upon request of a resident of a long-term care facility located within the state of Minnesota, the resident's authorized representative, or a contract pharmacy or licensed health care facility acting on behalf of the resident, the pharmacy will dispense medications prescribed for the resident in unit-dose packaging or, alternatively, comply with the provisions of section 151.415, subdivision 5.

 

Sec. 4. [151.415] LONG-TERM CARE RESIDENT ACCESS TO PHARMACEUTICALS ACT.

 

Subdivision 1. Title; citation. This section may be cited as the "Long-Term Care Resident Access to Pharmaceuticals Act."

 

Subd. 2. Definitions. For the purposes of this section, the following terms have the meanings given them unless otherwise provided by text:

 

(a) "Board" means the Board of Pharmacy.

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(b) "Contract pharmacy" means a pharmacy, licensed under this chapter, which is under contract to a long-term care facility.

 

(c) "Long-term care facility" means a nursing home licensed under sections 144A.02 to 144A.10, or a boarding care home licensed under sections 144.50 to 144.56. Facilities not certified under title XIX of the federal Social Security Act are not included in this definition.

 

(d) "Original dispensing pharmacy" shall mean a pharmacy, licensed in any state in the United States, which dispenses drugs in bulk prescription containers to a person who is a resident in a long-term care facility.

 

Subd. 3. Authorization to administer and repackage drugs. (a) A contract pharmacist or pharmacy may repackage a resident's prescription drugs, which have been lawfully dispensed from bulk prescription containers by an original dispensing pharmacy, into a unit-dose system compatible with the system used by the long-term care facility.

 

(b) A long-term care facility may administer drugs to residents of the facility that have been repackaged according to this subdivision. The contract pharmacy shall notify the long-term care facility whenever medications have been dispensed according to this subdivision and must certify that the repackaging and dispensing has been done in accordance with this subdivision.

 

(c) Drugs may be dispensed for a resident of a long-term care facility according to this subdivision, provided that:

 

(1) the drug is dispensed by the original dispensing pharmacy according to a current, valid prescription;

 

(2) the original bulk prescription container for the resident is delivered by the original dispensing pharmacy directly to the contract pharmacist or pharmacy;

 

(3) the contract pharmacist or pharmacy verifies the name and strength of the drug, the name of the manufacturer of the drug, the manufacturer's lot or control number, the manufacturer's expiration date for the drug, and the date the drug was dispensed by the original dispensing pharmacy;

 

(4) the contract pharmacist or pharmacy verifies the validity and accuracy of the current prescription order;

 

(5) the contract pharmacist or pharmacy repackages the drug in board-approved unit-dose packaging, with labeling that complies with Minnesota Rules, part 6800.6300, and that identifies that the drug has been repackaged according to this section;

 

(6) the resident for whom the medication is repackaged obtains medications from or receives medications at a discounted rate from the original dispensing pharmacy under the resident's state or federal health assistance program or a private health insurance plan; and

 

(7) the resident for whom the medication is to be repackaged, or the resident's authorized representative, has signed an informed consent form provided by the facility which includes an explanation of the repackaging process and which notifies the resident of the immunities from liability provided in this section.

 

Subd. 4. Maintenance of records. For each drug repackaged by a contract pharmacy under this section, the contract pharmacy shall maintain a record for at least two years of the following information:

 

(1) the name, manufacturer, manufacturer's lot number, manufacturer's expiration date, and quantity of the drug prescribed;

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(2) the name and address of the resident for whom the drug was repackaged;

 

(3) the name and address or other identifier of the prescriber;

 

(4) the date the prescription was issued and the date the drug was repackaged;

 

(5) the date the repackaged drug was delivered to the long-term care facility;

 

(6) the directions for use;

 

(7) a copy of the label that was affixed to the repackaged drug;

 

(8) the initials of the packager;

 

(9) the initials of the supervising pharmacist; and

 

(10) the name and business address of the original dispensing pharmacy.

 

Subd. 5. Duties of the original dispensing pharmacy. Upon request of the resident, the resident's authorized representative, or a contract pharmacy or licensed health care facility acting on behalf of the resident, the original dispensing pharmacy is required to deliver medications dispensed for the resident directly to the contract pharmacist or pharmacy. The original dispensing pharmacy is further required to provide the contract pharmacist or pharmacy with the name and strength of the drug, the name of the manufacturer of the drug, the manufacturer's lot or control number, the manufacturer's expiration date for the drug, and the date the drug was dispensed.

 

Subd. 6. Redispensing of returned drugs prohibited. Unused drugs repackaged according to this section that are returned to any pharmacy shall not be redispensed.

 

Subd. 7. Immunity from civil liability. (a) A contract pharmacist or pharmacy and its employees or agents repackaging a drug acquired from an original dispensing pharmacy shall be immune from civil liability arising from harm caused by the drug due to acts or omissions of other persons outside of the contract pharmacist or pharmacy if the contract pharmacist or pharmacy properly repackages the drug according to this section.

 

(b) A long-term care facility and the facility's employees or agents who properly administer a drug repackaged by a contract pharmacist or pharmacy under this section shall be immune from civil liability arising from harm caused by the drug due to acts or omissions of other persons outside the long-term care facility.

 

Subd. 8. Handling fee. A contract pharmacist or pharmacy may charge a monthly fee of no more than 250 percent of the medical assistance program dispensing fee for each drug repackaged according to this section, but no more than $100 per month for each individual resident.

 

Sec. 5. Minnesota Statutes 2006, section 152.11, is amended by adding a subdivision to read:

 

Subd. 2d. Identification requirement for schedule II or III controlled substance. No person may dispense a controlled substance included in schedule II or III without requiring the person purchasing the controlled substance, who need not be the person for whom the controlled substance prescription is written, to present valid photographic identification, unless the person purchasing the controlled substance, or if applicable the person for whom the controlled substance prescription is written, is known to the dispenser.

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Sec. 6. [152.126] SCHEDULE II AND III CONTROLLED SUBSTANCES PRESCRIPTION ELECTRONIC REPORTING SYSTEM.

 

Subdivision 1. Definitions. For purposes of this section, the terms defined in this subdivision have the meanings given.

 

(a) "Board" means the Minnesota State Board of Pharmacy established under chapter 151.

 

(b) "Controlled substances" means those substances listed in section 152.02, subdivisions 3 and 4, and those substances defined by the board pursuant to section 152.02, subdivisions 7, 8, and 12.

 

(c) "Dispense" or "dispensing" has the meaning given in section 151.01, subdivision 30. Dispensing does not include the direct administering of a controlled substance to a patient by a licensed health care professional.

 

(d) "Dispenser" means a person authorized by law to dispense a controlled substance, pursuant to a valid prescription. A dispenser does not include a licensed hospital pharmacy that distributes controlled substances for inpatient hospital care.

 

(e) "Prescriber" means a licensed health care professional who is authorized to prescribe a controlled substance under section 152.12, subdivision 1.

 

(f) "Prescription" has the meaning given in section 151.01, subdivision 16.

 

Subd. 2. Prescription electronic reporting system. (a) The board shall establish by January 1, 2009, an electronic system for reporting the information required under subdivision 4 for all controlled substances dispensed within the state. Data for controlled substance prescriptions that are dispensed in a quantity small enough to provide treatment to a patient for a period of 48 hours or less need not be reported.

 

(b) The board may contract with a vendor for the purpose of obtaining technical assistance in the design, implementation, and maintenance of the electronic reporting system. The vendor's role shall be limited to providing technical support to the board concerning the software, databases, and computer systems required to interface with the existing systems currently used by pharmacies to dispense prescriptions and transmit prescription data to other third parties.

 

Subd. 3. Prescription Electronic Reporting Advisory Committee. (a) The board shall convene an advisory committee. The committee must include at least one representative of:

 

(1) the Department of Health;

 

(2) the Department of Human Services;

 

(3) each health-related licensing board that licenses prescribers;

 

(4) a professional medical association, which may include an association of pain management and chemical dependency specialists;

 

(5) a professional pharmacy association;

 

(6) a consumer privacy or security advocate; and

 

(7) a consumer or patient rights organization.

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(b) The advisory committee shall advise the board on the development and operation of the electronic reporting system, including, but not limited to:

 

(1) technical standards for electronic prescription drug reporting;

 

(2) proper analysis and interpretation of prescription monitoring data; and

 

(3) an evaluation process for the program.

 

(c) The Board of Pharmacy, after consultation with the advisory committee, shall present recommendations and draft legislation on the issues addressed by the advisory committee under paragraph (b), to the legislature by December 15, 2007.

 

Subd. 4. Reporting requirements; notice. (a) Each dispenser must submit the following data to the board or its designated vendor, subject to the notice required under paragraph (d):

 

(1) name of the prescriber;

 

(2) national provider identifier of the prescriber;

 

(3) name of the dispenser;

 

(4) national provider identifier of the dispenser;

 

(5) name of the patient for whom the prescription was written;

 

(6) date of birth of the patient for whom the prescription was written;

 

(7) date the prescription was written;

 

(8) date the prescription was filled;

 

(9) name and strength of the controlled substance;

 

(10) quantity of controlled substance prescribed; and

 

(11) quantity of controlled substance dispensed.

 

(b) The dispenser must submit the required information by a procedure and in a format established by the board.

 

(c) A dispenser is not required to submit this data for those controlled substance prescriptions dispensed for:

 

(1) individuals residing in licensed skilled nursing or intermediate care facilities;

 

(2) individuals receiving assisted living services under chapter 144G or through a medical assistance home and community-based waiver;

 

(3) individuals receiving medication intravenously;

 

(4) individuals receiving hospice and other palliative or end-of-life care; and

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(5) individuals receiving services from a home care provider regulated under chapter 144A.

 

(d) A dispenser must not submit data under this subdivision unless a conspicuous notice of the reporting requirements of this section is given to the patient for whom the prescription was written.

 

Subd. 5. Use of data by board. (a) The board shall develop and maintain a database of the data reported under subdivision 4. The board shall maintain data that could identify an individual prescriber or dispenser in encrypted form. The database may be used by permissible users identified under subdivision 6 for the identification of:

 

(1) individuals receiving prescriptions for controlled substances from prescribers who subsequently obtain controlled substances from dispensers in quantities or with a frequency inconsistent with standards accepted by national and international pain management associations of dosage for those controlled substances; and

 

(2) individuals presenting forged or otherwise false or altered prescriptions for controlled substances to dispensers.

 

(b) No permissible user identified under subdivision 6 may access the database for the sole purpose of identifying prescribers of controlled substances for unusual or excessive prescribing patterns without a valid search warrant or court order.

 

(c) No personnel of a state or federal occupational licensing board or agency may access the database for the purpose of obtaining information to be used to initiate or substantiate a disciplinary action against a prescriber.

 

(d) Data reported under subdivision 4 shall be retained by the board in the database for a 12-month period, and shall be removed from the database 12 months from the date the data was received.

 

Subd. 6. Access to reporting system data. (a) Except as indicated in this subdivision, the data submitted to the board under subdivision 4 is private data on individuals as defined in section 13.02, subdivision 12, and not subject to public disclosure.

 

(b) Except as specified in subdivision 5, the following persons shall be considered permissible users and may access the data submitted under subdivision 4 in the same or similar manner, and for the same or similar purposes, as those persons who are authorized to access similar private data on individuals under federal and state law:

 

(1) a prescriber, to the extent the information relates specifically to a current patient of the prescriber, to whom the practitioner is prescribing or considering prescribing any controlled substance;

 

(2) a dispenser, to the extent the information relates specifically to a current patient to whom that dispenser is dispensing or considering dispensing any controlled substance;

 

(3) an individual who is the recipient of a controlled substance prescription for which data was submitted under subdivision 4, or a guardian of the individual, parent or guardian of a minor, or health care agent of the individual acting under a health care directive under chapter 145C;

 

(4) personnel of the board specifically assigned to conduct a bona fide investigation of a specific licensee;

 

(5) personnel of the board engaged in the collection of controlled substance prescription information as part of the assigned duties and responsibilities under this section;

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(6) authorized personnel of a vendor under contract with the board who are engaged in the design, implementation, and maintenance of the electronic reporting system as part of the assigned duties and responsibilities of their employment, provided that access to data is limited to the minimum amount necessary to test and maintain the system databases;

 

(7) federal, state, and local law enforcement authorities acting pursuant to a valid search warrant; and

 

(8) personnel of the medical assistance program assigned to use the data collected under this section to identify recipients whose usage of controlled substances may warrant restriction to a single primary care physician, a single outpatient pharmacy, or a single hospital.

 

For purposes of clause (3), access by an individual includes persons in the definition of an individual under section 13.02.

 

(c) Any permissible user identified in paragraph (b), who directly accesses the data electronically, shall implement and maintain a comprehensive information security program that contains administrative, technical, and physical safeguards that are appropriate to the user's size and complexity, and the sensitivity of the personal information obtained. The permissible user shall identify reasonably foreseeable internal and external risks to the security, confidentiality, and integrity of personal information that could result in the unauthorized disclosure, misuse, or other compromise of the information and assess the sufficiency of any safeguards in place to control the risks.

 

(d) The board shall not release data submitted under this section unless it is provided with evidence, satisfactory to the board, that the person requesting the information is entitled to receive the data.

 

(e) The board shall not release the name of a prescriber without the written consent of the prescriber or a valid search warrant or court order. The board shall provide a mechanism for a prescriber to submit to the board a signed consent authorizing the release of the prescriber's name when data containing the prescriber's name is requested.

 

(f) The board shall maintain a log of all persons who access the data and shall ensure that any permissible user complies with paragraph (c) prior to attaining direct access to the data.

 

Subd. 7. Disciplinary action. (a) A dispenser who knowingly fails to submit data to the board as required under this section is subject to disciplinary action by the appropriate health-related licensing board.

 

(b) A prescriber or dispenser authorized to access the data who knowingly discloses the data in violation of state or federal laws relating to the privacy of health care data shall be subject to disciplinary action by the appropriate health-related licensing board, and appropriate civil penalties.

 

Subd. 8. Evaluation and reporting. (a) The board shall evaluate the prescription electronic reporting system to determine if the system is cost-effective and whether it is negatively impacting appropriate prescribing practices of controlled substances. The board may contract with a vendor to design and conduct the evaluation.

 

(b) The board shall submit the evaluation of the system to the legislature by January 15, 2010.

 

Subd. 9. Immunity from liability; no requirement to obtain information. (a) A pharmacist, prescriber, or other dispenser making a report to the program in good faith under this section is immune from any civil, criminal, or administrative liability, which might otherwise be incurred or imposed as a result of the report, or on the basis that the pharmacist or prescriber did or did not seek or obtain or use information from the program.

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(b) Nothing in this section shall require a pharmacist, prescriber, or other dispenser to obtain information about a patient from the program, and the pharmacist, prescriber, or other dispenser, if acting in good faith, is immune from any civil, criminal, or administrative liability that might otherwise be incurred or imposed for requesting, receiving, or using information from the program.

 

EFFECTIVE DATE. This section is effective July 1, 2007, or upon receiving sufficient nonstate funds to implement the prescription electronic reporting program, whichever is later. In the event that nonstate funds are not secured by the Board of Pharmacy to adequately fund the implementation of the prescription electronic reporting program, the board is not required to implement this section without a subsequent appropriation from the legislature.

 

Sec. 7. Minnesota Statutes 2006, section 245.4874, is amended to read:

 

245.4874 DUTIES OF COUNTY BOARD.

 

(a) The county board must:

 

(1) develop a system of affordable and locally available children's mental health services according to sections 245.487 to 245.4887;

 

(2) establish a mechanism providing for interagency coordination as specified in section 245.4875, subdivision 6;

 

(3) consider the assessment of unmet needs in the county as reported by the local children's mental health advisory council under section 245.4875, subdivision 5, paragraph (b), clause (3). The county shall provide, upon request of the local children's mental health advisory council, readily available data to assist in the determination of unmet needs;

 

(4) assure that parents and providers in the county receive information about how to gain access to services provided according to sections 245.487 to 245.4887;

 

(5) coordinate the delivery of children's mental health services with services provided by social services, education, corrections, health, and vocational agencies to improve the availability of mental health services to children and the cost-effectiveness of their delivery;

 

(6) assure that mental health services delivered according to sections 245.487 to 245.4887 are delivered expeditiously and are appropriate to the child's diagnostic assessment and individual treatment plan;

 

(7) provide the community with information about predictors and symptoms of emotional disturbances and how to access children's mental health services according to sections 245.4877 and 245.4878;

 

(8) provide for case management services to each child with severe emotional disturbance according to sections 245.486; 245.4871, subdivisions 3 and 4; and 245.4881, subdivisions 1, 3, and 5;

 

(9) provide for screening of each child under section 245.4885 upon admission to a residential treatment facility, acute care hospital inpatient treatment, or informal admission to a regional treatment center;

 

(10) prudently administer grants and purchase-of-service contracts that the county board determines are necessary to fulfill its responsibilities under sections 245.487 to 245.4887;

 

(11) assure that mental health professionals, mental health practitioners, and case managers employed by or under contract to the county to provide mental health services are qualified under section 245.4871;

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(12) assure that children's mental health services are coordinated with adult mental health services specified in sections 245.461 to 245.486 so that a continuum of mental health services is available to serve persons with mental illness, regardless of the person's age;

 

(13) assure that culturally informed mental health consultants are used as necessary to assist the county board in assessing and providing appropriate treatment for children of cultural or racial minority heritage; and

 

(14) consistent with section 245.486, arrange for or provide a children's mental health screening to a child receiving child protective services or a child in out-of-home placement, a child for whom parental rights have been terminated, a child found to be delinquent, and a child found to have committed a juvenile petty offense for the third or subsequent time, unless a screening or diagnostic assessment has been performed within the previous 180 days, or the child is currently under the care of a mental health professional. The court or county agency must notify a parent or guardian whose parental rights have not been terminated of the potential mental health screening and the option to prevent the screening by notifying the court or county agency in writing. The screening shall be conducted with a screening instrument approved by the commissioner of human services according to criteria that are updated and issued annually to ensure that approved screening instruments are valid and useful for child welfare and juvenile justice populations, and shall be conducted by a mental health practitioner as defined in section 245.4871, subdivision 26, or a probation officer or local social services agency staff person who is trained in the use of the screening instrument. Training in the use of the instrument shall include training in the administration of the instrument, the interpretation of its validity given the child's current circumstances, the state and federal data practices laws and confidentiality standards, the parental consent requirement, and providing respect for families and cultural values. If the screen indicates a need for assessment, the child's family, or if the family lacks mental health insurance, the local social services agency, in consultation with the child's family, shall have conducted a diagnostic assessment, including a functional assessment, as defined in section 245.4871. The administration of the screening shall safeguard the privacy of children receiving the screening and their families and shall comply with the Minnesota Government Data Practices Act, chapter 13, and the federal Health Insurance Portability and Accountability Act of 1996, Public Law 104-191. Screening results shall be considered private data and the commissioner shall not collect individual screening results.

 

(b) When the county board refers clients to providers of children's therapeutic services and supports under section 256B.0943, the county board must clearly identify the desired services components not covered under section 256B.0943 and identify the reimbursement source for those requested services, the method of payment, and the payment rate to the provider.

 

Sec. 8. Minnesota Statutes 2006, section 253B.185, subdivision 2, is amended to read:

 

Subd. 2. Transfer to correctional facility. (a) If a person has been committed under this section and later is committed to the custody of the commissioner of corrections for any reason, including but not limited to, being sentenced for a crime or revocation of the person's supervised release or conditional release under section 244.05, 609.108, subdivision 6, or 609.109, subdivision 7, the person shall be transferred to a facility designated by the commissioner of corrections without regard to the procedures provided in section 253B.18.

 

(b) If a person is committed under this section after a commitment to the commissioner of corrections, the person shall first serve the sentence in a facility designated by the commissioner of corrections. After the person has served the sentence, the person shall be transferred to a treatment program designated by the commissioner of human services.

 

Sec. 9. Minnesota Statutes 2006, section 254A.03, subdivision 3, is amended to read:

 

Subd. 3. Rules for chemical dependency care. The commissioner of human services shall establish by rule criteria to be used in determining the appropriate level of chemical dependency care, whether outpatient, inpatient or short-term treatment programs, for each recipient of public assistance seeking treatment for alcohol or other drug dependency and abuse problems. The criteria shall address, at least, the family relationship, past treatment history, medical or physical problems, arrest record, and employment situation.

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Sec. 10. Minnesota Statutes 2006, section 254A.16, subdivision 2, is amended to read:

 

Subd. 2. Program and service guidelines. (a) The commissioner shall provide program and service guidelines and technical assistance to the county boards in carrying out services authorized under sections section 254A.08, 254A.12, 254A.14, and their responsibilities under chapter 256E.

 

(b) The commissioner shall recommend to the governor means of improving the efficiency and effectiveness of comprehensive program services in the state and maximizing the use of nongovernmental funds for providing comprehensive programs.

 

Sec. 11. Minnesota Statutes 2006, section 254B.02, subdivision 1, is amended to read:

 

Subdivision 1. Chemical dependency treatment allocation. The chemical dependency funds appropriated for allocation shall be placed in a special revenue account. The commissioner shall annually transfer funds from the chemical dependency fund to pay for operation of the drug and alcohol abuse normative evaluation system and to pay for all costs incurred by adding two positions for licensing of chemical dependency treatment and rehabilitation programs located in hospitals for which funds are not otherwise appropriated. For each year of the biennium ending June 30, 1999, the commissioner shall allocate funds to the American Indian chemical dependency tribal account for treatment of American Indians by eligible vendors under section 254B.05, equal to the amount allocated in fiscal year 1997. Six percent of the remaining money must be reserved for tribal allocation under section 254B.09, subdivisions 4 and 5. The commissioner shall annually divide the money available in the chemical dependency fund that is not held in reserve by counties from a previous allocation, or allocated to the American Indian chemical dependency tribal account. Six percent of the remaining money must be reserved for the nonreservation American Indian chemical dependency allocation for treatment of American Indians by eligible vendors under section 254B.05, subdivision 1. The remainder of the money must be allocated among the counties according to the following formula, using state demographer data and other data sources determined by the commissioner:

 

(a) For purposes of this formula, American Indians and children under age 14 are subtracted from the population of each county to determine the restricted population.

 

(b) The amount of chemical dependency fund expenditures for entitled persons for services not covered by prepaid plans governed by section 256B.69 in the previous year is divided by the amount of chemical dependency fund expenditures for entitled persons for all services to determine the proportion of exempt service expenditures for each county.

 

(c) The prepaid plan months of eligibility is multiplied by the proportion of exempt service expenditures to determine the adjusted prepaid plan months of eligibility for each county.

 

(d) The adjusted prepaid plan months of eligibility is added to the number of restricted population fee for service months of eligibility for the Minnesota family investment program, general assistance, and medical assistance and divided by the county restricted population to determine county per capita months of covered service eligibility.

 

(e) The number of adjusted prepaid plan months of eligibility for the state is added to the number of fee for service months of eligibility for the Minnesota family investment program, general assistance, and medical assistance for the state restricted population and divided by the state restricted population to determine state per capita months of covered service eligibility.

 

(f) The county per capita months of covered service eligibility is divided by the state per capita months of covered service eligibility to determine the county welfare caseload factor.

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(g) The median married couple income for the most recent three-year period available for the state is divided by the median married couple income for the same period for each county to determine the income factor for each county.

 

(h) The county restricted population is multiplied by the sum of the county welfare caseload factor and the county income factor to determine the adjusted population.

 

(i) $15,000 shall be allocated to each county.

 

(j) The remaining funds shall be allocated proportional to the county adjusted population.

 

Sec. 12. Minnesota Statutes 2006, section 254B.02, subdivision 5, is amended to read:

 

Subd. 5. Administrative adjustment. The commissioner may make payments to local agencies from money allocated under this section to support administrative activities under sections 254B.03 and 254B.04. The administrative payment must not exceed five percent of the first $50,000, four percent of the next $50,000, and three percent of the remaining payments for services from the allocation. Twenty-five percent of the administrative allowance shall be advanced at the beginning of each quarter, based on the payments for services made in the most recent quarter for which data is available. Adjustment of any overestimate or underestimate based on actual expenditures shall be made by the state agency by adjusting the administrative allowance for any succeeding quarter.

 

Sec. 13. Minnesota Statutes 2006, section 254B.03, subdivision 1, is amended to read:

 

Subdivision 1. Local agency duties. (a) Every local agency shall provide chemical dependency services to persons residing within its jurisdiction who meet criteria established by the commissioner for placement in a chemical dependency residential or nonresidential treatment service. Chemical dependency money must be administered by the local agencies according to law and rules adopted by the commissioner under sections 14.001 to 14.69.

 

(b) In order to contain costs, the county board shall, with the approval of the commissioner of human services, select eligible vendors of chemical dependency services who can provide economical and appropriate treatment. Unless the local agency is a social services department directly administered by a county or human services board, the local agency shall not be an eligible vendor under section 254B.05. The commissioner may approve proposals from county boards to provide services in an economical manner or to control utilization, with safeguards to ensure that necessary services are provided. If a county implements a demonstration or experimental medical services funding plan, the commissioner shall transfer the money as appropriate. If a county selects a vendor located in another state, the county shall ensure that the vendor is in compliance with the rules governing licensure of programs located in the state.

 

(c) The calendar year 2002 rate for vendors may not increase more than three percent above the rate approved in effect on January 1, 2001. The calendar year 2003 rate for vendors may not increase more than three percent above the rate in effect on January 1, 2002. The calendar years 2004 and 2005 rates may not exceed the rate in effect on January 1, 2003.

 

(d) (c) A culturally specific vendor that provides assessments under a variance under Minnesota Rules, part 9530.6610, shall be allowed to provide assessment services to persons not covered by the variance.

 

Sec. 14. Minnesota Statutes 2006, section 254B.03, subdivision 3, is amended to read:

 

Subd. 3. Local agencies to pay state for county share. Local agencies shall submit invoices to the state on forms supplied by the commissioner and according to procedures established by the commissioner. Local agencies

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shall pay the state for the county share of the invoiced services authorized by the local agency. Payments shall be made at the beginning of each month for services provided in the previous month. The commissioner shall bill the county monthly for services, based on the most recent month for which expenditure information is available. Adjustment of any overestimate or underestimate based on actual expenditures shall be made by the state agency by adjusting the estimate for any succeeding month.

 

Sec. 15. Minnesota Statutes 2006, section 254B.06, subdivision 3, is amended to read:

 

Subd. 3. Payment; denial. The commissioner shall pay eligible vendors for placements made by local agencies under section 254B.03, subdivision 1, and placements by tribal designated agencies according to section 254B.09. The commissioner may reduce or deny payment of the state share when services are not provided according to the placement criteria established by the commissioner. The commissioner may pay for all or a portion of improper county chemical dependency placements and bill the county for the entire payment made when the placement did not comply with criteria established by the commissioner. The commissioner may make payments to vendors and charge the county 100 percent of the payments if documentation of a county approved placement is received more than 30 working days, exclusive of weekends and holidays, after the date services began; or if the county approved invoice is received by the commissioner more than 120 days after the last date of service provided. The commissioner shall not pay vendors until private insurance company claims have been settled.

 

Sec. 16. Minnesota Statutes 2006, section 256B.0625, subdivision 23, is amended to read:

 

Subd. 23. Day treatment services. Medical assistance covers day treatment services as specified in sections 245.462, subdivision 8, and 245.4871, subdivision 10, that are provided under contract with the county board. Notwithstanding Minnesota Rules, part 9505.0323, subpart 15, the commissioner may set authorization thresholds for day treatment for adults according to section 256B.0625, subdivision 25. Notwithstanding Minnesota Rules, part 9505.0323, subpart 15, effective July 1, 2004, medical assistance covers day treatment services for children as specified under section 256B.0943.

 

Sec. 17. Minnesota Statutes 2006, section 256B.0943, subdivision 6, is amended to read:

 

Subd. 6. Provider entity clinical infrastructure requirements. (a) To be an eligible provider entity under this section, a provider entity must have a clinical infrastructure that utilizes diagnostic assessment, an individualized treatment plan, service delivery, and individual treatment plan review that are culturally competent, child-centered, and family-driven to achieve maximum benefit for the client. The provider entity must review and update the clinical policies and procedures every three years and must distribute the policies and procedures to staff initially and upon each subsequent update.

 

(b) The clinical infrastructure written policies and procedures must include policies and procedures for:

 

(1) providing or obtaining a client's diagnostic assessment that identifies acute and chronic clinical disorders, co-occurring medical conditions, sources of psychological and environmental problems, and a functional assessment. The functional assessment must clearly summarize the client's individual strengths and needs;

 

(2) developing an individual treatment plan that is:

 

(i) based on the information in the client's diagnostic assessment;

 

(ii) developed no later than the end of the first psychotherapy session after the completion of the client's diagnostic assessment by the mental health professional who provides the client's psychotherapy;

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(iii) developed through a child-centered, family-driven planning process that identifies service needs and individualized, planned, and culturally appropriate interventions that contain specific treatment goals and objectives for the client and the client's family or foster family;

 

(iv) reviewed at least once every 90 days and revised, if necessary; and

 

(v) signed by the client or, if appropriate, by the client's parent or other person authorized by statute to consent to mental health services for the client;

 

(3) developing an individual behavior plan that documents services to be provided by the mental health behavioral aide. The individual behavior plan must include:

 

(i) detailed instructions on the service to be provided;

 

(ii) time allocated to each service;

 

(iii) methods of documenting the child's behavior;

 

(iv) methods of monitoring the child's progress in reaching objectives; and

 

(v) goals to increase or decrease targeted behavior as identified in the individual treatment plan;

 

(4) clinical supervision of the mental health practitioner and mental health behavioral aide. A mental health professional must document the clinical supervision the professional provides by cosigning individual treatment plans and making entries in the client's record on supervisory activities. Clinical supervision does not include the authority to make or terminate court-ordered placements of the child. A clinical supervisor must be available for urgent consultation as required by the individual client's needs or the situation. Clinical supervision may occur individually or in a small group to discuss treatment and review progress toward goals. The focus of clinical supervision must be the client's treatment needs and progress and the mental health practitioner's or behavioral aide's ability to provide services;

 

(4a) CTSS certified provider entities providing day treatment programs must meet the conditions in items (i) to (iii):

 

(i) the provider supervisor must be present and available on the premises more than 50 percent of the time in a five-working-day period during which the supervisee is providing a mental health service;

 

(ii) the diagnosis and the client's individual treatment plan or a change in the diagnosis or individual treatment plan must be made by or reviewed, approved, and signed by the provider supervisor; and

 

(iii) every 30 days, the supervisor must review and sign the record of the client's care for all activities in the preceding 30-day period;

 

(4b) for all other services provided under CTSS, clinical supervision standards provided in items (i) to (iii) must be used:

 

(i) medical assistance shall reimburse a mental health practitioner who maintains a consulting relationship with a mental health professional who accepts full professional responsibility and is present on site for at least one observation during the first 12 hours in which the mental health practitioner provides the individual, family, or group skills training to the child or the child's family;

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(ii) thereafter, the mental health professional is required to be present on site for observation as clinically appropriate when the mental health practitioner is providing individual, family, or group skills training to the child or the child's family; and

 

(iii) the observation must be a minimum of one clinical unit. The on-site presence of the mental health professional must be documented in the child's record and signed by the mental health professional who accepts full professional responsibility;

 

(5) providing direction to a mental health behavioral aide. For entities that employ mental health behavioral aides, the clinical supervisor must be employed by the provider entity or other certified children's therapeutic supports and services provider entity to ensure necessary and appropriate oversight for the client's treatment and continuity of care. The mental health professional or mental health practitioner giving direction must begin with the goals on the individualized treatment plan, and instruct the mental health behavioral aide on how to construct therapeutic activities and interventions that will lead to goal attainment. The professional or practitioner giving direction must also instruct the mental health behavioral aide about the client's diagnosis, functional status, and other characteristics that are likely to affect service delivery. Direction must also include determining that the mental health behavioral aide has the skills to interact with the client and the client's family in ways that convey personal and cultural respect and that the aide actively solicits information relevant to treatment from the family. The aide must be able to clearly explain the activities the aide is doing with the client and the activities' relationship to treatment goals. Direction is more didactic than is supervision and requires the professional or practitioner providing it to continuously evaluate the mental health behavioral aide's ability to carry out the activities of the individualized treatment plan and the individualized behavior plan. When providing direction, the professional or practitioner must:

 

(i) review progress notes prepared by the mental health behavioral aide for accuracy and consistency with diagnostic assessment, treatment plan, and behavior goals and the professional or practitioner must approve and sign the progress notes;

 

(ii) identify changes in treatment strategies, revise the individual behavior plan, and communicate treatment instructions and methodologies as appropriate to ensure that treatment is implemented correctly;

 

(iii) demonstrate family-friendly behaviors that support healthy collaboration among the child, the child's family, and providers as treatment is planned and implemented;

 

(iv) ensure that the mental health behavioral aide is able to effectively communicate with the child, the child's family, and the provider; and

 

(v) record the results of any evaluation and corrective actions taken to modify the work of the mental health behavioral aide;

 

(6) providing service delivery that implements the individual treatment plan and meets the requirements under subdivision 9; and

 

(7) individual treatment plan review. The review must determine the extent to which the services have met the goals and objectives in the previous treatment plan. The review must assess the client's progress and ensure that services and treatment goals continue to be necessary and appropriate to the client and the client's family or foster family. Revision of the individual treatment plan does not require a new diagnostic assessment unless the client's mental health status has changed markedly. The updated treatment plan must be signed by the client, if appropriate, and by the client's parent or other person authorized by statute to give consent to the mental health services for the child.

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Sec. 18. Minnesota Statutes 2006, section 256B.0943, subdivision 9, is amended to read:

 

Subd. 9. Service delivery criteria. (a) In delivering services under this section, a certified provider entity must ensure that:

 

(1) each individual provider's caseload size permits the provider to deliver services to both clients with severe, complex needs and clients with less intensive needs. The provider's caseload size should reasonably enable the provider to play an active role in service planning, monitoring, and delivering services to meet the client's and client's family's needs, as specified in each client's individual treatment plan;

 

(2) site-based programs, including day treatment and preschool programs, provide staffing and facilities to ensure the client's health, safety, and protection of rights, and that the programs are able to implement each client's individual treatment plan;

 

(3) a day treatment program is provided to a group of clients by a multidisciplinary team under the clinical supervision of a mental health professional. The day treatment program must be provided in and by: (i) an outpatient hospital accredited by the Joint Commission on Accreditation of Health Organizations and licensed under sections 144.50 to 144.55; (ii) a community mental health center under section 245.62; and (iii) an entity that is under contract with the county board to operate a program that meets the requirements of sections 245.4712, subdivision 2, and 245.4884, subdivision 2, and Minnesota Rules, parts 9505.0170 to 9505.0475. The day treatment program must stabilize the client's mental health status while developing and improving the client's independent living and socialization skills. The goal of the day treatment program must be to reduce or relieve the effects of mental illness and provide training to enable the client to live in the community. The program must be available at least one day a week for a minimum three-hour time block. The three-hour time block must include at least one hour, but no more than two hours, of individual or group psychotherapy. The remainder of the three-hour time block may include recreation therapy, socialization therapy, or independent living skills therapy, but only if the therapies are included in the client's individual treatment plan. Day treatment programs are not part of inpatient or residential treatment services; and

 

(4) a preschool program is a structured treatment program offered to a child who is at least 33 months old, but who has not yet reached the first day of kindergarten, by a preschool multidisciplinary team in a day program licensed under Minnesota Rules, parts 9503.0005 to 9503.0175. The program must be available at least one day a week for a minimum two-hour time block. The structured treatment program may include individual or group psychotherapy and recreation therapy, socialization therapy, or independent living skills therapy, if included in the client's individual treatment plan.

 

(b) A provider entity must deliver the service components of children's therapeutic services and supports in compliance with the following requirements:

 

(1) individual, family, and group psychotherapy must be delivered as specified in Minnesota Rules, part 9505.0323;

 

(2) individual, family, or group skills training must be provided by a mental health professional or a mental health practitioner who has a consulting relationship with a mental health professional who accepts full professional responsibility for the training;

 

(3) crisis assistance must be time-limited and designed to resolve or stabilize crisis through arrangements for direct intervention and support services to the child and the child's family. Crisis assistance must utilize resources designed to address abrupt or substantial changes in the functioning of the child or the child's family as evidenced by a sudden change in behavior with negative consequences for well being, a loss of usual coping mechanisms, or the presentation of danger to self or others;

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(4) medically necessary services that are provided by a mental health behavioral aide must be designed to improve the functioning of the child and support the family in activities of daily and community living. A mental health behavioral aide must document the delivery of services in written progress notes. The mental health behavioral aide must implement goals in the treatment plan for the child's emotional disturbance that allow the child to acquire developmentally and therapeutically appropriate daily living skills, social skills, and leisure and recreational skills through targeted activities. These activities may include:

 

(i) assisting a child as needed with skills development in dressing, eating, and toileting;

 

(ii) assisting, monitoring, and guiding the child to complete tasks, including facilitating the child's participation in medical appointments;

 

(iii) observing the child and intervening to redirect the child's inappropriate behavior;

 

(iv) assisting the child in using age-appropriate self-management skills as related to the child's emotional disorder or mental illness, including problem solving, decision making, communication, conflict resolution, anger management, social skills, and recreational skills;

 

(v) implementing deescalation techniques as recommended by the mental health professional;

 

(vi) implementing any other mental health service that the mental health professional has approved as being within the scope of the behavioral aide's duties; or

 

(vii) assisting the parents to develop and use parenting skills that help the child achieve the goals outlined in the child's individual treatment plan or individual behavioral plan. Parenting skills must be directed exclusively to the child's treatment; and

 

(5) direction of a mental health behavioral aide must include the following:

 

(i) a total of one hour of on-site observation by a mental health professional during the first 12 hours of service provided to a child;

 

(ii) ongoing on-site observation by a mental health professional or mental health practitioner for at least a total of one hour during every 40 hours of service provided to a child; and

 

(iii) immediate accessibility of the mental health professional or mental health practitioner to the mental health behavioral aide during service provision.

 

Sec. 19. Minnesota Statutes 2006, section 256B.0943, subdivision 11, is amended to read:

 

Subd. 11. Documentation and billing. (a) A provider entity must document the services it provides under this section. The provider entity must ensure that the entity's documentation standards meet the requirements of federal and state laws. Services billed under this section that are not documented according to this subdivision shall be subject to monetary recovery by the commissioner. The provider entity may not bill for anything other than direct service time.

 

(b) An individual mental health provider must promptly document the following in a client's record after providing services to the client:

 

(1) each occurrence of the client's mental health service, including the date, type, length, and scope of the service;

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(2) the name of the person who gave the service;

 

(3) contact made with other persons interested in the client, including representatives of the courts, corrections systems, or schools. The provider must document the name and date of each contact;

 

(4) any contact made with the client's other mental health providers, case manager, family members, primary caregiver, legal representative, or the reason the provider did not contact the client's family members, primary caregiver, or legal representative, if applicable; and

 

(5) required clinical supervision, as appropriate.

 

Sec. 20. Minnesota Statutes 2006, section 256B.0943, subdivision 12, is amended to read:

 

Subd. 12. Excluded services. The following services are not eligible for medical assistance payment as children's therapeutic services and supports:

 

(1) service components of children's therapeutic services and supports simultaneously provided by more than one provider entity unless prior authorization is obtained;

 

(2) children's therapeutic services and supports provided in violation of medical assistance policy in Minnesota Rules, part 9505.0220;

 

(3) mental health behavioral aide services provided by a personal care assistant who is not qualified as a mental health behavioral aide and employed by a certified children's therapeutic services and supports provider entity;

 

(4) service components of CTSS that are the responsibility of a residential or program license holder, including foster care providers under the terms of a service agreement or administrative rules governing licensure; and

 

(5) adjunctive activities that may be offered by a provider entity but are not otherwise covered by medical assistance, including:

 

(i) a service that is primarily recreation oriented or that is provided in a setting that is not medically supervised. This includes sports activities, exercise groups, activities such as craft hours, leisure time, social hours, meal or snack time, trips to community activities, and tours;

 

(ii) a social or educational service that does not have or cannot reasonably be expected to have a therapeutic outcome related to the client's emotional disturbance;

 

(iii) consultation with other providers or service agency staff about the care or progress of a client;

 

(iv) prevention or education programs provided to the community; and

 

(v) treatment for clients with primary diagnoses of alcohol or other drug abuse.; and

 

(6) activities that are not direct service time.

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Sec. 21. Minnesota Statutes 2006, section 256E.35, subdivision 2, is amended to read:

 

Subd. 2. Definitions. (a) The definitions in this subdivision apply to this section.

 

(b) "Family asset account" means a savings account opened by a household participating in the Minnesota family assets for independence initiative.

 

(c) "Fiduciary organization" means:

 

(1) a community action agency that has obtained recognition under section 268.53 256E.31;

 

(2) a federal community development credit union serving the seven-county metropolitan area; or

 

(3) a women-oriented economic development agency serving the seven-county metropolitan area.

 

(d) "Financial institution" means a bank, bank and trust, savings bank, savings association, or credit union, the deposits of which are insured by the Federal Deposit Insurance Corporation or the National Credit Union Administration.

 

(e) "Permissible use" means:

 

(1) postsecondary educational expenses at an accredited public postsecondary institution including books, supplies, and equipment required for courses of instruction;

 

(2) acquisition costs of acquiring, constructing, or reconstructing a residence, including any usual or reasonable settlement, financing, or other closing costs;

 

(3) business capitalization expenses for expenditures on capital, plant, equipment, working capital, and inventory expenses of a legitimate business pursuant to a business plan approved by the fiduciary organization; and

 

(4) acquisition costs of a principal residence within the meaning of section 1034 of the Internal Revenue Code of 1986 which do not exceed 100 percent of the average area purchase price applicable to the residence determined according to section 143(e)(2) and (3) of the Internal Revenue Code of 1986.

 

(f) "Household" means all individuals who share use of a dwelling unit as primary quarters for living and eating separate from other individuals.

 

Sec. 22. Laws 2005, chapter 98, article 3, section 25, is amended to read:

 

Sec. 25. REPEALER.

 

Minnesota Statutes 2004, sections 245.713, subdivisions 2 and subdivision 4; 245.716; and 626.5551, subdivision 4, are repealed.

 

EFFECTIVE DATE. This section is effective retroactively from August 1, 2005.

 

Sec. 23. FEDERAL GRANTS.

 

The Board of Pharmacy shall apply for any applicable federal grants or other nonstate funds to establish and fully implement the prescription electronic reporting system.

 

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

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Sec. 24. BOARD OF PHARMACY.

 

The Board of Pharmacy shall not increase the license fees of pharmacists or pharmacies in order to adequately fund the prescription electronic reporting system under Minnesota Statutes, section 152.126, without specific authority from the legislature.

 

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

 

Sec. 25. BOARD OF MEDICAL PRACTICE.

 

The Board of Medical Practice shall convene a work group to discuss the appropriate prescribing of controlled substances listed in Minnesota Statutes, section 152.02, subdivisions 3 and 4, and those substances defined by the Board of Pharmacy under Minnesota Statutes, section 152.02, subdivisions 7, 8, and 12, for pain management, and shall report to the legislature by December 15, 2007.

 

Sec. 26. REPEALER.

 

(a) Minnesota Statutes 2006, sections 254A.02, subdivisions 7, 9, 12, 14, 15, and 16; 254A.085; 254A.086; 254A.12; 254A.14; 254A.15; 254A.16, subdivision 5; 254A.175; 254A.18; 256J.561, subdivision 1; 256J.62, subdivision 9; and 256J.65, are repealed.

 

(b) Minnesota Rules, part 9503.0035, subpart 2, is repealed.

 

ARTICLE 12

 

MISCELLANEOUS

 

Section 1. Minnesota Statutes 2006, section 16A.10, is amended by adding a subdivision to read:

 

Subd. 2a. Base budget detail. Within one week of the release of the budget forecasts required in section 16A.102 in November of an even-numbered year and February of an odd-numbered year, the commissioner, after consulting with the commissioners of human services and health, must provide to the legislature information at the program, budget activity and management activity level for the base level budget of the Department of Human Services and the Department of Health for the next biennium. The information must be organized in a manner that explains how base level budget appropriations are projected to be spent. Within one week of the release of the budget forecasts required in section 16A.102 in November of an even-numbered year, the commissioner must also provide the legislature with the information submitted by the commissioners of human services and health under subdivision 2, clauses (3) and (4).

 

Sec. 2. Minnesota Statutes 2006, section 62E.02, subdivision 7, is amended to read:

 

Subd. 7. Dependent. "Dependent" means a spouse or unmarried child under the age of 19 years, a dependent child who is a student under the age of 25, or a dependent child of any age who is disabled.

 

EFFECTIVE DATE. This section is effective January 1, 2008, and applies to coverage offered, sold, issued, or renewed on or after that date.

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Sec. 3. Minnesota Statutes 2006, section 62H.02, is amended to read:

 

62H.02 REQUIRED PROVISIONS.

 

(a) A joint self-insurance plan must include aggregate excess stop-loss coverage and individual excess stop-loss coverage provided by an insurance company licensed by the state of Minnesota.

 

(b) Aggregate excess stop-loss coverage must include provisions to cover incurred, unpaid claim liability in the event of plan termination. In addition,

 

(c) The plan of self-insurance must have participating employers fund an amount at least equal to the point at which the excess or stop-loss insurer has contracted to assume 100 percent of additional liability.

 

(d) A joint self-insurance plan must submit its proposed excess or stop-loss insurance contract to the commissioner of commerce at least 30 days prior to the proposed plan's effective date and at least 30 days subsequent to any renewal date. The commissioner shall review the contract to determine if they meet the standards established by sections 62H.01 to 62H.08 and respond within a 30-day period.

 

(e) Any excess or stop-loss insurance plan must contain a provision that the excess or stop-loss insurer will give the plan and the commissioner of commerce a minimum of 180 days' notice of termination or nonrenewal. If the plan fails to secure replacement coverage within 60 days after receipt of the notice of cancellation or nonrenewal, the commissioner shall issue an order providing for the orderly termination of the plan.

 

(f) The commissioner may waive the requirements of this section and of any rule relating to the requirements of this section, if the commissioner determines that a joint self-insurance plan has established alternative arrangements that fully fund the plan's liability or incurred but unpaid claims. The commissioner may not waive the requirement that a joint self-insurance plan have excess stop-loss coverage.

 

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

 

Sec. 4. Minnesota Statutes 2006, section 62J.07, subdivision 1, is amended to read:

 

Subdivision 1. Legislative oversight. The Legislative Commission on Health Care Access reviews the activities of the commissioner of health, the Health Technology Advisory Committee, and all other state agencies involved in the implementation and administration of this chapter, including efforts to obtain federal approval through waivers and other means shall make recommendations to the legislature on how to achieve the goal of universal health coverage as described in section 62Q.165. The recommendations shall include a timetable in which measurable progress must be achieved toward this goal. The commission shall submit to the legislature by January 15, 2008, the recommendations and corresponding timetable.

 

Sec. 5. Minnesota Statutes 2006, section 62J.07, subdivision 2, is amended to read:

 

Subd. 2. Membership. The Legislative Commission on Health Care Access consists of five seven members of the senate appointed under the rules of the senate and five seven members of the house of representatives appointed under the rules of the house of representatives. The Legislative Commission on Health Care Access must include three four members of the majority party and two three members of the minority party in each house.

 

Sec. 6. Minnesota Statutes 2006, section 62J.07, subdivision 3, is amended to read:

 

Subd. 3. Reports to the commission. The commissioner commissioners of health, human services, commerce, and the Health Technology Advisory Committee shall report on their activities annually and at other times at the request of the Legislative Commission on Health Care Access. The commissioners of health, commerce, and human services shall provide periodic reports to the legislative commission on the progress of rulemaking that is authorized

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or required under this chapter and shall notify members of the commission when a draft of a proposed rule has been completed and scheduled for publication in the State Register. At the request of a member of the commission, a commissioner shall provide a description and a copy of a proposed rule other state agencies shall provide assistance and technical support to the commission at the request of the commission. The commission may convene subcommittees to provide additional assistance and advice to the commission.

 

Sec. 7. Minnesota Statutes 2006, section 62L.02, subdivision 11, is amended to read:

 

Subd. 11. Dependent. "Dependent" means an eligible employee's spouse, unmarried child who is under the age of 19 years, unmarried child under the age of 25 years who is a full-time student as defined in section 62A.301, dependent child of any age who is disabled and who meets the eligibility criteria in section 62A.14, subdivision 2, or any other person whom state or federal law requires to be treated as a dependent for purposes of health plans. For the purpose of this definition, a child includes a child for whom the employee or the employee's spouse has been appointed legal guardian and an adoptive child as provided in section 62A.27.

 

EFFECTIVE DATE. This section is effective January 1, 2008, and applies to coverage offered, sold, issued, and renewed on or after that date.

 

Sec. 8. Minnesota Statutes 2006, section 144.05, is amended by adding a subdivision to read:

 

Subd. 5. Base budget detail. The commissioner shall provide the commissioner of finance with the information necessary to provide base budget detail to the legislature under section 16A.10, subdivision 2a.

 

Sec. 9. Minnesota Statutes 2006, section 151.37, subdivision 2, is amended to read:

 

Subd. 2. Prescribing and filing. (a) A licensed practitioner in the course of professional practice only, may prescribe, administer, and dispense a legend drug, and may cause the same to be administered by a nurse, a physician assistant, or medical student or resident under the practitioner's direction and supervision, and may cause a person who is an appropriately certified, registered, or licensed health care professional to prescribe, dispense, and administer the same within the expressed legal scope of the person's practice as defined in Minnesota Statutes. A licensed practitioner may prescribe a legend drug, without reference to a specific patient, by directing a nurse, pursuant to section 148.235, subdivisions 8 and 9, physician assistant, or medical student or resident to adhere to a particular practice guideline or protocol when treating patients whose condition falls within such guideline or protocol, and when such guideline or protocol specifies the circumstances under which the legend drug is to be prescribed and administered. An individual who verbally, electronically, or otherwise transmits a written, oral, or electronic order, as an agent of a prescriber, shall not be deemed to have prescribed the legend drug. This paragraph applies to a physician assistant only if the physician assistant meets the requirements of section 147A.18.

 

(b) A licensed practitioner that dispenses for profit a legend drug that is to be administered orally, is ordinarily dispensed by a pharmacist, and is not a vaccine, must file with the practitioner's licensing board a statement indicating that the practitioner dispenses legend drugs for profit, the general circumstances under which the practitioner dispenses for profit, and the types of legend drugs generally dispensed. It is unlawful to dispense legend drugs for profit after July 31, 1990, unless the statement has been filed with the appropriate licensing board. For purposes of this paragraph, "profit" means (1) any amount received by the practitioner in excess of the acquisition cost of a legend drug for legend drugs that are purchased in prepackaged form, or (2) any amount received by the practitioner in excess of the acquisition cost of a legend drug plus the cost of making the drug available if the legend drug requires compounding, packaging, or other treatment. The statement filed under this paragraph is public data under section 13.03. This paragraph does not apply to a licensed doctor of veterinary medicine or a registered pharmacist. Any person other than a licensed practitioner with the authority to prescribe, dispense, and administer a legend drug under paragraph (a) shall not dispense for profit. To dispense for profit does not include dispensing by a community health clinic when the profit from dispensing is used to meet operating expenses.

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(c) A prescription or drug order for a legend drug is not valid if it is based solely on an online questionnaire, unless it can be established that the prescription or order was based on a documented patient evaluation adequate to establish a diagnosis and identify underlying conditions and contraindications to treatment.

 

Sec. 10. Minnesota Statutes 2006, section 152.11, is amended by adding a subdivision to read:

 

Subd. 2d. Identification requirement for schedule II or III controlled substance. (a) No person may dispense a controlled substance included in schedule II or III without requiring the person purchasing the controlled substance, who need not be the person for whom the controlled substance prescription is written, to present valid photographic identification, unless the person purchasing the controlled substance, or if applicable the person for whom the controlled substance prescription is written, is known to the dispenser.

 

(b) This subdivision applies only to purchases of controlled substances that are not covered, in whole or in part, by a health plan company or other third-party payor. The Board of Pharmacy shall report to the legislature by July 1, 2009, on the effect of this subdivision. The board shall include in the report the incidence of complaints, if any, generated by the requirements of this subdivision and whether this subdivision is creating barriers to pharmaceutical access.

 

Sec. 11. Minnesota Statutes 2006, section 169A.70, subdivision 4, is amended to read:

 

Subd. 4. Assessor standards; rules; assessment time limits. A chemical use assessment required by this section must be conducted by an assessor appointed by the court. The assessor must meet the training and qualification requirements of rules adopted by the commissioner of human services under section 254A.03, subdivision 3 (chemical dependency treatment rules). Notwithstanding section 13.82 (law enforcement data), the assessor shall have access to any police reports, laboratory test results, and other law enforcement data relating to the current offense or previous offenses that are necessary to complete the evaluation. An assessor providing an assessment under this section may not have any direct or shared financial interest or referral relationship resulting in shared financial gain with a treatment provider, except as authorized under section 254A.20, subdivision 3. If an independent assessor is not available, the court may use the services of an assessor authorized to perform assessments for the county social services agency under a variance granted under rules adopted by the commissioner of human services under section 254A.03, subdivision 3. An appointment for the defendant to undergo the assessment must be made by the court, a court services probation officer, or the court administrator as soon as possible but in no case more than one week after the defendant's court appearance. The assessment must be completed no later than three weeks after the defendant's court appearance. If the assessment is not performed within this time limit, the county where the defendant is to be sentenced shall perform the assessment. The county of financial responsibility must be determined under chapter 256G.

 

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

 

Sec. 12. Minnesota Statutes 2006, section 179A.03, subdivision 7, is amended to read:

 

Subd. 7. Essential employee. "Essential employee" means firefighters, peace officers subject to licensure under sections 626.84 to 626.863, 911 system and police and fire department public safety dispatchers, guards at correctional facilities, confidential employees, supervisory employees, assistant county attorneys, assistant city attorneys, principals, and assistant principals. However, for state employees, "essential employee" means all employees, except for nonprofessional employees employed by the Department of Human Services in mental health facilities for the treatment of psychopathic personalities, sexual predators, and the criminally insane, in law enforcement, public safety radio communications operators, health care professionals, correctional guards, professional engineering, and supervisory collective bargaining units, irrespective of severance, and no other employees. For University of Minnesota employees, "essential employee" means all employees in law enforcement, nursing professional and supervisory units, irrespective of severance, and no other employees. "Firefighters" means

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salaried employees of a fire department whose duties include, directly or indirectly, controlling, extinguishing, preventing, detecting, or investigating fires. Employees for whom the state court administrator is the negotiating employer are not essential employees. For Hennepin Healthcare System, Inc. employees, "essential employees" means all employees.

 

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

 

Sec. 13. [254A.20] CHEMICAL USE ASSESSMENTS.

 

Subdivision 1. Persons arrested outside of home county. When a chemical use assessment is required under Minnesota Rules, parts 9530.6600 to 9530.6655, for a person who is arrested and taken into custody by a peace officer outside of the person's county of residence, the assessment must be completed by the person's county of residence no later than three weeks after the assessment is initially requested. If the assessment is not performed within this time limit, the county where the person is to be sentenced shall perform the assessment. The county of financial responsibility is determined under chapter 256G.

 

Subd. 2. Probation officer as contact. When a chemical use assessment is required under Minnesota Rules, parts 9530.6600 to 9530.6655, for a person who is on probation or under other correctional supervision, the assessor, either orally or in writing, shall contact the person's probation officer to verify or supplement the information provided by the person.

 

Subd. 3. Financial conflicts of interest. (a) Except as provided in paragraph (b), an assessor conducting a chemical use assessment under Minnesota Rules, parts 9530.6600 to 9530.6655, may not have any direct or shared financial interest or referral relationship resulting in shared financial gain with a treatment provider.

 

(b) A county may contract with an assessor having a conflict described in paragraph (a) if the county documents that:

 

(1) the assessor is employed by a culturally specific service provider or a service provider with a program designed to treat individuals of a specific age, sex, or sexual preference;

 

(2) the county does not employ a sufficient number of qualified assessors and the only qualified assessors available in the county have a direct or shared financial interest or a referral relationship resulting in shared financial gain with a treatment provider; or

 

(3) the county social service agency has an existing relationship with an assessor or service provider and elects to enter into a contract with that assessor to provide both assessment and treatment under circumstances specified in the county's contract, provided the county retains responsibility for making placement decisions.

 

An assessor under this paragraph may not place clients in treatment. The assessor shall gather required information and provide it to the county along with any required documentation. The county shall make all placement decisions for clients assessed by assessors under this paragraph.

 

EFFECTIVE DATE. This section is effective July 1, 2007, except for subdivision 3, which is effective the day following final enactment.

 

Sec. 14. Minnesota Statutes 2006, section 256.01, is amended by adding a subdivision to read:

 

Subd. 25. Base budget detail. The commissioner shall provide the commissioner of finance with the information necessary to provide base budget detail to the legislature under section 16A.10, subdivision 2a.

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Sec. 15. [256B.0636] PRESCRIBING OF CONTROLLED SUBSTANCES; ABUSE PREVENTION.

 

The commissioner shall develop and implement a plan to:

 

(1) monitor the prescribing of controlled substances listed in section 152.02, subdivisions 3 and 4, and those substances defined by the Board of Pharmacy under section 152.02, subdivisions 8 and 12, by enrolled providers and providers under contract with participating managed care plans;

 

(2) require enrolled providers and providers under contract with participating managed care plans to report information related to potential patient abuse of the controlled substances to the commissioner, and the Board of Pharmacy; and

 

(3) provide education to Minnesota health care program enrollees on the proper use of controlled substances.

 

Sec. 16. Minnesota Statutes 2006, section 609.115, subdivision 8, is amended to read:

 

Subd. 8. Chemical use assessment required. (a) If a person is convicted of a felony, the probation officer shall determine in the report prepared under subdivision 1 whether or not alcohol or drug use was a contributing factor to the commission of the offense. If so, the report shall contain the results of a chemical use assessment conducted in accordance with this subdivision. The probation officer shall make an appointment for the defendant to undergo the chemical use assessment if so indicated.

 

(b) The chemical use assessment report must include a recommended level of care for the defendant in accordance with the criteria contained in rules adopted by the commissioner of human services under section 254A.03, subdivision 3. The assessment must be conducted by an assessor qualified under rules adopted by the commissioner of human services under section 254A.03, subdivision 3. An assessor providing a chemical use assessment may not have any direct or shared financial interest or referral relationship resulting in shared financial gain with a treatment provider, except as authorized under section 254A.20, subdivision 3. If an independent assessor is not available, the probation officer may use the services of an assessor authorized to perform assessments for the county social services agency under a variance granted under rules adopted by the commissioner of human services under section 254A.03, subdivision 3.

 

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

 

Sec. 17. INTERPRETER SERVICES WORK GROUP.

 

(a) The commissioner of health shall convene a work group of interested parties to discuss the provision of interpreter services to patients in medical and dental care settings.

 

(b) The work group shall develop findings and recommendations on the following:

 

(1) ensuring access to interpreter services;

 

(2) compliance with requirements of federal law and guidance;

 

(3) developing a quality assurance program to ensure the quality of health care interpreting services, including requirements for training and establishing a certification process; and

 

(4) identifying broad-based funding mechanisms for interpreter services.

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(c) The work group shall report findings and recommendations to the commissioner of health and to the chairs of the health policy and finance committees in the house and senate by January 15, 2008.

 

(d) The work group expires the day following the submission of the report required by paragraph (c).

 

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

 

Sec. 18. AGRICULTURAL COOPERATIVE HEALTH PLAN FOR FARMERS.

 

Subdivision 1. Pilot project requirements. Notwithstanding contrary provisions of Minnesota Statutes, chapter 62H, the following apply to a joint self-insurance pilot project administered by a trust sponsored by one or more agricultural cooperatives organized under Minnesota Statutes, chapter 308A, or under a federal charter for the purpose of offering health coverage to members of the cooperatives and their families, provided the project satisfies the other requirements of Minnesota Statutes, chapter 62H:

 

(1) Minnesota Statutes, section 62H.02, paragraph (b), does not apply;

 

(2) the notice period required under Minnesota Statutes, section 62H.02, paragraph (e), is 90 days;

 

(3) a joint self-insurance plan may elect to treat the sale of a health plan to or for an employer that has only one eligible employee who has not waived coverage as the sale of an individual health plan as allowed under Minnesota Statutes, section 62L.02, subdivision 26;

 

(4) Minnesota Statutes, section 297I.05, subdivision 12, paragraph (c), applies; and

 

(5) the trust must pay the assessment for the Minnesota Comprehensive Health Association as provided under Minnesota Statutes, section 62E.11.

 

Subd. 2. Evaluation and renewal. The pilot project authorized under this section is for a period of four years from the date of initial enrollment. The commissioner of commerce shall grant an extension of four additional years if the trust provides evidence that it remains in compliance with the requirements of this section and other applicable laws and rules. If the commissioner determines that the operation of the trust has not improved access, expanded health plan choices, or improved the affordability of health coverage for farm families, or that it has significantly damaged access, choice, or affordability for other consumers not enrolled in the trust, the commissioner shall provide at least 180 days' advance written notice to the trust and to the chairs of the senate and house finance and policy committees with jurisdiction over health and insurance of the commissioner's intention not to renew the pilot project at the expiration of a four-year period.

 

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

 

Sec. 19. HEALTH PLAN PURCHASING POOL STUDY GROUP.

 

Subdivision 1. Creation; membership. (a) A health plan purchasing pool study group is created to study and make recommendations regarding the creation of a voluntary, statewide health plan purchasing pool that would contract directly with providers to provide affordable health coverage to eligible Minnesota residents. The study group is composed of:

 

(1) three members of the senate appointed by the Subcommittee on Committees of the Committee on Rules and Administration, including one member of the minority;

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(2) three members of the house of representatives, two from the majority party appointed by the speaker of the house of representatives, and one from the minority party appointed by the minority leader of the house of representatives;

 

(3) the attorney general or the attorney general's designated representative;

 

(4) three representatives of health care providers appointed as follows:

 

(i) one member appointed by the governor;

 

(ii) one member appointed by the speaker of the house; and

 

(iii) one member appointed by the Subcommittee on Committees of the senate Committee on Rules and Administration;

 

(5) one member selected by the American Federation of State, County, and Municipal employees;

 

(6) one member selected by the Minnesota Association of Professional Employees;

 

(7) one member selected by Education Minnesota;

 

(8) one member selected by the Minnesota Business Partnership; and

 

(9) one member selected by the Metropolitan Interdependent Business Organization.

 

All appointments made under this subdivision must be made within 30 days of the effective date of this act.

 

(b) The attorney general or the attorney general's designee shall convene the first meeting of the study group. The study group shall select its chair at the first meeting.

 

Subd. 2. Study; report. The study group shall study and make recommendations on the following issues related to the creation, maintenance, and funding of a voluntary, statewide health plan purchasing pool to provide comprehensive, cost-effective, and medically appropriate health coverage to all public and private employees in Minnesota and all Minnesota residents:

 

(1) the creation of an independent public entity to administer the pool;

 

(2) eligibility and participation requirements for existing public and private health care purchasing pools, public and private employers, and residents of this state;

 

(3) how to contract directly with providers to provide comprehensive coverage for preventive, mental health, dental and other medical services, and comprehensive drug benefits to enrollees and maximize the cost savings and other efficiencies that a large purchasing pool would be expected to generate without the need for a public subsidy;

 

(4) provisions that allow the pool to contract directly with health care providers to provide coverage to enrollees;

 

(5) incentives designed to attract and retain the maximum number of enrollees;

 

(6) recommendations for the administration of the pool and the plans that will be available to enrollees including, but not limited to, recommendations to keep the pool solvent and profitable so that public subsidies are not necessary; and

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(7) other elements the study group concludes are necessary or desirable for the pool to possess.

 

The study group shall submit its report and the draft legislation necessary to implement its recommendations to the chairs of the legislative committees and divisions with jurisdiction over health care policy and finance, the Health Care Access Commission, and the governor by February 1, 2008.

 

Subd. 3. Staffing. State agencies shall assist the study group with any requests for information the study group considers necessary to complete the study and report under subdivision 2.

 

Subd. 4. Removal; vacancies; expenses. Removal of members, vacancies, and expenses for members shall be as provided in Minnesota Statutes, section 15.059.

 

Subd. 5. Expiration. This section expires after the submission of the report as required in subdivision 2.

 

Sec. 20. REPEALER.

 

Minnesota Statutes 2006, section 62A.301, is repealed.

 

ARTICLE 13

 

CHILDREN'S HEALTH PROGRAMS; MINNESOTACARE

 

Section 1. Minnesota Statutes 2006, section 256B.057, is amended by adding a subdivision to read:

 

Subd. 2c. Extended coverage for children. A child receiving medical assistance under subdivision 2, who becomes ineligible due to excess income, is eligible for two additional months of medical assistance. Eligibility under this section is effective following any coverage available under section 256B.0625.

 

A child eligible for extended coverage under this section is deemed automatically eligible for MinnesotaCare until renewal. MinnesotaCare coverage begins in accordance with section 256L.05, subdivision 3.

 

EFFECTIVE DATE. This section is effective October 1, 2008, or upon federal approval, whichever is later.

 

Sec. 2. Minnesota Statutes 2006, section 256L.04, subdivision 1, is amended to read:

 

Subdivision 1. Families with children. (a) Families with children with family income equal to or less than 275 percent of the federal poverty guidelines for the applicable family size shall be eligible for MinnesotaCare according to this section. All other provisions of sections 256L.01 to 256L.18, including the insurance-related barriers to enrollment under section 256L.07, shall apply unless otherwise specified.

 

(b) Parents who enroll in the MinnesotaCare program must also enroll their children, if the children are eligible. Children may be enrolled separately without enrollment by parents. However, if one parent in the household enrolls, both parents must enroll, unless other insurance is available. If one child from a family is enrolled, all children must be enrolled, unless other insurance is available. If one spouse in a household enrolls, the other spouse in the household must also enroll, unless other insurance is available. Families cannot choose to enroll only certain uninsured members.

 

(c) Beginning October 1, 2003, the dependent sibling definition no longer applies to the MinnesotaCare program. These persons are no longer counted in the parental household and may apply as a separate household.

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(d) Beginning July 1, 2003, or upon federal approval, whichever is later, parents are not eligible for MinnesotaCare if their gross income exceeds $50,000.

 

(e) Children formerly enrolled in medical assistance and automatically deemed eligible for MinnesotaCare according to section 256B.057, subdivision 2c, are exempt from the requirements of this section until renewal.

 

EFFECTIVE DATE. This section is effective October 1, 2008, or upon federal approval, whichever is later.

 

Sec. 3. Minnesota Statutes 2006, section 256L.07, is amended by adding a subdivision to read:

 

Subd. 7. Exception for certain children. Children formerly enrolled in medical assistance and automatically deemed eligible for MinnesotaCare according to section 256B.057, subdivision 2c, are exempt from the requirements of this section until renewal.

 

EFFECTIVE DATE. This section is effective October 1, 2008, or upon federal approval, whichever is later.

 

Sec. 4. [256L.22] DEFINITION; CHILDREN'S HEALTH PROGRAM.

 

For purposes of sections 256L.22 to 256L.28, "children's health program" means the medical assistance and MinnesotaCare programs to the extent medical assistance and MinnesotaCare provide health coverage to children.

 

EFFECTIVE DATE. This section is effective October 1, 2008, or upon federal approval, whichever is later.

 

Sec. 5. [256L.24] HEALTH CARE ELIGIBILITY FOR CHILDREN.

 

Subdivision 1. Applicability. This section applies to children who are enrolled in a children's health program.

 

Subd. 2. Application procedure. The commissioner shall develop an application form for children's health programs for children that is easily understandable and does not exceed four pages in length. The provisions of section 256L.05, subdivision 1, apply.

 

Subd. 3. Premiums. Children enrolled in MinnesotaCare shall pay premiums as provided in section 256L.15, except that notwithstanding section 256L.15, subdivision 3, children in families with incomes at or below 200 percent of the federal poverty guidelines shall pay a monthly premium of $4.

 

Subd. 4. Eligibility renewal. The commissioner shall require children to renew eligibility every 12 months.

 

Subd. 5. Employer-subsidized coverage. Section 256L.07, subdivision 2, does not apply to children.

 

EFFECTIVE DATE. This section is effective October 1, 2008, or upon federal approval, whichever is later.

 

Sec. 6. [256L.26] ASSISTANCE TO APPLICANTS.

 

The commissioner shall assist children in choosing a managed care organization or fee-for-service provider to receive services under a children's health program, by:

 

(1) establishing a Web site to provide information about managed care organizations and to allow online enrollment;

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(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.

 

EFFECTIVE DATE. This section is effective October 1, 2008, or upon federal approval, whichever is later.

 

Sec. 7. [256L.28] FEDERAL APPROVAL.

 

The commissioner shall seek all federal waivers and approvals necessary to implement sections 256L.22 to 256L.28, including, but not limited to, waivers and approvals necessary to:

 

(1) coordinate medical assistance and MinnesotaCare coverage for children; and

 

(2) maximize receipt of the federal medical assistance match for covered children, by increasing income standards through the use of more liberal income methodologies as provided under United States Code, title 42, sections 1396a and 1396u-1.

 

EFFECTIVE DATE. This section is effective October 1, 2008, or upon federal approval, whichever is later.

 

ARTICLE 14

 

HEALTH CARE REFORM POLICY

 

Section 1. Minnesota Statutes 2006, section 62J.82, is amended to read:

 

62J.82 HOSPITAL CHARGE INFORMATION REPORTING DISCLOSURE.

 

Subdivision 1. Required information. The Minnesota Hospital Association shall develop a Web-based system, available to the public free of charge, for reporting charge information the following, for Minnesota residents,:

 

(1) hospital-specific performance on the measures of care developed under section 256B.072 for acute myocardial infarction, heart failure, and pneumonia;

 

(2) by January 1, 2009, hospital-specific performance on the public reporting measures for hospital-acquired infections as published by the National Quality Forum and collected by the Minnesota Hospital Association and Stratis Health in collaboration with infection control practitioners; and

 

(3) charge information, including, but not limited to, number of discharges, average length of stay, average charge, average charge per day, and median charge, for each of the 50 most common inpatient diagnosis-related groups and the 25 most common outpatient surgical procedures as specified by the Minnesota Hospital Association.

 

Subd. 2. Web site. The Web site must provide information that compares hospital-specific data to hospital statewide data. The Web site must be established by October 1, 2006, and must be updated annually. The commissioner shall provide a link to this reporting information on the department's Web site.

 

Subd. 3. Enforcement. The commissioner shall provide a link to this information on the department's Web site. If a hospital does not provide this information to the Minnesota Hospital Association, the commissioner of health may require the hospital to do so in accordance with section 144.55, subdivision 6. The commissioner shall provide a link to this information on the department's Web site.

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ARTICLE 15

 

HEALTH CARE REFORM

 

Section 1. [62A.67] MINNESOTA HEALTH INSURANCE EXCHANGE.

 

Subdivision 1. Title; citation. This section may be cited as the "Minnesota Health Insurance Exchange."

 

Subd. 2. Creation; tax exemption. The Minnesota Health Insurance Exchange is created for the limited purpose of providing individuals with greater access, choice, portability, and affordability of health insurance products. The Minnesota Health Insurance Exchange is a not-for-profit corporation under chapter 317A and section 501(c) of the Internal Revenue Code.

 

Subd. 3. Definitions. The following terms have the meanings given them unless otherwise provided in text.

 

(a) "Board" means the board of directors of the Minnesota Health Insurance Exchange under subdivision 13.

 

(b) "Commissioner" means:

 

(1) the commissioner of commerce for health insurers subject to the jurisdiction of the Department of Commerce;

 

(2) the commissioner of health for health insurers subject to the jurisdiction of the Department of Health; or

 

(3) either commissioner's designated representative.

 

(c) "Exchange" means the Minnesota Health Insurance Exchange.

 

(d) "HIPAA" means the Health Insurance Portability and Accountability Act of 1996.

 

(e) "Individual market health plans," unless otherwise specified, means individual market health plans defined in section 62A.011.

 

(f) "Section 125 Plan" means a cafeteria or Premium Only Plan under section 125 of the Internal Revenue Code that allows employees to pay for health insurance premiums with pretax dollars.

 

Subd. 4. Insurer and health plan participation. All health plans as defined in section 62A.011, subdivision 3, issued or renewed in the individual market shall participate in the exchange. No health plans in the individual market may be issued or renewed outside of the exchange. Group health plans as defined in section 62A.10 shall not be offered through the exchange. Health plans offered through the Minnesota Comprehensive Health Association as defined in section 62E.10 are offered through the exchange to eligible enrollees as determined by the Minnesota Comprehensive Health Association. Health plans offered through MinnesotaCare under chapter 256L are offered through the exchange to eligible enrollees as determined by the commissioner of human services.

 

Subd. 5. Approval of health plans. No health plan may be offered through the exchange unless the commissioner has first certified that:

 

(1) the insurer seeking to offer the health plan is licensed to issue health insurance in the state;

 

(2) notwithstanding section 62A.021, the health plan meets a loss ratio of 82 percent as calculated under section 62A.021; and

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(3) the health plan meets the requirements of this section, and the health plan and the insurer are in compliance with all other applicable health insurance laws.

 

Subd. 6. Individual market health plans. Individual market health plans offered through the exchange continue to be regulated by the commissioner as specified in chapters 62A, 62C, 62D, 62E, 62Q, and 72A, and must include the following provisions that apply to all health plans issued or renewed through the exchange:

 

(1) premiums for children under the age of 19 shall not vary by age in the exchange; and

 

(2) premiums for children under the age of 19 must be excluded from rating factors under section 62A.65, subdivision 3, paragraph (b).

 

Subd. 7. Individual participation and eligibility. Individuals are eligible to purchase health plans directly through the exchange or through an employer Section 125 Plan under section 62A.68. Nothing in this section requires guaranteed issue of individual market health plans offered through the exchange. Individuals are eligible to purchase individual market health plans through the exchange by meeting one or more of the following qualifications:

 

(1) the individual is a Minnesota resident, meaning the individual is physically residing on a permanent basis in a place that is the person's principal residence and from which the person is absent only for temporary purposes;

 

(2) the individual is a student attending an institution outside of Minnesota and maintains Minnesota residency;

 

(3) the individual is not a Minnesota resident but is employed by an employer physically located within the state and the individual's employer is required to offer a Section 125 Plan under section 62A.68;

 

(4) the individual is not a Minnesota resident but is self-employed and the individual's principal place of business is in the state; or

 

(5) the individual is a dependent as defined in section 62L.02, of another individual who is eligible to participate in the exchange.

 

Subd. 8. Continuation of coverage. Enrollment in a health plan may be canceled for nonpayment of premiums, fraud, or changes in eligibility for MinnesotaCare under chapter 256L. Enrollment in an individual market health plan may not be canceled or nonrenewed because of any change in employer or employment status, marital status, health status, age, residence, or any other change that does not affect eligibility as defined in this section.

 

Subd. 9. Responsibilities of the exchange. The exchange shall serve as the sole entity for enrollment and collection and transfer of premium payments for health plans sold to individuals through the exchange. The exchange shall be responsible for the following functions:

 

(1) publicize the exchange, including but not limited to its functions, eligibility rules, and enrollment procedures;

 

(2) provide assistance to employers to establish Section 125 Plans under section 62A.68;

 

(3) provide education and assistance to employers to help them understand the requirements of Section 125 Plans and compliance with applicable regulations;

 

(4) create a system to allow individuals to compare and enroll in health plans offered through the exchange;

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(5) create a system to collect and transmit to the applicable plans all premium payments made by individuals, including developing mechanisms to receive and process automatic payroll deductions for individuals who purchase coverage through employer Section 125 Plans;

 

(6) not accept premium payments for individual market health plans from an employer Section 125 Plan if the employer offers a group health plan as defined in section 62A.10 or has offered a group health plan in the last 12 months, or if the employer is a self-insurer as defined in section 62E.02;

 

(7) provide jointly with health insurers a cancellation notice directly to the primary insured at least ten days prior to termination of coverage for nonpayment of premium;

 

(8) bill the employer for the premiums payable by an employee, provided that the employer is not liable for payment except from payroll deductions for that purpose;

 

(9) refer individuals interested in MinnesotaCare under chapter 256L to the Department of Human Services to determine eligibility;

 

(10) establish a mechanism with the Department of Human Services to transfer premiums and subsidies for MinnesotaCare to qualify for federal matching payments;

 

(11) upon request, issue certificates of previous coverage according to the provisions of HIPAA and as referenced in section 62Q.181 to all such individuals who cease to be covered by a participating health plan through the exchange;

 

(12) establish procedures to account for all funds received and disbursed by the exchange for individual participants of the exchange;

 

(13) make available to the public, at the end of each calendar year, a report of an independent audit of the exchange's accounts; and

 

(14) provide copies of written and signed statements from employers stating that the employer is not contributing to the employee's premiums for health plans purchased by an employee through the exchange to all health insurers with enrolled employees of the employer.

 

Health insurers may rely on the employer's statement in clause (14) provided by the Minnesota Health Insurance Exchange and are not required to guarantee-issue individual health plans to the employer's employees.

 

Subd. 10. State not liable. The state of Minnesota shall not be liable for the actions of the Minnesota Health Insurance Exchange.

 

Subd. 11. Powers of the exchange. The exchange shall have the power to:

 

(1) contract with insurance producers licensed in accident and health insurance under chapter 60K and vendors to perform one or more of the functions specified in subdivision 10;

 

(2) contract with employers to collect premiums through a Section 125 Plan for eligible individuals who purchase an individual market health plan through the exchange;

 

(3) establish and assess fees on health plan premiums of health plans purchased through the exchange to fund the cost of administering the exchange;

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(4) seek and directly receive grant funding from government agencies or private philanthropic organizations to defray the costs of operating the exchange;

 

(5) establish and administer rules and procedures governing the operations of the exchange;

 

(6) establish one or more service centers within Minnesota;

 

(7) sue or be sued or otherwise take any necessary or proper legal action;

 

(8) establish bank accounts and borrow money; and

 

(9) enter into agreements with the commissioners of commerce, health, human services, revenue, employment and economic development, and other state agencies as necessary for the exchange to implement the provisions of this section.

 

Subd. 12. Dispute resolution. The exchange shall establish procedures for resolving disputes with respect to the eligibility of an individual to participate in the exchange. The exchange does not have the authority or responsibility to intervene in or resolve disputes between an individual and a health plan or health insurer. The exchange shall refer complaints from individuals participating in the exchange to the commissioner to be resolved according to sections 62Q.68 to 62Q.73.

 

Subd. 13. Governance. The exchange shall be governed by a board of directors with 11 members. The board shall convene on or before July 1, 2007, after the initial board members have been selected. The initial board membership consists of the following:

 

(1) the commissioner of commerce;

 

(2) the commissioner of human services;

 

(3) the commissioner of health;

 

(4) four members appointed by a joint committee of the Minnesota senate and the Minnesota house of representatives to serve three-year terms; and

 

(5) four members appointed by the governor to serve three-year terms.

 

Subd. 14. Subsequent board membership. Ongoing membership of the exchange consists of the following effective July 1, 2010:

 

(1) the commissioner of commerce;

 

(2) the commissioner of human services;

 

(3) the commissioner of health;

 

(4) two members appointed by the governor with the approval of a joint committee of the senate and house of representatives to serve two-year terms; and

 

(5) six members elected by the membership of the exchange of which three are elected to serve a two-year term and three are elected to serve a three-year term. Appointed and elected members may serve more than one term.

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Subd. 15. Operations of the board. Officers of the board of directors are elected by members of the board and serve one-year terms. Six members of the board constitutes a quorum, and the affirmative vote of six members of the board is necessary and sufficient for any action taken by the board. Board members serve without pay, but are reimbursed for actual expenses incurred in the performance of their duties.

 

Subd. 16. Operations of the exchange. The board of directors shall appoint an exchange director who shall:

 

(1) be a full-time employee of the exchange;

 

(2) administer all of the activities and contracts of the exchange; and

 

(3) hire and supervise the staff of the exchange.

 

Subd. 17. Insurance producers. An individual has the right to choose any insurance producer licensed in accident and health insurance under chapter 60K to assist them in purchasing an individual market health plan through the exchange. When a producer licensed in accident and health insurance under chapter 60K enrolls an eligible individual in the exchange, the health plan chosen by an individual may pay the producer a commission.

 

Subd. 18. Implementation. Health plan coverage through the exchange begins on January 1, 2009. The exchange must be operational to assist employers and individuals by September 1, 2008, and be prepared for enrollment by December 1, 2008. Enrollees of individual market health plans, MinnesotaCare, and the Minnesota Comprehensive Health Association as of December 2, 2008, are automatically enrolled in the exchange on January 1, 2009, in the same health plan and at the same premium that they were enrolled as of December 2, 2008, subject to the provisions of this section. As of January 1, 2009, all enrollees of individual market health plans, MinnesotaCare, and the Minnesota Comprehensive Health Association shall make premium payments to the exchange.

 

Sec. 2. [62A.68] SECTION 125 PLANS.

 

Subdivision 1. Definitions. The following terms have the meanings given unless otherwise provided in text:

 

(a) "Current employee" means an employee currently on an employer's payroll other than a retiree or disabled former employee.

 

(b) "Employer" means a person, firm, corporation, partnership, association, business trust, or other entity employing one or more persons, including a political subdivision of the state, filing payroll tax information on such employed person or persons.

 

(c) "Section 125 Plan" means a cafeteria or Premium Only Plan under section 125 of the Internal Revenue Code that allows employees to purchase health insurance with pretax dollars.

 

(d) "Exchange" means the Minnesota Health Insurance Exchange under section 62A.67.

 

(e) "Exchange director" means the appointed director under section 62A.67, subdivision 16.

 

Subd. 2. Section 125 Plan requirement. (a) Effective January 1, 2009, all employers with 11 or more current employees shall establish a Section 125 Plan to allow their employees to purchase individual market health plan coverage with pretax dollars. Nothing in this section requires or mandates employers to offer or purchase health insurance coverage for their employees. The following employers are exempt from the Section 125 Plan requirement:

 

(1) employers that offer a group health insurance plan as defined in 62A.10;

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(2) employers that are self-insurers as defined in section 62E.02; and

 

(3) employers with fewer than 11 current employees, except that employers under this clause may voluntarily offer a Section 125 Plan.

 

(b) Employers that offer a Section 125 Plan may enter into an agreement with the exchange to administer the employer's Section 125 Plan.

 

Subd. 3. Tracking compliance. By July 1, 2008, the exchange, in consultation with the commissioners of commerce, health, employment and economic development, and revenue shall establish a method for tracking employer compliance with the Section 125 Plan requirement.

 

Subd. 4. Employer requirements. Employers that are required to offer or choose to offer a Section 125 Plan shall:

 

(1) allow employees to purchase any individual market health plan for themselves and their dependents through the exchange;

 

(2) allow employees to choose any insurance producer licensed in accident and health insurance under chapter 60K to assist them in purchasing an individual market health plan through the exchange;

 

(3) provide a written and signed statement to the exchange stating that the employer is not contributing to the employee's premiums for health plans purchased by an employee through the exchange;

 

(4) upon an employee's request, deduct premium amounts on a pretax basis in an amount not to exceed an employee's wages, and remit these employee payments to the exchange; and

 

(5) provide notice to employees that individual market health plans purchased through the exchange are not employer-sponsored or administered. Employers shall be held harmless from any and all liability claims related to the individual market health plans purchased through the exchange by employees under a Section 125 Plan.

 

Subd. 5. Section 125 eligible health plans. Individuals who are eligible to use an employer Section 125 Plan to pay for health insurance coverage purchased through the exchange may enroll in any health plan offered through the exchange for which the individual is eligible including individual market health plans, MinnesotaCare, and the Minnesota Comprehensive Health Association.

 

Sec. 3. Minnesota Statutes 2006, section 62E.141, is amended to read:

 

62E.141 INCLUSION IN EMPLOYER-SPONSORED PLAN.

 

No employee of an employer that offers a group health plan, under which the employee is eligible for coverage, is eligible to enroll, or continue to be enrolled, in the comprehensive health association, except for enrollment or continued enrollment necessary to cover conditions that are subject to an unexpired preexisting condition limitation, preexisting condition exclusion, or exclusionary rider under the employer's health plan. This section does not apply to persons enrolled in the Comprehensive Health Association as of June 30, 1993. With respect to persons eligible to enroll in the health plan of an employer that has more than 29 current employees, as defined in section 62L.02, this section does not apply to persons enrolled in the Comprehensive Health Association as of December 31, 1994.

 

Sec. 4. [62J.431] EVIDENCE-BASED HEALTH CARE GUIDELINES.

 

Evidence-based guidelines must meet the following criteria:

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(1) the scope and application are clear;

 

(2) authorship is stated and any conflicts of interest disclosed;

 

(3) authors represent all pertinent clinical fields or other means of input have been used;

 

(4) the development process is explicitly stated;

 

(5) the guideline is grounded in evidence;

 

(6) the evidence is cited and grated;

 

(7) the document itself is clear and practical;

 

(8) the document is flexible in use, with exceptions noted or provided for with general statements;

 

(9) measures are included for use in systems improvement; and

 

(10) the guideline has scheduled reviews and updating.

 

Sec. 5. Minnesota Statutes 2006, section 62J.495, is amended to read:

 

62J.495 HEALTH INFORMATION TECHNOLOGY AND INFRASTRUCTURE ADVISORY COMMITTEE.

 

Subdivision 1. Establishment; members; duties 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 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.

 

Subd. 2. Health Information Technology and Infrastructure Advisory Committee. (a) The commissioner shall establish a Health Information Technology and Infrastructure Advisory Committee governed by section 15.059 to advise the commissioner on the following matters:

 

(1) assessment of the use of health information technology by the state, licensed health care providers and facilities, and local public health agencies;

 

(2) recommendations for implementing a statewide interoperable health information infrastructure, to include estimates of necessary resources, and for determining standards for administrative data exchange, clinical support programs, patient privacy requirements, and maintenance of the security and confidentiality of individual patient data; and

 

(3) other related issues as requested by the commissioner.

 

(b) The members of the Health Information Technology and Infrastructure Advisory Committee shall include the commissioners, or commissioners' designees, of health, human services, administration, and commerce and additional members to be appointed by the commissioner to include persons representing Minnesota's local public health agencies, licensed hospitals and other licensed facilities and providers, private purchasers, the medical and

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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.

 

Subd. 2. Annual report. (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.

 

Subd. 3. Expiration. (d) Notwithstanding section 15.059, this section subdivision expires June 30, 2009 2015.

 

Sec. 6. [62J.496] ELECTRONIC HEALTH RECORD SYSTEM REVOLVING ACCOUNT AND LOAN PROGRAM.

 

Subdivision 1. Account establishment. 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.

 

Subd. 2. Eligibility. (a) "Eligible borrower" means one of the following:

 

(1) community clinics, as defined under section 145.9268;

 

(2) hospitals eligible for rural hospital capital improvement grants, as defined in section 144.148;

 

(3) physician clinics located in a community with a population of less than 50,000 according to United States Census Bureau statistics and outside the seven-county metropolitan area;

 

(4) nursing facilities licensed under sections 144A.01 to 144A.27; and

 

(5) other providers of health or health care services approved by the commissioner for which interoperable electronic health record capability would improve quality of care, patient safety, or community health.

 

(b) To be eligible for a loan under this section, the applicant must submit a loan application to the commissioner of health on forms prescribed by the commissioner. The application must include, at a minimum:

 

(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 or plans in the future to interconnect with other health care entities and provider groups located in the same geographical area.

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Subd. 3. Loans. (a) The commissioner of health may make a no interest loan to a provider or provider group who is eligible under subdivision 2 on a first-come, first-served basis provided that the applicant is able to comply with this section. The total accumulative loan principal must not exceed $1,500,000 per loan. The commissioner of health has discretion over the size and number of loans made.

 

(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.

 

(c) The borrower must begin repaying the principal no later than two years from the date of the loan. Loans must be amortized no later than six years from the date of the loan.

 

(d) Repayments must be credited to the account.

 

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. 7. [62J.536] UNIFORM ELECTRONIC TRANSACTIONS AND IMPLEMENTATION GUIDE STANDARDS.

 

Subdivision 1. Electronic claims and eligibility transactions required. (a) Beginning January 15, 2009, all group purchasers must accept from health care providers the eligibility for a health plan transaction described under Code of Federal Regulations, title 45, part 162, subpart L. Beginning July 15, 2009, all group purchasers must accept from health care providers the health care claims or equivalent encounter information transaction described under Code of Federal Regulations, title 45, part 162, subpart K.

 

(b) Beginning January 15, 2009, all group purchasers must transmit to providers the eligibility for a health plan transaction described under Code of Federal Regulations, title 45, part 162, subpart L. Beginning December 1, 2009, all group purchasers must transmit to providers the health care payment and remittance advice transaction described under Code of Federal Regulations, title 45, part 162, subpart P.

 

(c) Beginning January 15, 2009, all health care providers must submit to group purchasers the eligibility for a health plan transaction described under Code of Federal Regulations, title 45, part 162, subpart L. Beginning July 15, 2009, all health care providers must submit to group purchasers the health care claims or equivalent encounter information transaction described under Code of Federal Regulations, title 45, part 162, subpart K.

 

(d) Beginning January 15, 2009, all health care providers must accept from group purchasers the eligibility for a health plan transaction described under Code of Federal Regulations, title 45, part 162, subpart L. Beginning December 15, 2009, all health care providers must accept from group purchasers the health care payment and remittance advice transaction described under Code of Federal Regulations, title 45, part 162, subpart P.

 

(e) Each of the transactions described in paragraphs (a) to (d) shall require the use of a single, uniform companion guide to the implementation guides described under Code of Federal Regulations, title 45, part 162. The companion guides will be developed pursuant to subdivision 2.

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(f) Notwithstanding any other provisions in sections 62J.50 to 62J.61, all group purchasers and health care providers must exchange claims and eligibility information electronically using the transactions, companion guides, implementation guides, and timelines required under this subdivision. Group purchasers may not impose any fee on providers for the use of the transactions prescribed in this subdivision.

 

(g) Nothing in this subdivision shall prohibit group purchasers and health care providers from using a direct data entry, Web-based methodology for complying with the requirements of this subdivision. Any direct data entry method for conducting the transactions specified in this subdivision must be consistent with the data content component of the single, uniform companion guides required in paragraph (e) and the implementation guides described under Code of Federal Regulations, title 45, part 162.

 

Subd. 2. Establishing uniform, standard companion guides. (a) At least 12 months prior to the timelines required in subdivision 1, the commissioner of health shall promulgate rules pursuant to section 62J.61 establishing and requiring group purchasers and health care providers to use the transactions and the uniform, standard companion guides required under subdivision 1, paragraph (e).

 

(b) The commissioner of health must consult with the Minnesota Administrative Uniformity Committee on the development of the single, uniform companion guides required under subdivision 1, paragraph (e), for each of the transactions in subdivision 1. The single uniform companion guides required under subdivision 1, paragraph (e), must specify uniform billing and coding standards. The commissioner of health shall base the companion guides required under subdivision 1, paragraph (e), billing and coding rules, and standards on the Medicare program, with modifications that the commissioner deems appropriate after consulting the Minnesota Administrative Uniformity Committee.

 

(c) No group purchaser or health care provider may add to or modify the single, uniform companion guides defined in subdivision 1, paragraph (e), through additional companion guides or other requirements.

 

(d) In promulgating the rules in paragraph (a), the commissioner shall not require data content that is not essential to accomplish the purpose of the transactions in subdivision 1.

 

Subd. 3. Definition. Notwithstanding section 62J.03, subdivision 8, for purposes of this section, "health care provider" includes licensed nursing homes, licensed boarding care homes, and licensed home care providers.

 

Sec. 8. Minnesota Statutes 2006, section 62J.692, subdivision 1, is amended to read:

 

Subdivision 1. Definitions. For purposes of this section, the following definitions apply:

 

(a) "Accredited clinical training" means the clinical training provided by a medical education program that is accredited through an organization recognized by the Department of Education, the Centers for Medicare and Medicaid Services, or another national body who reviews the accrediting organizations for multiple disciplines and whose standards for recognizing accrediting organizations are reviewed and approved by the commissioner of health in consultation with the Medical Education and Research Advisory Committee.

 

(b) "Commissioner" means the commissioner of health.

 

(c) "Clinical medical education program" means the accredited clinical training of physicians (medical students and residents), doctor of pharmacy practitioners, doctors of chiropractic, dentists, advanced practice nurses (clinical nurse specialists, certified registered nurse anesthetists, nurse practitioners, and certified nurse midwives), and physician assistants.

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(d) "Sponsoring institution" means a hospital, school, or consortium located in Minnesota that sponsors and maintains primary organizational and financial responsibility for a clinical medical education program in Minnesota and which is accountable to the accrediting body.

 

(e) "Teaching institution" means a hospital, medical center, clinic, or other organization that conducts a clinical medical education program in Minnesota.

 

(f) "Trainee" means a student or resident involved in a clinical medical education program.

 

(g) "Eligible trainee FTEs FTE's" means the number of trainees, as measured by full-time equivalent counts, that are at training sites located in Minnesota with a currently active medical assistance provider number enrollment status and a National Provider Identification (NPI) number where training occurs in either an inpatient or ambulatory patient care setting and where the training is funded, in part, by patient care revenues. Training that occurs in nursing facility settings is not eligible for funding under this section.

 

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

 

Sec. 9. Minnesota Statutes 2006, section 62J.692, subdivision 4, is amended to read:

 

Subd. 4. Distribution of funds. (a) Following the distribution described under paragraph (b), the commissioner shall annually distribute 90 percent of the available medical education funds to all qualifying applicants based on a distribution formula that reflects a summation of two factors:

 

(1) an education factor, which is determined by the total number of eligible trainee FTEs and the total statewide average costs per trainee, by type of trainee, in each clinical medical education program; and

 

(2) a public program volume factor, which is determined by the total volume of public program revenue received by each training site as a percentage of all public program revenue received by all training sites in the fund pool; and

 

(2) a supplemental public program volume factor, which is determined by providing a supplemental payment of 20 percent of each training site's grant to training sites whose public program revenue accounted for at least 0.98 percent of the total public program revenue received by all eligible training sites. Grants to training sites whose public program revenue accounted for less than 0.98 percent of the total public program revenue received by all eligible training sites shall be reduced by an amount equal to the total value of the supplemental payment.

 

In this formula, the education factor is weighted at 67 percent and the public program volume factor is weighted at 33 percent.

 

Public program revenue for the distribution formula includes revenue from medical assistance, prepaid medical assistance, general assistance medical care, and prepaid general assistance medical care. Training sites that receive no public program revenue are ineligible for funds available under this paragraph subdivision. For purposes of determining training-site level grants to be distributed under paragraph (a), total statewide average costs per trainee for medical residents is based on audited clinical training costs per trainee in primary care clinical medical education programs for medical residents. Total statewide average costs per trainee for dental residents is based on audited clinical training costs per trainee in clinical medical education programs for dental students. Total statewide average costs per trainee for pharmacy residents is based on audited clinical training costs per trainee in clinical medical education programs for pharmacy students.

 

(b) The commissioner shall annually distribute ten percent of total available medical education funds to all qualifying applicants based on the percentage received by each applicant under paragraph (a). These funds are to be used to offset clinical education costs at eligible clinical training sites based on criteria developed by the clinical

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medical education program. Applicants may choose to distribute funds allocated under this paragraph based on the distribution formula described in paragraph (a). $3,550,000 of the available medical education funds shall be distributed as follows:

 

(1) $1,475,000 to the University of Minnesota Medical Center-Fairview;

 

(2) $2,075,000 to the University of Minnesota School of Dentistry; and

 

(3) $1,800,000 to the Academic Health Center.

 

(c) Funds distributed shall not be used to displace current funding appropriations from federal or state sources.

 

(d) Funds shall be distributed to the sponsoring institutions indicating the amount to be distributed to each of the sponsor's clinical medical education programs based on the criteria in this subdivision and in accordance with the commissioner's approval letter. Each clinical medical education program must distribute funds allocated under paragraph (a) to the training sites as specified in the commissioner's approval letter. Sponsoring institutions, which are accredited through an organization recognized by the Department of Education or the Centers for Medicare and Medicaid Services, may contract directly with training sites to provide clinical training. To ensure the quality of clinical training, those accredited sponsoring institutions must:

 

(1) develop contracts specifying the terms, expectations, and outcomes of the clinical training conducted at sites; and

 

(2) take necessary action if the contract requirements are not met. Action may include the withholding of payments under this section or the removal of students from the site.

 

(e) Any funds not distributed in accordance with the commissioner's approval letter must be returned to the medical education and research fund within 30 days of receiving notice from the commissioner. The commissioner shall distribute returned funds to the appropriate training sites in accordance with the commissioner's approval letter.

 

(f) The commissioner shall distribute by June 30 of each year an amount equal to the funds transferred under subdivision 10, plus five percent interest to the University of Minnesota Board of Regents for the instructional costs of health professional programs at the Academic Health Center and for interdisciplinary academic initiatives within the Academic Health Center.

 

(g) A maximum of $150,000 of the funds dedicated to the commissioner under section 297F.10, subdivision 1, paragraph (b), clause (2), may be used by the commissioner for administrative expenses associated with implementing this section.

 

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

 

Sec. 10. Minnesota Statutes 2006, section 62J.692, subdivision 5, is amended to read:

 

Subd. 5. Report. (a) Sponsoring institutions receiving funds under this section must sign and submit a medical education grant verification report (GVR) to verify that the correct grant amount was forwarded to each eligible training site. If the sponsoring institution fails to submit the GVR by the stated deadline, or to request and meet the deadline for an extension, the sponsoring institution is required to return the full amount of funds received to the commissioner within 30 days of receiving notice from the commissioner. The commissioner shall distribute returned funds to the appropriate training sites in accordance with the commissioner's approval letter.

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(b) The reports must provide verification of the distribution of the funds and must include:

 

(1) the total number of eligible trainee FTEs in each clinical medical education program;

 

(2) the name of each funded program and, for each program, the dollar amount distributed to each training site;

 

(3) documentation of any discrepancies between the initial grant distribution notice included in the commissioner's approval letter and the actual distribution;

 

(4) a statement by the sponsoring institution describing the distribution of funds allocated under subdivision 4, paragraph (b), including information on which clinical training sites received funding and the rationale used for determining funding priorities;

 

(5) a statement by the sponsoring institution stating that the completed grant verification report is valid and accurate; and

 

(6) (5) other information the commissioner, with advice from the advisory committee, deems appropriate to evaluate the effectiveness of the use of funds for medical education.

 

(c) By February 15 of each year, the commissioner, with advice from the advisory committee, shall provide an annual summary report to the legislature on the implementation of this section.

 

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

 

Sec. 11. Minnesota Statutes 2006, section 62J.692, subdivision 8, is amended to read:

 

Subd. 8. Federal financial participation. (a) The commissioner of human services shall seek to maximize federal financial participation in payments for medical education and research costs. If the commissioner of human services determines that federal financial participation is available for the medical education and research, the commissioner of health shall transfer to the commissioner of human services the amount of state funds necessary to maximize the federal funds available. The amount transferred to the commissioner of human services, plus the amount of federal financial participation, shall be distributed to medical assistance providers in accordance with the distribution methodology described in subdivision 4.

 

(b) For the purposes of paragraph (a), The commissioner shall use physician clinic rates where possible to maximize federal financial participation. Any additional funds that become available must be distributed under subdivision 4, paragraph (a).

 

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

 

Sec. 12. Minnesota Statutes 2006, section 62J.81, subdivision 1, is amended to read:

 

Subdivision 1. Required disclosure of estimated payment. (a) A health care provider, as defined in section 62J.03, subdivision 8, or the provider's designee as agreed to by that designee, shall, at the request of a consumer, and at no cost to the consumer or the consumer's employer, provide that consumer with a good faith estimate of the reimbursement allowable payment the provider expects to receive from the health plan company in which the consumer is enrolled has agreed to accept from the consumer's health plan company for the services specified by the consumer, specifying the amount of the allowable payment due from the health plan company. Health plan companies must allow contracted providers, or their designee, to release this information. A good faith estimate must also be made available at the request of a consumer who is not enrolled in a health plan company. If a consumer has no applicable public or private coverage, the health care provider must give the consumer, and at no

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cost to the consumer, a good faith estimate of the average allowable reimbursement the provider accepts as payment from private third-party payers for the services specified by the consumer and the estimated amount the noncovered consumer will be required to pay. Payment information provided by a provider, or by the provider's designee as agreed to by that designee, to a patient pursuant to this subdivision does not constitute a legally binding estimate of the allowable charge for or cost to the consumer of services.

 

(b) A health plan company, as defined in section 62J.03, subdivision 10, shall, at the request of an enrollee or the enrollee's designee, provide that enrollee with a good faith estimate of the reimbursement allowable amount the health plan company would expect to pay to has contracted for with a specified provider within the network as total payment for a health care service specified by the enrollee and the portion of the allowable amount due from the enrollee and the enrollee's out-of-pocket costs. If requested by the enrollee, the health plan company shall also provide to the enrollee a good faith estimate of the enrollee's out-of-pocket cost for the health care service. An estimate provided to an enrollee under this paragraph is not a legally binding estimate of the reimbursement allowable amount or enrollee's out-of-pocket cost.

 

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

 

Sec. 13. Minnesota Statutes 2006, section 62L.12, subdivision 2, is amended to read:

 

Subd. 2. Exceptions. (a) A health carrier may sell, issue, or renew individual conversion policies to eligible employees otherwise eligible for conversion coverage under section 62D.104 as a result of leaving a health maintenance organization's service area.

 

(b) A health carrier may sell, issue, or renew individual conversion policies to eligible employees otherwise eligible for conversion coverage as a result of the expiration of any continuation of group coverage required under sections 62A.146, 62A.17, 62A.21, 62C.142, 62D.101, and 62D.105.

 

(c) A health carrier may sell, issue, or renew conversion policies under section 62E.16 to eligible employees.

 

(d) A health carrier may sell, issue, or renew individual continuation policies to eligible employees as required.

 

(e) A health carrier may sell, issue, or renew individual health plans if the coverage is appropriate due to an unexpired preexisting condition limitation or exclusion applicable to the person under the employer's group health plan or due to the person's need for health care services not covered under the employer's group health plan.

 

(f) A health carrier may sell, issue, or renew an individual health plan, if the individual has elected to buy the individual health plan not as part of a general plan to substitute individual health plans for a group health plan nor as a result of any violation of subdivision 3 or 4.

 

(g) Nothing in this subdivision relieves a health carrier of any obligation to provide continuation or conversion coverage otherwise required under federal or state law.

 

(h) Nothing in this chapter restricts the offer, sale, issuance, or renewal of coverage issued as a supplement to Medicare under sections 62A.3099 to 62A.44, or policies or contracts that supplement Medicare issued by health maintenance organizations, or those contracts governed by sections 1833, 1851 to 1859, 1860D, or 1876 of the federal Social Security Act, United States Code, title 42, section 1395 et seq., as amended.

 

(i) Nothing in this chapter restricts the offer, sale, issuance, or renewal of individual health plans necessary to comply with a court order.

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(j) A health carrier may offer, issue, sell, or renew an individual health plan to persons eligible for an employer group health plan, if the individual health plan is a high deductible health plan for use in connection with an existing health savings account, in compliance with the Internal Revenue Code, section 223. In that situation, the same or a different health carrier may offer, issue, sell, or renew a group health plan to cover the other eligible employees in the group.

 

(k) A health carrier may offer, sell, issue, or renew an individual health plan to one or more employees of a small employer if the individual health plan is marketed directly through the Minnesota Health Insurance Exchange under section 62A.67 or 62A.68 to all employees of the small employer and the small employer does not contribute directly or indirectly to the premiums or facilitate the administration of the individual health plan. The requirement to market an individual health plan to all employees through the Minnesota Health Insurance Exchange under section 62A.67 or 62A.68 does not require the health carrier to offer or issue an individual health plan to any employee. For purposes of this paragraph, an employer is not contributing to the premiums or facilitating the administration of the individual health plan if the employer does not contribute to the premium and merely collects the premiums from an employee's wages or salary through payroll deductions and submits payment for the premiums of one or more employees in a lump sum to the health carrier to the Minnesota Health Insurance Exchange under section 62A.67 or 62A.68. Except for coverage under section 62A.65, subdivision 5, paragraph (b), or 62E.16, at the request of an employee, the health carrier Minnesota Health Insurance Exchange under section 62A.67 or 62A.68 may bill the employer for the premiums payable by the employee, provided that the employer is not liable for payment except from payroll deductions for that purpose. If an employer is submitting payments under this paragraph, the health carrier and the Minnesota Health Insurance Exchange under section 62A.67 or 62A.68 shall jointly provide a cancellation notice directly to the primary insured at least ten days prior to termination of coverage for nonpayment of premium. Individual coverage under this paragraph may be offered only if the small employer has not provided coverage under section 62L.03 to the employees within the past 12 months.

 

The employer must provide a written and signed statement to the health carrier Minnesota Health Insurance Exchange under section 62A.67 or 62A.68 that the employer is not contributing directly or indirectly to the employee's premiums. The Minnesota Health Insurance Exchange under section 62A.67 or 62A.68 shall provide all health carriers with enrolled employees of the employer with a copy of the employer's statement. The health carrier may rely on the employer's statement provided by the Minnesota Health Insurance Exchange under section 62A.67 or 62A.68 and is not required to guarantee-issue individual health plans to the employer's other current or future employees.

 

Sec. 14. Minnesota Statutes 2006, section 62L.12, subdivision 4, is amended to read:

 

Subd. 4. Employer prohibition. A small employer offering a health benefit plan shall not encourage or direct an employee or applicant to:

 

(1) refrain from filing an application for health coverage when other similarly situated employees may file an application for health coverage;

 

(2) file an application for health coverage during initial eligibility for coverage, the acceptance of which is contingent on health status, when other similarly situated employees may apply for health coverage, the acceptance of which is not contingent on health status;

 

(3) seek coverage from another health carrier, including, but not limited to, MCHA; or

 

(4) cause coverage to be issued on different terms because of the health status or claims experience of that person or the person's dependents.

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Sec. 15. [62Q.101] EVALUATION OF PROVIDER PERFORMANCE.

 

A health plan company, or a vendor of risk management services as defined under section 60A.23, subdivision 8, shall, in evaluating the performance of a health care provider:

 

(1) conduct the evaluation using a bona fide baseline based upon practice experience of the provider group; and

 

(2) disclose the baseline to the health care provider in writing and prior to the beginning of the time period used for the evaluation.

 

Sec. 16. Minnesota Statutes 2006, section 62Q.165, subdivision 1, is amended to read:

 

Subdivision 1. Definition. It is the commitment of the state to achieve universal health coverage for all Minnesotans by the year 2011. Universal coverage is achieved when:

 

(1) every Minnesotan has access to a full range of quality health care services;

 

(2) every Minnesotan is able to obtain affordable health coverage which pays for the full range of services, including preventive and primary care; and

 

(3) every Minnesotan pays into the health care system according to that person's ability.

 

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

 

Sec. 17. Minnesota Statutes 2006, section 62Q.165, subdivision 2, is amended to read:

 

Subd. 2. Goal. It is the goal of the state to make continuous progress toward reducing the number of Minnesotans who do not have health coverage so that by January 1, 2000, fewer than four percent of the state's population will be without health coverage 2011, all Minnesota residents have access to affordable health care. The goal will be achieved by improving access to private health coverage through insurance reforms and market reforms, by making health coverage more affordable for low-income Minnesotans through purchasing pools and state subsidies, and by reducing the cost of health coverage through cost containment programs and methods of ensuring that all Minnesotans are paying into the system according to their ability.

 

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

 

Sec. 18. Minnesota Statutes 2006, section 144.698, subdivision 1, is amended to read:

 

Subdivision 1. Yearly reports. Each hospital and each outpatient surgical center, which has not filed the financial information required by this section with a voluntary, nonprofit reporting organization pursuant to section 144.702, shall file annually with the commissioner of health after the close of the fiscal year:

 

(1) a balance sheet detailing the assets, liabilities, and net worth of the hospital or outpatient surgical center;

 

(2) a detailed statement of income and expenses;

 

(3) a copy of its most recent cost report, if any, filed pursuant to requirements of Title XVIII of the United States Social Security Act;

 

(4) a copy of all changes to articles of incorporation or bylaws;

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(5) information on services provided to benefit the community, including services provided at no cost or for a reduced fee to patients unable to pay, teaching and research activities, or other community or charitable activities;

 

(6) information required on the revenue and expense report form set in effect on July 1, 1989, or as amended by the commissioner in rule;

 

(7) information on changes in ownership or control; and

 

(8) other information required by the commissioner in rule.;

 

(9) information on the number of available hospital beds that are dedicated to certain specialized services, as designated by the commissioner, and annual occupancy rates for those beds, separately for adult and pediatric care;

 

(10) from outpatient surgical centers, the total number of surgeries; and

 

(11) a report on health care capital expenditures during the previous year, as required by section 62J.17.

 

Sec. 19. [145.985] HEALTH PROMOTION AND WELLNESS.

 

Community health boards as defined in section 145A.02, subdivision 5, may work with schools, health care providers, and others to coordinate health and wellness programs in their communities. In order to meet the requirements of this section, community health boards may:

 

(1) provide instruction, technical assistance, and recommendations on how to evaluate project outcomes;

 

(2) assist with on-site health and wellness programs utilizing volunteers and others addressing health and wellness topics including smoking, nutrition, obesity, and others; and

 

(3) encourage health and wellness programs consistent with the Centers for Disease Control and Prevention's Community Guide and goals consistent with the Centers for Disease Control and Prevention's Healthy People 2010 initiative.

 

Sec. 20. Minnesota Statutes 2006, section 256.01, subdivision 2b, is amended to read:

 

Subd. 2b. Performance payments. (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) Upon federal approval 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.

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Sec. 21. Minnesota Statutes 2006, section 256B.0625, is amended by adding a subdivision to read:

 

Subd. 49. Provider-directed care coordination services. The commissioner shall develop and implement a provider-directed care coordination program for medical assistance recipients who are not enrolled in the prepaid medical assistance program and who are receiving services on a fee-for-service basis. This program provides payment to primary care clinics for care coordination for people who have complex and chronic medical conditions. Clinics must meet certain criteria such as the capacity to develop care plans; have a dedicated care coordinator; and have an adequate number of fee-for-service clients, evaluation mechanisms, and quality improvement processes to qualify for reimbursement. For purposes of this subdivision, a primary care clinic is a medical clinic designated as the patient's first point of contact for medical care, available 24 hours a day, seven days a week, that provides or arranges for the patient's comprehensive health care needs, and provides overall integration, coordination and continuity over time and referrals for specialty care.

 

Sec. 22. HEALTH CARE PAYMENT SYSTEM REFORM.

 

Subdivision 1. Payment reform plan. The commissioners of employee relations, human services, commerce, and health shall develop a plan for promoting and facilitating changes in payment rates and methods for paying for health care services, drugs, devices, supplies, and equipment in order to:

 

(1) reward the provision of cost-effective primary and preventive care;

 

(2) reward the use of evidence-based care;

 

(3) discourage underutilization, overuse, and misuse;

 

(4) reward the use of the most cost-effective settings, drugs, devices, providers, and treatments; and

 

(5) encourage consumers to maintain good health and use the health care system appropriately.

 

In developing the plan, the commissioners shall analyze existing data to determine specific services and health conditions for which changes in payment rates and methods would lead to significant improvements in quality of care. The commissioners shall include a definition of the term "quality" for uniform understanding of the plan's impact.

 

Subd. 2. Report. The commissioners shall submit a report to the legislature by December 15, 2007, describing the payment reform plan. The report must include proposed legislation for implementing those components of the plan requiring legislative action or appropriations of money.

 

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

 

Sec. 23. COMMUNITY INITIATIVES TO COVER UNINSURED AND UNDERINSURED.

 

Subdivision 1. Community partnerships. The commissioner of health shall provide planning grants to up to three community partnerships that satisfy the requirements in this section. A community partnership is eligible for a grant if the community partnership includes:

 

(1) at least one county;

 

(2) at least one local hospital;

 

(3) at least one local employer who collectively provides at least 300 jobs in the community;

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(4) at least one school system;

 

(5) at least one of the following:

 

(i) one or more integrated health care clinics or physician groups. For purposes of this section, "integrated health care" means integrated mental health and primary care; or

 

(ii) one or more health care clinics or physician groups and one or more mental health clinics; and

 

(6) a third-party payer, which may include a county-based purchasing plan, an employer, or a health plan company.

 

Subd. 2 Proposal requirements. The planning grants shall be used by community partnerships to develop a comprehensive proposal to provide affordable health care services to uninsured and underinsured individuals with chronic health conditions through an integrated community partnership system. A community partnership requesting a planning grant must submit to the commissioner a planning proposal that includes:

 

(1) methods for identifying potential uninsured or underinsured individuals and patients who have or who are at risk of developing a chronic health condition;

 

(2) methods to integrate and coordinate medical, mental health, and chemical health services with services provided through county social services, corrections, public health, school districts, and health care providers;

 

(3) providing early intervention and prevention activities; and

 

(4) methods to identify and support accountability across public and private systems, including means to measure outcomes and economic savings from providing services through an integrated system.

 

Subd. 3. Planning grant criteria. (a) Proposals for planning grants shall be submitted to the commissioner. Preference shall be given to planning proposals that:

 

(1) have broad community support from local business, providers, counties, and other public and private organizations;

 

(2) propose to provide services to uninsured or underinsured individuals of every age who have or are at risk of developing multiple, co-occurring chronic conditions;

 

(3) integrate or coordinate resources from multiple sources; and

 

(4) demonstrate how administrative costs for health plan companies and providers can be reduced through greater simplification, coordination, consolidation, standardization, reducing billing errors, or other methods.

 

(b) Community partnerships receiving a planning grant under this section shall submit their proposed initiatives to the commissioner by December 15, 2007.

 

(c) The commissioner shall submit a report to the legislature by February 15, 2008, that:

 

(1) identifies the community partnerships that received a planning grant under this section; and

 

(2) summarizes the planned initiatives submitted to the commissioner based on the requirements in this section.

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Sec. 24. CARE COORDINATION PILOT PROJECTS.

 

Subdivision 1. Pilot projects. (a) The commissioner of human services shall develop and administer up to four pilot projects for children and adults with complex health care needs who are enrolled in fee-for-service medical assistance, to the extent permitted by federal requirements. At least two of the grantees must focus on children with autism or children with complex/multi-diagnoses physical conditions. The purpose of the projects is to pilot primary care clinic models of care delivery focused on care coordination and family involvement in order to:

 

(1) incent and support the provision of cost-effective primary and preventive care;

 

(2) reward the use of evidence-based care;

 

(3) reward coordination of care for patients with chronic conditions;

 

(4) discourage overuse and misuse of high cost services;

 

(5) reward the use of the most cost-effective settings, drugs, devices, providers, and treatments; and

 

(6) encourage consumers to maintain good health and use the health care system appropriately.

 

(b) The pilot projects must involve the use of designated care professionals or clinics to serve as a patient's medical home and be responsible for coordinating health care services across the continuum of care.

 

Subd. 2. Requirements. In order to be designated a pilot project, health care professionals or clinics must demonstrate the ability to:

 

(1) be the patient's first point of contact by telephone or other means, 24 hours per day, seven days a week;

 

(2) provide or arrange for patients' comprehensive health care needs, including the ability to structure planned chronic disease visits and train and support the caregivers to effectively monitor and manage the person's health condition;

 

(3) coordinate patients' care when care must be provided outside the medical home;

 

(4) provide longitudinal care, not just episodic care, including meeting long-term and unique personal needs; and

 

(5) systematically improve quality of care using, among other inputs, patient feedback.

 

Subd. 3. Evaluation. Pilot projects must be evaluated based on patient satisfaction, provider satisfaction, clinical process and outcome measures, program costs and savings, and economic impact on health care providers. Pilot projects must be evaluated based on the extent to which the medical home:

 

(1) coordinated health care services across the continuum of care and thereby reduced duplication of services and enhanced communication across providers;

 

(2) provided safe and high-quality care by increasing utilization of effective treatments, reduced use of ineffective treatments, reduced barriers to essential care and services, and eliminated barriers to access;

 

(3) reduced unnecessary hospitalizations and emergency room visits and increased use of cost-effective care and settings;

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(4) encouraged long-term patient and provider relationships by shifting from episodic care to consistent, coordinated communication and care with a specified team of providers or individual providers;

 

(5) engaged and educated consumers by encouraging shared patient and provider responsibility and accountability for disease prevention, health promotion, chronic disease management, acute care, and overall well-being, encouraging informed medical decision-making, ensuring the availability of accurate medical information, and facilitated the transfer of accurate medical information;

 

(6) fostered the expansion of a technology infrastructure that supports collaboration; and

 

(7) reduced overall health care costs as compared to conventional payment methods for similar patient populations.

 

Subd. 4. Rulemaking. The commissioner is exempt from administrative rulemaking under chapter 14 for purposes of developing, administering, contracting for, and evaluating pilot projects under this section. The commissioner shall publish a proposed request for proposals in the State Register and allow 30 days for comment before issuing the final request for proposals.

 

Subd. 5. Care coordination payments. Grantees under this section are not eligible for care coordination payments under Minnesota Statutes, section 256B.0625, subdivision 49.

 

Sec. 25. MERC DISTRIBUTION FORMULA.

 

The commissioner of health shall evaluate the effect of the 2007 revisions to the medical education and research costs (MERC) distribution formula adopted in this act on sponsoring institutions and clinical training sites with low numbers of eligible trainee full-time employees. The commissioner shall present to the legislature, by January 15, 2008, any recommendations for changes in the MERC distribution formula necessary to ensure the financial viability of clinical medical education at these sponsoring institutions and clinical training sites.

 

Sec. 26. REPEALER.

 

(a) Minnesota Statutes 2006, section 62J.052, subdivision 1, is repealed effective August 1, 2007.

 

(b) Minnesota Statutes 2006, section 62J.692, subdivision 10, is repealed effective January 1, 2008.

 

ARTICLE 16

 

PUBLIC HEALTH POLICY

 

Section 1. Minnesota Statutes 2006, section 16B.61, is amended by adding a subdivision to read:

 

Subd. 3b. Window fall prevention device code. The commissioner of labor and industry shall adopt rules for window fall prevention devices as part of the state Building Code. Window fall prevention devices include, but are not limited to, safety screens, hardware, guards, and other devices that comply with the standards established by the commissioner of labor and industry. The rules shall require compliance with standards for window fall prevention devices developed by ASTM International, contained in the International Building Code as the model language with amendments deemed necessary to coordinate with the other adopted building codes in Minnesota. The rules shall establish a scope that includes the applicable building occupancies, and the types, locations, and sizes of windows that will require the installation of fall devices. The rules will be effective July 1, 2009. The commissioner shall report to the legislature on the status of the rulemaking on or before February 15, 2008.

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Sec. 2. Minnesota Statutes 2006, section 103I.101, subdivision 6, is amended to read:

 

Subd. 6. Fees for variances. The commissioner shall charge a nonrefundable application fee of $175 $215 to cover the administrative cost of processing a request for a variance or modification of rules adopted by the commissioner under this chapter.

 

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

 

Sec. 3. Minnesota Statutes 2006, section 103I.208, subdivision 1, is amended to read:

 

Subdivision 1. Well notification fee. The well notification fee to be paid by a property owner is:

 

(1) for a new water supply well, $175 $215, which includes the state core function fee;

 

(2) for a well sealing, $35 $50 for each well, which includes the state core function fee, except that for monitoring wells constructed on a single property, having depths within a 25 foot range, and sealed within 48 hours of start of construction, a single fee of $35 $50; and

 

(3) for construction of a dewatering well, $175 $215, which includes the state core function fee, for each dewatering well except a dewatering project comprising five or more dewatering wells shall be assessed a single fee of $875 $1,075 for the dewatering wells recorded on the notification.

 

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

 

Sec. 4. Minnesota Statutes 2006, section 103I.208, subdivision 2, is amended to read:

 

Subd. 2. Permit fee. The permit fee to be paid by a property owner is:

 

(1) for a water supply well that is not in use under a maintenance permit, $150 $175 annually;

 

(2) for construction of a monitoring well, $175 $215, which includes the state core function fee;

 

(3) for a monitoring well that is unsealed under a maintenance permit, $150 $175 annually;

 

(4) for monitoring wells used as a leak detection device at a single motor fuel retail outlet, a single petroleum bulk storage site excluding tank farms, or a single agricultural chemical facility site, the construction permit fee is $175 $215, which includes the state core function fee, per site regardless of the number of wells constructed on the site, and the annual fee for a maintenance permit for unsealed monitoring wells is $150 $175 per site regardless of the number of monitoring wells located on site;

 

(5) for a groundwater thermal exchange device, in addition to the notification fee for water supply wells, $175 $215, which includes the state core function fee;

 

(6) for a vertical heat exchanger, $175 $215;

 

(7) for a dewatering well that is unsealed under a maintenance permit, $150 $175 annually for each dewatering well, except a dewatering project comprising more than five dewatering wells shall be issued a single permit for $750 $875 annually for dewatering wells recorded on the permit; and

 

(8) for an elevator boring, $175 $215 for each boring.

 

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

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Sec. 5. Minnesota Statutes 2006, section 103I.235, subdivision 1, is amended to read:

 

Subdivision 1. Disclosure of wells to buyer. (a) Before signing an agreement to sell or transfer real property, the seller must disclose in writing to the buyer information about the status and location of all known wells on the property, by delivering to the buyer either a statement by the seller that the seller does not know of any wells on the property, or a disclosure statement indicating the legal description and county, and a map drawn from available information showing the location of each well to the extent practicable. In the disclosure statement, the seller must indicate, for each well, whether the well is in use, not in use, or sealed.

 

(b) At the time of closing of the sale, the disclosure statement information, name and mailing address of the buyer, and the quartile, section, township, and range in which each well is located must be provided on a well disclosure certificate signed by the seller or a person authorized to act on behalf of the seller.

 

(c) A well disclosure certificate need not be provided if the seller does not know of any wells on the property and the deed or other instrument of conveyance contains the statement: "The Seller certifies that the Seller does not know of any wells on the described real property."

 

(d) If a deed is given pursuant to a contract for deed, the well disclosure certificate required by this subdivision shall be signed by the buyer or a person authorized to act on behalf of the buyer. If the buyer knows of no wells on the property, a well disclosure certificate is not required if the following statement appears on the deed followed by the signature of the grantee or, if there is more than one grantee, the signature of at least one of the grantees: "The Grantee certifies that the Grantee does not know of any wells on the described real property." The statement and signature of the grantee may be on the front or back of the deed or on an attached sheet and an acknowledgment of the statement by the grantee is not required for the deed to be recordable.

 

(e) This subdivision does not apply to the sale, exchange, or transfer of real property:

 

(1) that consists solely of a sale or transfer of severed mineral interests; or

 

(2) that consists of an individual condominium unit as described in chapters 515 and 515B.

 

(f) For an area owned in common under chapter 515 or 515B the association or other responsible person must report to the commissioner by July 1, 1992, the location and status of all wells in the common area. The association or other responsible person must notify the commissioner within 30 days of any change in the reported status of wells.

 

(g) For real property sold by the state under section 92.67, the lessee at the time of the sale is responsible for compliance with this subdivision.

 

(h) If the seller fails to provide a required well disclosure certificate, the buyer, or a person authorized to act on behalf of the buyer, may sign a well disclosure certificate based on the information provided on the disclosure statement required by this section or based on other available information.

 

(i) A county recorder or registrar of titles may not record a deed or other instrument of conveyance dated after October 31, 1990, for which a certificate of value is required under section 272.115, or any deed or other instrument of conveyance dated after October 31, 1990, from a governmental body exempt from the payment of state deed tax, unless the deed or other instrument of conveyance contains the statement made in accordance with paragraph (c) or (d) or is accompanied by the well disclosure certificate containing all the information required by paragraph (b) or (d). The county recorder or registrar of titles must not accept a certificate unless it contains all the required information. The county recorder or registrar of titles shall note on each deed or other instrument of conveyance accompanied by a well disclosure certificate that the well disclosure certificate was received. The notation must

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include the statement "No wells on property" if the disclosure certificate states there are no wells on the property. The well disclosure certificate shall not be filed or recorded in the records maintained by the county recorder or registrar of titles. After noting "No wells on property" on the deed or other instrument of conveyance, the county recorder or registrar of titles shall destroy or return to the buyer the well disclosure certificate. The county recorder or registrar of titles shall collect from the buyer or the person seeking to record a deed or other instrument of conveyance, a fee of $40 $45 for receipt of a completed well disclosure certificate. By the tenth day of each month, the county recorder or registrar of titles shall transmit the well disclosure certificates to the commissioner of health. By the tenth day after the end of each calendar quarter, the county recorder or registrar of titles shall transmit to the commissioner of health $32.50 $37.50 of the fee for each well disclosure certificate received during the quarter. The commissioner shall maintain the well disclosure certificate for at least six years. The commissioner may store the certificate as an electronic image. A copy of that image shall be as valid as the original.

 

(j) No new well disclosure certificate is required under this subdivision if the buyer or seller, or a person authorized to act on behalf of the buyer or seller, certifies on the deed or other instrument of conveyance that the status and number of wells on the property have not changed since the last previously filed well disclosure certificate. The following statement, if followed by the signature of the person making the statement, is sufficient to comply with the certification requirement of this paragraph: "I am familiar with the property described in this instrument and I certify that the status and number of wells on the described real property have not changed since the last previously filed well disclosure certificate." The certification and signature may be on the front or back of the deed or on an attached sheet and an acknowledgment of the statement is not required for the deed or other instrument of conveyance to be recordable.

 

(k) The commissioner in consultation with county recorders shall prescribe the form for a well disclosure certificate and provide well disclosure certificate forms to county recorders and registrars of titles and other interested persons.

 

(l) Failure to comply with a requirement of this subdivision does not impair:

 

(1) the validity of a deed or other instrument of conveyance as between the parties to the deed or instrument or as to any other person who otherwise would be bound by the deed or instrument; or

 

(2) the record, as notice, of any deed or other instrument of conveyance accepted for filing or recording contrary to the provisions of this subdivision.

 

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

 

Sec. 6. Minnesota Statutes 2006, section 144.123, is amended to read:

 

144.123 FEES FOR DIAGNOSTIC LABORATORY SERVICES; EXCEPTIONS.

 

Subdivision 1. Who must pay. Except for the limitation contained in this section, the commissioner of health shall charge a handling fee for each specimen submitted to the Department of Health for analysis for diagnostic purposes by any hospital, private laboratory, private clinic, or physician. No fee shall be charged to any entity which receives direct or indirect financial assistance from state or federal funds administered by the Department of Health, including any public health department, nonprofit community clinic, venereal sexually transmitted disease clinic, family planning clinic, or similar entity. No fee will be charged for any biological materials submitted to the Department of Health as a requirement of Minnesota Rules, part 4605.7040, or for those biological materials requested by the department to gather information for disease prevention or control purposes. The commissioner of health may establish by rule other exceptions to the handling fee as may be necessary to gather information for epidemiologic purposes protect the public's health. All fees collected pursuant to this section shall be deposited in the state treasury and credited to the state government special revenue fund.

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Subd. 2. Rules for Fee amounts. The commissioner of health shall promulgate rules, in accordance with chapter 14, which shall specify the amount of the charge a handling fee prescribed in subdivision 1. The fee shall approximate the costs to the department of handling specimens including reporting, postage, specimen kit preparation, and overhead costs. The fee prescribed in subdivision 1 shall be $15 $25 per specimen until the commissioner promulgates rules pursuant to this subdivision.

 

Sec. 7. Minnesota Statutes 2006, section 144.125, is amended to read:

 

144.125 TESTS OF INFANTS FOR HERITABLE AND CONGENITAL DISORDERS.

 

Subdivision 1. Duty to perform testing. It is the duty of (1) the administrative officer or other person in charge of each institution caring for infants 28 days or less of age, (2) the person required in pursuance of the provisions of section 144.215, to register the birth of a child, or (3) the nurse midwife or midwife in attendance at the birth, to arrange to have administered to every infant or child in its care tests for heritable and congenital disorders according to subdivision 2 and rules prescribed by the state commissioner of health. Testing and the recording and reporting of test results shall be performed at the times and in the manner prescribed by the commissioner of health. The commissioner shall charge laboratory service fees a fee so that the total of fees collected will approximate the costs of conducting the tests and implementing and maintaining a system to follow-up infants with heritable or congenital disorders, including hearing loss detected through the early hearing detection and intervention program under section 144.966. The laboratory service fee is $61 $101 per specimen. Costs associated with capital expenditures and the development of new procedures may be prorated over a three-year period when calculating the amount of the fees.

 

Subd. 2. Determination of tests to be administered. The commissioner shall periodically revise the list of tests to be administered for determining the presence of a heritable or congenital disorder. Revisions to the list shall reflect advances in medical science, new and improved testing methods, or other factors that will improve the public health. In determining whether a test must be administered, the commissioner shall take into consideration the adequacy of laboratory analytical methods to detect the heritable or congenital disorder, the ability to treat or prevent medical conditions caused by the heritable or congenital disorder, and the severity of the medical conditions caused by the heritable or congenital disorder. The list of tests to be performed may be revised if the changes are recommended by the advisory committee established under section 144.1255, approved by the commissioner, and published in the State Register. The revision is exempt from the rulemaking requirements in chapter 14, and sections 14.385 and 14.386 do not apply.

 

Subd. 3. Objection of parents to test. Persons with a duty to perform testing under subdivision 1 shall advise parents of infants (1) that the blood or tissue samples used to perform testing thereunder as well as the results of such testing may be retained by the Department of Health, (2) the benefit of retaining the blood or tissue sample, and (3) that the following options are available to them with respect to the testing: (i) to decline to have the tests, or (ii) to elect to have the tests but to require that all blood samples and records of test results be destroyed within 24 months of the testing. If the parents of an infant object in writing to testing for heritable and congenital disorders or elect to require that blood samples and test results be destroyed, the objection or election shall be recorded on a form that is signed by a parent or legal guardian and made part of the infant's medical record. A written objection exempts an infant from the requirements of this section and section 144.128.

 

Sec. 8. Minnesota Statutes 2006, section 144.9507, is amended by adding a subdivision to read:

 

Subd. 6. Medical assistance. Medical assistance reimbursement for lead risk assessment services under section 256B.0625, subdivision 49, shall not be used to replace or decrease existing state or local funding for lead services and lead-related activities.

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Sec. 9. Minnesota Statutes 2006, section 144.9512, is amended to read:

 

144.9512 LEAD ABATEMENT PROGRAM.

 

Subdivision 1. Definitions. (a) The definitions in section 144.9501 and in this subdivision apply to this section.

 

(b) "Eligible organization" means a lead contractor, city, board of health, community health department, community action agency as defined in section 256E.30, or community development corporation.

 

(c) "Commissioner" means the commissioner of health, or the commissioner of the Minnesota Housing Finance Agency as authorized by section 462A.05, subdivision 15c.

 

Subd. 2. Grants; administration. Within the limits of the available appropriation, the commissioner must develop a swab team services program which may shall make demonstration and training grants to eligible organizations a nonprofit organization currently operating the CLEARCorps lead hazard reduction project to train workers to provide swab team services and swab team services for residential property. Grants may be awarded to nonprofit organizations to provide technical assistance and training to ensure quality and consistency within the statewide program. Grants must be awarded to help ensure full-time employment to workers providing swab team services and must be awarded for a two-year period.

 

Grants awarded under this section must be made in consultation with the commissioner of the Housing Finance Agency and representatives of neighborhood groups from areas at high risk for toxic lead exposure, a labor organization, the lead coalition, community action agencies, and the legal aid society. The consulting team must review grant applications and recommend awards to eligible organizations that meet requirements for receiving a grant under this section.

 

Subd. 3. Applicants. (a) Interested eligible organizations may apply to the commissioner for grants under this section. Two or more eligible organizations may jointly apply for a grant. Priority shall be given to community action agencies in greater Minnesota and to either community action agencies or neighborhood based nonprofit organizations in cities of the first class. Of the total annual appropriation, 12.5 percent may be used for administrative purposes. The commissioner may deviate from this percentage if a grantee can justify the need for a larger administrative allowance. Of this amount, up to five percent may be used by the commissioner for state administrative purposes. Applications must provide information requested by the commissioner, including at least the information required to assess the factors listed in paragraph (d).

 

(b) The commissioner must consult with boards of health to provide swab team services for purposes of secondary prevention. The priority for swab teams created by grants to eligible organizations under this section must be work assigned by the commissioner of health, or by a board of health if so designated by the commissioner of health, to provide secondary prevention swab team services to fulfill the requirements of section 144.9504, subdivision 6, in response to a lead order. Swab teams assigned work under this section by the commissioner, that are not engaged daily in fulfilling the requirements of section 144.9504, subdivision 6, must deliver swab team services in response to elevated blood lead levels as defined in section 144.9501, subdivision 9, where lead orders were not issued, and for purposes of primary prevention in census tracts known to be in areas at high risk for toxic lead exposure as described in section 144.9503, subdivision 2.

 

(c) Any additional money must be used for grants to establish swab teams for primary prevention under section 144.9503, in census tracts in areas at high risk for toxic lead exposure as determined under section 144.9503, subdivision 2.

 

(d) In evaluating grant applications, the commissioner must consider the following criteria:

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(1) the use of lead contractors and lead workers for residential swab team services;

 

(2) the participation of neighborhood groups and individuals, as swab team workers, in areas at high risk for toxic lead exposure;

 

(3) plans for the provision of swab team services for primary and secondary prevention as required under subdivision 4;

 

(4) plans for supervision, training, career development, and postprogram placement of swab team members;

 

(5) plans for resident and property owner education on lead safety;

 

(6) plans for distributing cleaning supplies to area residents and educating residents and property owners on cleaning techniques;

 

(7) sources of other funding and cost estimates for training, lead inspections, swab team services, equipment, monitoring, testing, and administration;

 

(8) measures of program effectiveness;

 

(9) coordination of program activities with other federal, state, and local public health, job training, apprenticeship, and housing renovation programs including programs under sections 116L.86 to 116L.881; and

 

(10) prior experience in providing swab team services.

 

Subd. 4. Lead supervisor or certified firm Eligible grant activities. (a) Eligible organizations and lead supervisors or certified firms may participate in the swab team program. An eligible organization The nonprofit receiving a grant under this section must assure ensure that all participating lead supervisors or certified firms are licensed and that all swab team workers are certified by the Department of Health under section 144.9505. Eligible organizations and lead supervisors or certified firms may distinguish between interior and exterior services in assigning duties and The nonprofit organization may participate in the program by:

 

(1) providing on-the-job training for swab team workers;

 

(2) providing swab team services to meet the requirements of sections 144.9503, subdivision 4, and 144.9504, subdivision 6;

 

(3) providing a removal and replacement component using skilled craft workers under subdivision 7 lead hazard reduction to meet the requirements of section 144.9501, subdivision 17;

 

(4) providing lead testing according to subdivision 8;

 

(5) (4) providing lead dust cleaning supplies cleanup equipment and materials, as described in section 144.9507 144.9503, subdivision 4, paragraph (c) 1, to residents; or

 

(6) (5) having a swab team worker instruct residents and property owners on appropriate lead control techniques, including the lead-safe directives developed by the commissioner of health.;

 

(6) conducting blood lead testing events including screening children and pregnant women according to Department of Health screening guidelines;

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(7) performing case management services according to Department of Health case management guidelines; or

 

(8) conducting mandated risk assessments under Minnesota Statutes, section 144.9504, subdivision 2.

 

(b) Participating lead supervisors or certified firms must:

 

(1) demonstrate proof of workers' compensation and general liability insurance coverage;

 

(2) be knowledgeable about lead abatement requirements established by the Department of Housing and Urban Development and the Occupational Safety and Health Administration and lead hazard reduction requirements and lead-safe directives of the commissioner of health;

 

(3) demonstrate experience with on-the-job training programs;

 

(4) demonstrate an ability to recruit employees from areas at high risk for toxic lead exposure; and

 

(5) demonstrate experience in working with low-income clients.

 

Subd. 5. Swab team workers. Each worker engaged in swab team services established under this section must have blood lead concentrations below 15 micrograms of lead per deciliter of whole blood as determined by a baseline blood lead screening. Any The nonprofit organization receiving a grant under this section is responsible for lead screening and must assure ensure that all swab team workers meet the standards established in this subdivision. Grantees The nonprofit organization must use appropriate workplace procedures including following the lead-safe directives developed by the commissioner of health to reduce risk of elevated blood lead levels. Grantees The nonprofit organization and participating contractors must report all employee blood lead levels that exceed 15 micrograms of lead per deciliter of whole blood to the commissioner of health.

 

Subd. 6. On-the-job training component. (a) Programs established under this section must provide on-the-job training for swab team workers.

 

(b) Swab team workers must receive monetary compensation equal to the prevailing wage as defined in section 177.42, subdivision 6, for comparable jobs in the licensed contractor's principal business.

 

Subd. 7. Removal and replacement component. (a) Within the limits of the available appropriation and if a need is identified by a lead inspector, the commissioner may establish a component for removal and replacement of deteriorated paint in residential properties according to the following criteria:

 

(1) components within a residence must have both deteriorated lead-based paint and substrate damage beyond repair or rotting wooden framework to be eligible for removal and replacement;

 

(2) all removal and replacement must be done using least-cost methods and following lead-safe directives;

 

(3) whenever windows and doors or other components covered with deteriorated lead-based paint have sound substrate or are not rotting, those components should be repaired, sent out for stripping, planed down to remove deteriorated lead-based paint, or covered with protective guards instead of being replaced, provided that such an activity is the least-cost method of providing the swab team service;

 

(4) removal and replacement or repair must be done by lead contractors using skilled craft workers or trained swab team members; and

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(5) all craft work that requires a state license must be supervised by a person with a state license in the craft work being supervised. The grant recipient may contract for this supervision.

 

(b) The program design must:

 

(1) identify the need for on-the-job training of swab team workers to be removal and replacement workers; and

 

(2) describe plans to involve appropriate groups in designing methods to meet the need for training swab team workers.

 

Subd. 8. Testing and evaluation. (a) Testing of the environment is not necessary by swab teams whose work is assigned by the commissioner of health or a designated board of health under section 144.9504. The commissioner of health or designated board of health must share the analytical testing data collected on each residence for purposes of secondary prevention under section 144.9504 with the swab team workers in order to provide constructive feedback on their work and to the commissioner for the purposes set forth in paragraph (c).

 

(b) For purposes of primary prevention evaluation, the following samples must be collected: pretesting and posttesting of one noncarpeted floor dust lead sample and a notation of the extent and location of bare soil and of deteriorated lead-based paint. The analytical testing data collected on each residence for purposes of primary prevention under section 144.9503 must be shared with the swab team workers in order to provide constructive feedback on their work and to the commissioner for the purposes set forth in paragraph (c).

 

(c) The commissioner of health must establish a program to collect appropriate data as required under paragraphs (a) and (b), in order to conduct an ongoing evaluation of swab team services for primary and secondary prevention. Within the limits of available appropriations, the commissioner of health must conduct on up to 1,000 residences which have received primary or secondary prevention swab team services, a postremediation evaluation, on at least a quarterly basis for a period of at least two years for each residence. The evaluation must note the condition of the paint within the residence, the extent of bare soil on the grounds, and collect and analyze one noncarpeted floor dust lead sample. The data collected must be evaluated to determine the efficacy of providing swab team services as a method of reducing lead exposure in young children. In evaluating this data, the commissioner of health must consider city size, community location, historic traffic flow, soil lead level of the property by area or census tract, distance to industrial point sources that emit lead, season of the year, age of the housing, age and number of children living at the residence, the presence of pets that move in and out of the residence, and other relevant factors as the commissioner of health may determine.

 

Subd. 9. Program benefits. As a condition of providing swab team services under this section, an the nonprofit organization may require a property owner to not increase rents on a property solely as a result of a substantial improvement made with public funds under the programs in this section.

 

Subd. 10. Requirements of organizations receiving grants the nonprofit organization. An eligible The nonprofit organization that is awarded a training and demonstration grant under this section must prepare and submit a quarterly progress report to the commissioner beginning three months after receipt of the grant.

 

Sec. 10. [144.966] EARLY HEARING DETECTION AND INTERVENTION PROGRAM.

 

Subdivision 1. Definitions. (a) "Child" means a person 18 years of age or younger.

 

(b) "False positive rate" means the proportion of infants identified as having a significant hearing loss by the screening process who are ultimately found to not have a significant hearing loss.

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(c) "False negative rate" means the proportion of infants not identified as having a significant hearing loss by the screening process who are ultimately found to have a significant hearing loss.

 

(d) "Hearing screening test" means automated auditory brain stem response, otoacoustic emissions, or another appropriate screening test approved by the Department of Health.

 

(e) "Hospital" means a birthing health care facility or birthing center licensed in this state that provides obstetrical services.

 

(f) "Infant" means a child who is not a newborn and has not attained the age of one year.

 

(g) "Newborn" means an infant 28 days of age or younger.

 

(h) "Parent" means a natural parent, stepparent, adoptive parent, guardian, or custodian of a newborn or infant.

 

Subd. 2. Newborn Hearing Screening Advisory Committee. (a) The commissioner of health shall establish a Newborn Hearing Screening Advisory Committee to advise and assist the Department of Health and the Department of Education in:

 

(1) developing protocols and timelines for screening, rescreening, and diagnostic audiological assessment and early medical, audiological, and educational intervention services for children who are deaf or hard-of-hearing;

 

(2) designing protocols for tracking children from birth through age three that may have passed newborn screening but are at risk for delayed or late onset of permanent hearing loss;

 

(3) designing a technical assistance program to support facilities implementing the screening program and facilities conducting rescreening and diagnostic audiological assessment;

 

(4) designing implementation and evaluation of a system of follow-up and tracking; and

 

(5) evaluating program outcomes to increase effectiveness and efficiency and ensure culturally appropriate services for children with a confirmed hearing loss and their families.

 

(b) The commissioner of health shall appoint at least one member from each of the following groups with no less than two of the members being deaf or hard-of-hearing:

 

(1) a representative from a consumer organization representing culturally deaf persons;

 

(2) a parent with a child with hearing loss representing a parent organization;

 

(3) a consumer from an organization representing oral communication options;

 

(4) a consumer from an organization representing cued speech communication options;

 

(5) an audiologist who has experience in evaluation and intervention of infants and young children;

 

(6) a speech-language pathologist who has experience in evaluation and intervention of infants and young children;

 

(7) two primary care providers who have experience in the care of infants and young children, one of which shall be a pediatrician;

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(8) a representative from the early hearing detection intervention teams;

 

(9) a representative from the Department of Education resource center for the deaf and hard-of-hearing or the representative's designee;

 

(10) a representative of the Minnesota Commission Serving Deaf and Hard of Hearing People;

 

(11) a representative from the Department of Human Services Deaf and Hard of Hearing Services Division;

 

(12) one or more of the Part C coordinators from the Department of Education, the Department of Health, or the Department of Human Services or the department's designees;

 

(13) the Department of Health early hearing detection and intervention coordinator;

 

(14) two birth hospital representatives from one rural and one urban hospital;

 

(15) a pediatric geneticist;

 

(16) an otolaryngologist;

 

(17) a representative from the Newborn Screening Advisory Committee under this subdivision; and

 

(18) a representative of the Department of Education regional low-incidence facilitators.

 

The commissioner must complete the appointments required under this subdivision by September 1, 2007.

 

(c) The Department of Health member shall chair the first meeting of the committee. At the first meeting, the committee shall elect a chair from its membership. The committee shall meet at the call of the chair, at least four times a year. The committee shall adopt written bylaws to govern its activities. The Department of Health shall provide technical and administrative support services as required by the committee. These services shall include technical support from individuals qualified to administer infant hearing screening, rescreening, and diagnostic audiological assessments.

 

Members of the committee shall receive no compensation for their service, but shall be reimbursed as provided in section 15.059 for expenses incurred as a result of their duties as members of the committee.

 

(d) This subdivision expires June 30, 2013.

 

Subd. 3. Early hearing detection and intervention programs. All hospitals shall establish an early hearing detection and intervention (EHDI) program. Each EHDI program shall:

 

(1) in advance of any hearing screening testing, provide to the newborn's or infant's parents or parent information concerning the nature of the screening procedure, applicable costs of the screening procedure, the potential risks and effects of hearing loss, and the benefits of early detection and intervention;

 

(2) comply with parental consent under section 144.125, subdivision 3;

 

(3) develop policies and procedures for screening and rescreening based on Department of Health recommendations;

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(4) provide appropriate training and monitoring of individuals responsible for performing hearing screening tests as recommended by the Department of Health;

 

(5) test the newborn's hearing prior to discharge, or, if the newborn is expected to remain in the hospital for a prolonged period, testing shall be performed prior to three months of age or when medically feasible;

 

(6) develop and implement procedures for documenting the results of all hearing screening tests;

 

(7) inform the newborn's or infant's parents or parent, primary care physician, and the Department of Health according to recommendations of the Department of Health of the results of the hearing screening test or rescreening if conducted, or if the newborn or infant was not successfully tested. The hospital that discharges the newborn or infant to home is responsible for the screening; and

 

(8) collect performance data specified by the Department of Health.

 

Subd. 4. Notification and information. (a) Notification to the parents or parent, primary care provider, and the Department of Health shall occur prior to discharge or no later than ten days following the date of testing. Notification shall include information recommended by the Department of Health.

 

(b) A physician, nurse, midwife, or other health professional attending a birth outside a hospital or institution shall provide information, orally and in writing, as established by the Department of Health, to parents regarding places where the parents may have their infant's hearing screened and the importance of the screening.

 

(c) The professional conducting the diagnostic procedure to confirm the hearing loss must report the results to the parents, primary care provider, and Department of Health according to the Department of Health recommendations.

 

Subd. 5. Oversight responsibility. The Department of Health shall exercise oversight responsibility for EHDI programs, including establishing a performance data set and reviewing performance data collected by each hospital.

 

Subd. 6. Civil and criminal immunity and penalties. (a) No physician or hospital shall be civilly or criminally liable for failure to conduct hearing screening testing.

 

(b) No physician, midwife, nurse, other health professional, or hospital acting in compliance with this section shall be civilly or criminally liable for any acts conforming with this section, including furnishing information required according to this section.

 

Subd. 7. Fees. The commissioner shall charge a fee so that the total of fees collected will approximate the costs of implementing and maintaining a system to follow up on infants and provide technical assistance, a tracking system, data management, and evaluation. The fee shall be incorporated in the fee charged under section 144.125.

 

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

 

Sec. 11. Minnesota Statutes 2006, section 144E.101, subdivision 6, is amended to read:

 

Subd. 6. Basic life support. (a) Except as provided in paragraph (e), a basic life support ambulance shall be staffed by at least two ambulance service personnel, at least one of which must be an EMT, who provide a level of care so as to ensure that:

 

(1) life-threatening situations and potentially serious injuries are recognized;

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(2) patients are protected from additional hazards;

 

(3) basic treatment to reduce the seriousness of emergency situations is administered; and

 

(4) patients are transported to an appropriate medical facility for treatment.

 

(b) A basic life support service shall provide basic airway management.

 

(c) By January 1, 2001, a basic life support service shall provide automatic defibrillation, as provided in section 144E.103, subdivision 1, paragraph (b).

 

(d) A basic life support service licensee's medical director may authorize the ambulance service personnel to carry and to use medical antishock trousers and to perform intravenous infusion if the ambulance service personnel have been properly trained.

 

(e) Upon application from an ambulance service that includes evidence demonstrating hardship, the board may grant a temporary variance from the staff requirements in paragraph (a) and may authorize a basic life support ambulance to be staffed by one EMT and one first responder. The variance shall apply to basic life support ambulances operated by the ambulance service for up to one year from the date of the variance's issuance until the ambulance service renews its license. When a variance expires, an ambulance service may apply for a new variance under this paragraph. For purposes of this paragraph, "ambulance service" means either an ambulance service whose primary service area is located outside the metropolitan counties listed in section 473.121, subdivision 4, and outside the cities of Duluth, Mankato, Moorhead, Rochester, and St. Cloud; or an ambulance service based in a community with a population of less than 1,000.

 

Sec. 12. Minnesota Statutes 2006, section 144E.127, is amended to read:

 

144E.127 INTERHOSPITAL; INTERFACILITY TRANSFER.

 

Subdivision 1. Interhospital transfers. When transporting a patient from one licensed hospital to another, a licensee may substitute for one of the required ambulance service personnel, a physician, a registered nurse, or physician's assistant who has been trained to use the equipment in the ambulance and is knowledgeable of the licensee's ambulance service protocols.

 

Subd. 2. Interfacility transfers. In an interfacility transport, a licensee whose primary service area is located outside the metropolitan counties listed in section 473.121, subdivision 4, and outside the cities of Duluth, Mankato, Moorhead, Rochester, and St. Cloud; or an ambulance service based in a community with a population of less than 1,000, may substitute one EMT with a registered first responder if an EMT or EMT-paramedic, physician, registered nurse, or physician's assistant is in the patient compartment. If using a physician, registered nurse, or physician's assistant as the sole provider in the patient compartment, the individual must be trained to use the equipment in the ambulance and be knowledgeable of the ambulance service protocols.

 

Sec. 13. Minnesota Statutes 2006, section 144E.35, subdivision 1, is amended to read:

 

Subdivision 1. Repayment for volunteer training. Any political subdivision, or nonprofit hospital or nonprofit corporation operating A licensed ambulance service shall be reimbursed by the board for the necessary expense of the initial training of a volunteer ambulance attendant upon successful completion by the attendant of a basic emergency care course, or a continuing education course for basic emergency care, or both, which has been approved by the board, pursuant to section 144E.285. Reimbursement may include tuition, transportation, food, lodging, hourly payment for the time spent in the training course, and other necessary expenditures, except that in no instance shall a volunteer ambulance attendant be reimbursed more than $450 $600 for successful completion of a basic course, and $225 $275 for successful completion of a continuing education course.

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Sec. 14. [156.015] FEES.

 

Subdivision 1. Verification of licensure. The board may charge a fee of $25 per license verification to a licensee for verification of licensure status provided to other veterinary licensing boards.

 

Subd. 2. Continuing education review. The board may charge a fee of $50 per submission to a sponsor for review and approval of individual continuing education seminars, courses, wet labs, and lectures. This fee does not apply to continuing education sponsors that already meet the criteria for preapproval under Minnesota Rules, part 9100.1000, subpart 3, item A.

 

Sec. 15. Minnesota Statutes 2006, section 198.075, is amended to read:

 

198.075 MINNESOTA VETERANS HOME EMPLOYEES; EXCLUDED FROM COMMISSARY PRIVILEGES.

 

Except as provided in this section, no commissary privileges including food, laundry service, janitorial service, and household supplies shall be furnished to any employee of the Minnesota veterans homes. An employee of the Minnesota veterans homes who works a second shift that is consecutive with a regularly scheduled shift may be allowed one free meal at the veterans home on the day of that extra shift.

 

Sec. 16. Minnesota Statutes 2006, section 256B.0625, is amended by adding a subdivision to read:

 

Subd. 49. Lead risk assessments. (a) Effective October 1, 2007, or six months after federal approval, whichever is later, medical assistance covers lead risk assessments provided by a lead risk assessor who is licensed by the commissioner of health under section 144.9505 and employed by an assessing agency as defined in section 144.9501. Medical assistance covers a onetime on-site investigation of a recipient's home or primary residence to determine the existence of lead so long as the recipient is under the age of 21 and has a venous blood lead level specified in section 144.9504, subdivision 2, paragraph (a).

 

(b) Medical assistance reimbursement covers the lead risk assessor's time to complete the following activities:

 

(1) gathering samples;

 

(2) interviewing family members;

 

(3) gathering data, including meter readings; and

 

(4) providing a report with the results of the investigation and options for reducing lead-based paint hazards.

 

Medical assistance coverage of lead risk assessment does not include testing of environmental substances such as water, paint, or soil or any other laboratory services. Medical assistance coverage of lead risk assessments is not included in the capitated services for children enrolled in health plans through the prepaid medical assistance program and the MinnesotaCare program.

 

(c) Payment for lead risk assessment must be cost-based and must meet the criteria for federal financial participation under the Medicaid program. The rate must be based on allowable expenditures from cost information gathered. Under section 144.9507, subdivision 5, federal medical assistance funds may not replace existing funding for lead-related activities. The nonfederal share of costs for services provided under this subdivision must be from state or local funds and is the responsibility of the agency providing the risk assessment. When the risk assessment is conducted by the commissioner of health, the state share must be from appropriations to the commissioner of health for this purpose. Eligible expenditures for the nonfederal share of costs may not be made from federal funds or funds used to match other federal funds. Any federal disallowances are the responsibility of the agency providing risk assessment services.

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Sec. 17. Minnesota Statutes 2006, section 471.59, subdivision 1, is amended to read:

 

Subdivision 1. Agreement. Two or more governmental units, by agreement entered into through action of their governing bodies, may jointly or cooperatively exercise any power common to the contracting parties or any similar powers, including those which are the same except for the territorial limits within which they may be exercised. The agreement may provide for the exercise of such powers by one or more of the participating governmental units on behalf of the other participating units. The term "governmental unit" as used in this section includes every city, county, town, school district, other political subdivision of this or another state, another state, the University of Minnesota, nonprofit hospitals licensed under sections 144.50 to 144.56, rehabilitation facilities and extended employment providers that are certified by the commissioner of employment and economic development, day training and habilitation services licensed under sections 245B.01 to 245B.08, nonprofit community health clinics providing family planning services as defined in section 145.925, and any agency of the state of Minnesota or the United States, and includes any instrumentality of a governmental unit. For the purpose of this section, an instrumentality of a governmental unit means an instrumentality having independent policy making and appropriating authority.

 

Sec. 18. Laws 2005, First Special Session chapter 4, article 9, section 3, subdivision 2, is amended to read:

 

      Subd. 2. Community and Family Health Improvement

 

                                                   Summary by Fund

 

General                                 40,413,000                              40,382,000

 

State Government

Special Revenue                      141,000                                   128,000

 

Health Care Access             3,510,000                                3,516,000

 

Federal TANF                       6,000,000                                6,000,000

 

Family Planning Base Reduction. Base level funding for the family planning special projects grant program is reduced by $1,877,000 each year of the biennium beginning July 1, 2007, provided that this reduction shall only take place upon full implementation of the family planning project section of the 1115 waiver. Notwithstanding Minnesota Statutes, section 145.925, the commissioner shall give priority to community health care clinics providing family planning services that either serve a high number of women who do not qualify for medical assistance or are unable to participate in the medical assistance program as a medical assistance provider when allocating the remaining appropriations. Notwithstanding section 15, this paragraph shall not expire.

 

Shaken Baby Video. Of the state government special revenue fund appropriation, $13,000 in 2006 is appropriated to the commissioner of health to provide a video to hospitals on shaken baby syndrome. The commissioner of health shall assess a fee to hospitals to cover the cost of the approved shaken baby video and the revenue received is to be deposited in the state government special revenue fund.

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Sec. 19. STUDY OF BLOOD LEAD TESTING METHODS.

 

(a) The commissioner of health, in consultation with the commissioner of human services, cities of the first class, health care providers, and other interested parties, shall conduct a study to evaluate blood lead testing methods used to confirm elevated blood lead status. The study shall examine:

 

(1) the false positive rate of capillary tests for children who are younger than 72 months old;

 

(2) current protocols for conducting capillary testing, including filter paper methodology; and

 

(3) existing guidelines and regulations from other states and federal agencies regarding lead testing.

 

(b) The commissioner shall make recommendations on:

 

(1) the use of capillary tests to initiate environmental investigations and case management, including number and timing of tests and fiscal implications for state and local lead programs; and

 

(2) reducing the state mandatory intervention to ten micrograms of lead per deciliter of whole blood.

 

(c) The commissioner shall submit the results of the study and recommendations, including any necessary legislative changes, to the legislature by January 15, 2008.

 

Sec. 20. WINDOW SAFETY EDUCATION.

 

The commissioner of health shall create in the department's current educational safety program a component targeted at parents and caregivers of young children to provide awareness of the need to take precautions to prevent children from falling through open windows. The commissioner of health shall consult with representatives of the residential building industry, the window products industry, the child safety advocacy community, and the Department of Labor and Industry to create the window safety program component. The program must include the gathering of data about falls from windows that result in severe injury in order to measure the effectiveness of the safety program. The commissioner of health may consult with other child safety advocacy groups, experts, and interested parties in the development and implementation of the window safety program. The commissioner of health shall prepare and submit a final report on the window safety program to the legislature by March 1, 2011. The commissioner shall prepare and submit a yearly progress report to the legislature by March 1 of each year beginning in 2008 until the submission of the final report. The final report must include a summary of the safety program, the impact of the program on children falling from windows, and any recommendations for further study or action.

 

Sec. 21. REVISOR'S INSTRUCTION.

 

The revisor of statutes shall change the range reference "144.9501 to 144.9509" to "144.9501 to 144.9512" wherever the reference appears in Minnesota Statutes and Minnesota Rules.

 

Sec. 22. REPEALER.

 

Laws 2004, chapter 288, article 6, section 27, is repealed.

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ARTICLE 17

 

PUBLIC HEALTH

 

Section 1. Minnesota Statutes 2006, section 144.2215, subdivision 1, is amended to read:

 

Subdivision 1. Establishment. Within the limits of available appropriations, the commissioner of health shall establish and maintain an information system containing data on the cause, treatment, prevention, and cure of major birth defects. The commissioner shall consult with representatives and experts in epidemiology, medicine, insurance, health maintenance organizations, genetics, consumers, and voluntary organizations in developing the system and may phase in the implementation of the system. After the parents have provided informed consent under section 144.2216, subdivision 4, the commissioner shall offer the parents with their informed consent a visit by a trained health care worker to interview the parents about:

 

(1) all previous home addresses, occupations, and places of work including from childhood;

 

(2) the time and place of any military service; and

 

(3) known occasions or sites of toxic exposures.

 

Sec. 2. Minnesota Statutes 2006, section 145A.17, is amended to read:

 

145A.17 FAMILY HOME VISITING PROGRAMS.

 

Subdivision 1. Establishment; goals. The commissioner shall establish a program to fund family home visiting programs designed to foster a healthy beginning for children in families at or below 200 percent of the federal poverty guidelines beginnings, improve pregnancy outcomes, promote school readiness, prevent child abuse and neglect, reduce juvenile delinquency, promote positive parenting and resiliency in children, and promote family health and economic self-sufficiency for children and families. The commissioner shall promote partnerships, collaboration, and multidisciplinary visiting done by teams of professionals and paraprofessionals from the fields of public health nursing, social work, and early childhood education. A program funded under this section must serve families at or below 200 percent of the federal poverty guidelines, and other families determined to be at risk, including but not limited to being at risk for child abuse, child neglect, or juvenile delinquency. Programs must give priority for services to families considered to be in need of services, including but not limited to begin prenatally whenever possible and must be targeted to families with:

 

(1) adolescent parents;

 

(2) a history of alcohol or other drug abuse;

 

(3) a history of child abuse, domestic abuse, or other types of violence;

 

(4) a history of domestic abuse, rape, or other forms of victimization;

 

(5) reduced cognitive functioning;

 

(6) a lack of knowledge of child growth and development stages;

 

(7) low resiliency to adversities and environmental stresses; or

 

(8) insufficient financial resources to meet family needs;

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(9) a history of homelessness;

 

(10) a risk of long-term welfare dependence or family instability due to employment barriers; or

 

(11) other risk factors as determined by the commissioner.

 

Subd. 3. Requirements for programs; process. (a) Before a community health board or tribal government may receive an allocation under subdivision 2, a community health board or tribal government must submit a proposal to the commissioner that includes identification, based on a community assessment, of the populations at or below 200 percent of the federal poverty guidelines that will be served and the other populations that will be served. Each program that receives funds must Community health boards and tribal governments that receive funding under this section must submit a plan to the commissioner describing a multidisciplinary approach to targeted home visiting for families. The plan must be submitted on forms provided by the commissioner. At a minimum, the plan must include the following:

 

(1) a description of outreach strategies to families prenatally or at birth;

 

(2) provisions for the seamless delivery of health, safety, and early learning services;

 

(3) methods to promote continuity of services when families move within the state;

 

(4) a description of the community demographics;

 

(5) a plan for meeting outcome measures; and

 

(6) a proposed work plan that includes:

 

(i) coordination to ensure nonduplication of services for children and families;

 

(ii) a description of the strategies to ensure that children and families at greatest risk receive appropriate services; and

 

(iii) collaboration with multidisciplinary partners including public health, ECFE, Head Start, community health workers, social workers, community home visiting programs, school districts, and other relevant partners. Letters of intent from multidisciplinary partners must be submitted with the plan.

 

(b) Each program that receives funds must accomplish the following program requirements:

 

(1) use either a broad community-based or selective community-based strategy to provide preventive and early intervention home visiting services;

 

(2) offer a home visit by a trained home visitor. If a home visit is accepted, the first home visit must occur prenatally or as soon after birth as possible and must include a public health nursing assessment by a public health nurse;

 

(3) offer, at a minimum, information on infant care, child growth and development, positive parenting, preventing diseases, preventing exposure to environmental hazards, and support services available in the community;

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(4) provide information on and referrals to health care services, if needed, including information on and assistance in applying for health care coverage for which the child or family may be eligible; and provide information on preventive services, developmental assessments, and the availability of public assistance programs as appropriate;

 

(5) provide youth development programs when appropriate;

 

(6) recruit home visitors who will represent, to the extent possible, the races, cultures, and languages spoken by families that may be served;

 

(7) train and supervise home visitors in accordance with the requirements established under subdivision 4;

 

(8) maximize resources and minimize duplication by coordinating activities or contracting with local social and human services organizations, education organizations, and other appropriate governmental entities and community-based organizations and agencies; and

 

(9) utilize appropriate racial and ethnic approaches to providing home visiting services; and

 

(10) connect eligible families, as needed, to additional resources available in the community, including, but not limited to, early care and education programs, health or mental health services, family literacy programs, employment agencies, social services, and child care resources and referral agencies.

 

(c) When available, programs that receive funds under this section must offer or provide the family with a referral to center-based or group meetings that meet at least once per month for those families identified with additional needs. The meetings must focus on further enhancing the information, activities, and skill-building addressed during home visitation; offering opportunities for parents to meet with and support each other; and offering infants and toddlers a safe, nurturing, and stimulating environment for socialization and supervised play with qualified teachers.

 

(b) (d) Funds available under this section shall not be used for medical services. The commissioner shall establish an administrative cost limit for recipients of funds. The outcome measures established under subdivision 6 must be specified to recipients of funds at the time the funds are distributed.

 

(c) (e) Data collected on individuals served by the home visiting programs must remain confidential and must not be disclosed by providers of home visiting services without a specific informed written consent that identifies disclosures to be made. Upon request, agencies providing home visiting services must provide recipients with information on disclosures, including the names of entities and individuals receiving the information and the general purpose of the disclosure. Prospective and current recipients of home visiting services must be told and informed in writing that written consent for disclosure of data is not required for access to home visiting services.

 

Subd. 4. Training. The commissioner shall establish training requirements for home visitors and minimum requirements for supervision by a public health nurse. The requirements for nurses must be consistent with chapter 148. The commissioner must provide training for home visitors. Training must include child development, positive parenting techniques, screening and referrals for child abuse and neglect, and diverse cultural practices in child rearing and family systems the following:

 

(1) effective relationships for engaging and retaining families and ensuring family health, safety, and early learning;

 

(2) effective methods of implementing parent education, conducting home visiting, and promoting quality early childhood development;

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(3) early childhood development from birth to age five;

 

(4) diverse cultural practices in child rearing and family systems;

 

(5) recruiting, supervising, and retaining qualified staff;

 

(6) increasing services for underserved populations; and

 

(7) relevant issues related to child welfare and protective services, with information provided being consistent with state child welfare agency training.

 

Subd. 5. Technical assistance. The commissioner shall provide administrative and technical assistance to each program, including assistance in data collection and other activities related to conducting short- and long-term evaluations of the programs as required under subdivision 7. The commissioner may request research and evaluation support from the University of Minnesota.

 

Subd. 6. Outcome and performance measures. The commissioner shall establish outcomes measures to determine the impact of family home visiting programs funded under this section on the following areas:

 

(1) appropriate utilization of preventive health care;

 

(2) rates of substantiated child abuse and neglect;

 

(3) rates of unintentional child injuries;

 

(4) rates of children who are screened and who pass early childhood screening; and

 

(5) rates of children accessing early care and educational services;

 

(6) program retention rates;

 

(7) number of home visits provided compared to the number of home visits planned;

 

(8) participant satisfaction;

 

(9) rates of at-risk populations reached; and

 

(10) any additional qualitative goals and quantitative measures established by the commissioner.

 

Subd. 7. Evaluation. Using the qualitative goals and quantitative outcome and performance measures established under subdivisions 1 and 6, the commissioner shall conduct ongoing evaluations of the programs funded under this section. Community health boards and tribal governments shall cooperate with the commissioner in the evaluations and shall provide the commissioner with the information necessary to conduct the evaluations. As part of the ongoing evaluations, the commissioner shall rate the impact of the programs on the outcome measures listed in subdivision 6, and shall periodically determine whether home visiting programs are the best way to achieve the qualitative goals established under subdivisions 1 and 6. If the commissioner determines that home visiting programs are not the best way to achieve these goals, the commissioner shall provide the legislature with alternative methods for achieving them.

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Subd. 8. Report. By January 15, 2002, and January 15 of each even-numbered year thereafter, the commissioner shall submit a report to the legislature on the family home visiting programs funded under this section and on the results of the evaluations conducted under subdivision 7.

 

Subd. 9. No supplanting of existing funds. Funding available under this section may be used only to supplement, not to replace, nonstate funds being used for home visiting services as of July 1, 2001.

 

Sec. 3. WATER LEVEL STANDARDS.

 

(a) Until the commissioner of health adopts rules setting the health risk limits required in paragraph (b), the health risk limit for all contaminants in private wells and public water systems must be the more stringent of the state standards or the federal standards determined by the United States Environmental Protection Agency.

 

(b) By March 1, 2008, the commissioner of health must publish in the State Register notice of intent to adopt rules relating to health risk limits for commonly detected contaminants. The commissioner of health shall review current scientific information to establish health risk limits for commonly detected contaminants in groundwater and in private wells that provides a reasonable margin of safety to adequately protect the health of developing fetuses, infants, and children, in accordance with the requirements of Minnesota Statutes, section 144.0751. Nothing in paragraph (a) prohibits the commissioner from setting standards that are stricter than the federal standards.

 

(c) By March 1, 2009, the commissioner shall adopt rules relating to health risk limits for the ten most commonly detected contaminants.

 

Sec. 4. FUNDING FOR ENVIRONMENTAL JUSTICE MAPPING.

 

The commissioner of health, in conjunction with the commissioner of the Pollution Control Agency, shall apply for federal funding to renew and expand the state's environmental justice mapping capacity in order to promote public health tracking. If implemented, the commissioner of health shall coordinate the project with the Pollution Control Agency and the Department of Agriculture in order to explore possible links between environmental health and toxic exposures and to help create a system for environmental public health tracking and make recommendations to the legislature for additional sources of funding within the state.

 

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

 

Sec. 5. FRAGRANCE-FREE SCHOOLS EDUCATION PILOT PROJECT.

 

Subdivision 1. Purpose. Recognizing that scented products may trigger asthma or chemical sensitivity reactions in students and school staff, which can contribute to learning and breathing problems, the commissioner of health shall develop a fragrance-free schools education pilot project.

 

Subd. 2. Education. The commissioner of health, in collaboration with the Minneapolis Board of Education, shall establish a working group composed of at least three students, two teachers, one school administrator, and one member of the Minneapolis Board of Education to recommend an education campaign in Minneapolis public schools to inform students and parents about the potentially harmful effects of the use of fragrance products on sensitive students and school personnel in Minneapolis schools. The commissioner shall report findings to the legislature by February 1, 2008.

 

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

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Sec. 6. MEDICAL ASSISTANCE COVERAGE FOR ARSENIC TESTING.

 

The commissioner of human services shall inform providers that testing for arsenic under Minnesota Statutes, section 144.967, is covered under medical assistance.

 

ARTICLE 18

 

HUMAN SERVICES FORECAST ADJUSTMENTS

 

      Section 1. SUMMARY OF APPROPRIATIONS; DEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENT.

 

      The dollar amounts shown are added to or, if shown in parentheses, are subtracted from the appropriations in Laws 2006, chapter 282, from the general fund, or any other fund named, to the Department of Human Services for the purposes specified in this article, to be available for the fiscal year indicated for each purpose. The figure "2007" used in this article means that the appropriation or appropriations listed are available for the fiscal year ending June 30, 2007.

 

                    2007

 

General Fund                                                                                                                                                                  $(25,226,000)

 

Health Care Access                                                                                                                                                      $(53,980,000)

 

TANF                                                                                                                                                                              $(24,805,000)

 

Total                                                                                                                                                                           $(104,011,000)

 

      Sec. 2. COMMISSIONER OF HUMAN SERVICES

 

      Subdivision 1. Total Appropriation                                                                                                                $(104,011,000)

 

                                        Appropriations by Fund

 

                                                                                                        2007

 

General                                                                              (25,226,000)

 

Health Care Access                                                        (53,980,000)

 

TANF                                                                                (24,805,000)

 

      Subd. 2. Revenue and Pass Through

 

TANF                                                                                                                                                                                     (106,000)

 

      Subd. 3. Children and Economic Assistance Grants

 

General                                                                                                                                                                                   3,221,000

 

TANF                                                                                                                                                                                (24,699,000)

 

The amounts that may be spent from this appropriation for each purpose are as follows:

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(a) MFIP/DWP Grants

 

General                                                                                                                                                                                 13,827,000

 

TANF                                                                                                                                                                                (24,699,000)

 

(b) MFIP Child Care Assistance Grants

 

General                                                                                                                                                                                (4,733,000)

 

(c) General Assistance Grants

 

General                                                                                                                                                                                   1,081,000

 

(d) Minnesota Supplemental Aid Grants

 

General                                                                                                                                                                                (1,099,000)

 

(e) Group Residential Housing Grants

 

General                                                                                                                                                                                (5,855,000)

 

      Subd. 4. Basic Health Care Grants

 

General                                                                                                                                                                                 17,592,000

 

Health Care Access                                                                                                                                                        (53,980,000)

 

The amounts that may be spent from this appropriation for each purpose are as follows:

 

(a) MinnesotaCare Health Care Access                                                                                                                      (53,980,000)

 

(b) MA Basic Health Care - Families and Children

 

General                                                                                                                                                                                 15,729,000

 

(c) MA Basic Health Care - Elderly and Disabled

 

General                                                                                                                                                                                (4,540,000)

 

(d) General Assistance Medical Care

 

General                                                                                                                                                                                   6,403,000

 

      Subd. 5. Continuing Care Grants

 

General                                                                                                                                                                              (46,039,000)

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The amounts that may be spent from this appropriation for each purpose are as follows:

 

(a) MA Long-Term Care Facilities

 

General                                                                                                                                                                              (15,028,000)

 

(b) MA Long-Term Care Waivers

 

General                                                                                                                                                                              (20,677,000)

 

(c) Chemical Dependency Entitlement Grants

 

General                                                                                                                                                                              (10,334,000)

 

      Sec. 3. EFFECTIVE DATE.

 

      Sections 1 and 2 are effective the day following final enactment.

 

ARTICLE 19

 

HUMAN SERVICES APPROPRIATIONS

 

      Section 1. SUMMARY OF APPROPRIATIONS.

 

      The amounts shown in this section summarize direct appropriations, by fund, made in this article.

 

                                                                                                                       2008                               2009                               Total

 

General                                                                                          $4,791,706,000               $5,135,500,000               $9,927,206,000

 

State Government Special Revenue                                                59,686,000                      58,595,000                    118,281,000

 

Health Care Access                                                                         448,782,000                    526,391,000                    975,173,000

 

Federal TANF                                                                                   265,813,000                    278,334,000                 5,444,147,000

 

Lottery Prize Fund                                                                               2,185,000                        1,790,000                        3,975,000

 

Total                                                                                          $5,568,172,000           $6,000,610,000         $11,568,782,000

 

Sec. 2. HEALTH AND HUMAN SERVICES APPROPRIATIONS.

 

The sums shown in the columns marked "Appropriations" are appropriated to the agencies and for the purposes specified in this article. The appropriations are from the general fund, or another named fund, and are available for the fiscal years indicated for each purpose. The figures "2008" and "2009" used in this article mean that the appropriations listed under them are available for the fiscal year ending June 30, 2008, or June 30, 2009, respectively. "The first year" is fiscal year 2008. "The second year" is fiscal year 2009. "The biennium" is fiscal years 2008 and 2009. Appropriations for the fiscal year ending June 30, 2007, are effective the day following final enactment.

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                                                                                                                                                             APPROPRIATIONS

                                                                                                                                                            Available for the Year

                                                                                                                                                                  Ending June 30

                                                                                                                                                   2008                                      2009

 

      Sec. 3. HUMAN SERVICES

 

      Subdivision 1. Total Appropriation                                                                       $5,331,907,000           $5,776,086,000

 

                                        Appropriations by Fund

 

                                                        2008                                        2009

 

General                            4,646,624,000                         5,000,874,000

 

State Government

Special Revenue                      549,000                                   565,000

 

Health Care Access         428,154,000                            506,256,000

 

Federal TANF                   254,394,000                            266,601,000

 

Lottery Prize Fund               2,185,000                                1,790,000

 

The amounts that may be spent for each purpose are specified in the following subdivisions.

 

Receipts for Systems Projects. Appropriations and federal receipts for information system projects for MAXIS, PRISM, MMIS, and SSIS must be deposited in the state system account authorized in Minnesota Statutes, section 256.014. Money appropriated for computer projects approved by the Minnesota Office of Enterprise Technology, funded by the legislature, and approved by the commissioner of finance, may be transferred from one project to another and from development to operations as the commissioner of human services considers necessary. Any unexpended balance in the appropriation for these projects does not cancel but is available for ongoing development and operations.

 

Pay for Performance. (a) Of the general fund appropriation, $272,000 each year is available to the commissioner of human services only under the following circumstances:

 

(1) $272,000 shall be made available by the commissioner of finance on January 1, 2009, only after notification by the commissioner of human services to the commissioner of finance and to the chairs of the relevant house of representatives and senate finance and policy committees that the average number of days from the receipt of a MinnesotaCare application at the state

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                                                                                                                                                             APPROPRIATIONS

                                                                                                                                                            Available for the Year

                                                                                                                                                                  Ending June 30

                                                                                                                                                   2008                                      2009

 

processing unit until the initial eligibility determination of the application was 30 days or less during the period October 1, 2007, to September 30, 2008. Applications transferred from counties to the state processing unit are excluded from this calculation; and

 

(2) $272,000 shall be made available by the commissioner of finance on January 1, 2009, only after notification by the commissioner of human services to the commissioner of finance and to the chairs of the relevant house of representatives and senate finance and policy committees that the commissioner initiated a separate treatment program for persons in the Minnesota sex offenders program who are between the ages of 18 and 25 by January 1, 2008.

 

(b) Regardless of whether these appropriations are made available to the commissioner of human services, they shall be part of base level funding for the biennium beginning July 1, 2009.

 

Nonfederal Share Transfers. The nonfederal share of activities for which federal administrative reimbursement is appropriated to the commissioner may be transferred to the special revenue fund.

 

TANF Maintenance of Effort. (a) In order to meet the basic MOE requirements of the TANF block grant specified under Code of Federal Regulations, title 45, section 263.1, the commissioner may only report nonfederal money expended for allowable activities listed in the following clauses as TANF/MOE expenditures:

 

(1) MFIP cash, diversionary work program, and food assistance benefits under Minnesota Statutes, chapter 256J;

 

(2) the child care assistance programs under Minnesota Statutes, sections 119B.03 and 119B.05, and county child care administrative costs under Minnesota Statutes, section 119B.15;

 

(3) state and county MFIP administrative costs under Minnesota Statutes, chapters 256J and 256K;

 

(4) state, county, and tribal MFIP employment services under Minnesota Statutes, chapters 256J and 256K;

 

(5) expenditures made on behalf of noncitizen MFIP recipients who qualify for the medical assistance without federal financial participation program under Minnesota Statutes, section 256B.06, subdivision 4, paragraphs (d), (e), and (j); and

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                                                                                                                                                             APPROPRIATIONS

                                                                                                                                                            Available for the Year

                                                                                                                                                                  Ending June 30

                                                                                                                                                   2008                                      2009

 

(6) qualifying working family credit expenditures under Minnesota Statutes, section 290.0671.

 

(b) The commissioner shall ensure that sufficient qualified nonfederal expenditures are made each year to meet the state's TANF/MOE requirements. For the activities listed in paragraph (a), clauses (2) to (6), the commissioner may only report expenditures that are excluded from the definition of assistance under Code of Federal Regulations, title 45, section 260.31.

 

(c) The commissioner shall ensure that the MOE used by the commissioner of finance for the February and November forecasts required under Minnesota Statutes, section 16A.103, contains expenditures under paragraph (a), clause (1), equal to at least 16 percent of the total required under Code of Federal Regulations, title 45, section 263.1.

 

(d) Minnesota Statutes, section 256.011, subdivision 3, which requires that federal grants or aids secured or obtained under that subdivision be used to reduce any direct appropriations provided by law, does not apply if the grants or aids are federal TANF funds.

 

(e) Notwithstanding any contrary provision in this article, this rider expires June 30, 2011.

 

Working Family Credit Expenditures as TANF/MOE. The commissioner may claim as TANF/MOE up to $6,707,000 per year for fiscal year 2008 through fiscal year 2011. Notwithstanding any contrary provision in this article, this rider expires June 30, 2011.

 

Additional Working Family Credit Expenditures to be Claimed for TANF/MOE. In addition to the amounts provided in this section, the commissioner may count the following amounts of working family credit expenditure as TANF/MOE:

 

(1) fiscal year 2008, $8,126,000;

 

(2) fiscal year 2009, $22,593,000;

 

(3) fiscal year 2010, $12,259,000; and

 

(4) fiscal year 2011, $11,334,000.

 

Notwithstanding any contrary provision in this article, this rider expires June 30, 2011.

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                                                                                                                                                             APPROPRIATIONS

                                                                                                                                                            Available for the Year

                                                                                                                                                                  Ending June 30

                                                                                                                                                   2008                                      2009

 

Capitation Rate Increase. Of the health care access fund appropriations to the University of Minnesota in the higher education omnibus appropriation bill, $2,157,000 in fiscal year 2008 and $2,157,000 in fiscal year 2009 are to be used to increase the capitation payments under Minnesota Statutes, section 256B.69.

 

      Subd. 2. Agency Management

 

The amounts that may be spent from the appropriation for each purpose are as follows:

 

(a) Financial Operations

 

                                        Appropriations by Fund

 

General                                   7,165,000                                7,652,000

 

Health Care Access                893,000                                   888,000

 

Federal TANF                          122,000                                   122,000

 

Base Adjustment. The general fund base is increased by $454,000 in fiscal year 2010 and $454,000 in fiscal year 2011 for financial operations.

 

(b) Legal and Regulation Operations

 

                                        Appropriations by Fund

 

General                                 12,352,000                              12,439,000

 

State Government

Special Revenue                      427,000                                   440,000

 

Health Care Access                900,000                                   926,000

 

Federal TANF                          100,000                                   100,000

 

Base Adjustment. The general fund base is $12,376,000 for each of fiscal years 2010 and 2011.

 

Child Care Licensing. $116,000 in fiscal year 2008 and $233,000 in fiscal year 2009 are appropriated from the general fund to the commissioner of human services for purposes of completing background studies for family and group family child care providers under Minnesota Statutes, chapter 245C. This appropriation will be $144,000 in fiscal year 2010 and $56,000 in fiscal year 2011.

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                                                                                                                                                             APPROPRIATIONS

                                                                                                                                                            Available for the Year

                                                                                                                                                                  Ending June 30

                                                                                                                                                   2008                                      2009

 

(c) Management Operations

 

                                        Appropriations by Fund

 

General                                   4,332,000                                4,419,000

 

Health Care Access                236,000                                   243,000

 

(d) Information Technology Operations

 

                                        Appropriations by Fund

 

General                                 23,949,000                              23,922,000

 

Health Care Access             6,015,000                                5,972,000

 

      Subd. 3. Revenue and Pass-Through Expenditures

 

Federal TANF                     59,246,000                              61,680,000

 

TANF Transfer to Federal Child Care and Development Fund. The following TANF fund amounts are appropriated to the commissioner for the purposes of MFIP transition year child care under MFIP, Minnesota Statutes, section 119B.05:

 

(1) fiscal year 2008, $2,737,000;

 

(2) fiscal year 2009, $4,783,000;

 

(3) fiscal year 2010, $4,789,000; and

 

(4) fiscal year 2011, $4,821,000.

 

The commissioner shall authorize transfer of sufficient TANF funds to the federal child care and development fund to meet this appropriation and shall ensure that all transferred funds are expended according the federal child care and development fund regulations.

 

      Subd. 4. Children and Economic Assistance Grants

 

The amounts that may be spent from this appropriation for each purpose are as follows:

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                                                                                                                                                             APPROPRIATIONS

                                                                                                                                                            Available for the Year

                                                                                                                                                                  Ending June 30

                                                                                                                                                   2008                                      2009

 

(a) MFIP/DWP Grants

 

                                        Appropriations by Fund

 

General                                 62,069,000                              62,514,000

 

Federal TANF                     78,402,000                              85,211,000

 

(b) Support Services Grants

 

                                        Appropriations by Fund

 

General                                   8,715,000                                8,715,000

 

Federal TANF                   113,429,000                            115,902,000

 

TANF Prior Appropriation Cancellation. Notwithstanding Laws 2001, First Special Session chapter 9, article 17, section 2, subdivision 11, paragraph (b), any unexpended TANF funds appropriated to the commissioner to contract with the Board of Trustees of Minnesota State Colleges and Universities, to provide tuition waivers to employees of health care and human service providers that are members of qualifying consortia operating under Minnesota Statutes, sections 116L.10 to 116L.15, must cancel at the end of fiscal year 2007.

 

MFIP Pilot Program. Of the general fund appropriation, $100,000 in fiscal year 2008 and $750,000 in fiscal year 2009 are for a grant to the Stearns-Benton Employment and Training Council for the Workforce U pilot program. Base level funding for this program shall be $750,000 in 2010 and $0 in 2011.

 

Supported Work. (1) $5,468,000 in fiscal year 2008 and $7,291,000 in fiscal year 2009 are appropriated from the TANF fund to the commissioner for the biennium beginning July 1, 2007, for supported work for MFIP participants, to be allocated to counties and tribes based on the criteria under clauses (2) and (3). Paid transitional work experience and other supported employment under this rider provides a continuum of employment assistance, including outreach and recruitment, program orientation and intake, testing and assessment, job development and marketing, preworksite training, supported worksite experience, job coaching, and postplacement follow-up, in addition to extensive case management and referral services.

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                                                                                                                                                            Available for the Year

                                                                                                                                                                  Ending June 30

                                                                                                                                                   2008                                      2009

 

(2) A county or tribe is eligible to receive an allocation under this rider if:

 

(i) the county or tribe is not meeting the federal work participation rate;

 

(ii) the county or tribe has participants who are required to perform work activities under Minnesota Statutes, chapter 256J, but are not meeting hourly work requirements; and

 

(iii) the county or tribe has assessed participants who have completed six weeks of job search or are required to perform work activities and are not meeting the hourly requirements, and the county or tribe has determined that the participant would benefit from working in a supported work environment.

 

(3) A county or tribe may also be eligible for funds in order to contract for supplemental hours of paid work at the participant's child's place of education, child care location, or the child's physical or mental health treatment facility or office. This grant to counties and tribes is specifically for MFIP participants who need to work up to five hours more per week in order to meet the hourly work requirement, and the participant's employer cannot or will not offer more hours to the participant.

 

Work Study. $750,000 in fiscal year 2008 and $750,000 in fiscal year 2009 are appropriated from the TANF fund to the commissioner to contract with the Minnesota Office of Higher Education for the biennium beginning July 1, 2007, for work study grants under Minnesota Statutes, section 136A.233, specifically for low-income individuals who receive assistance under Minnesota Statutes, chapter 256J, and for grants to opportunities industrialization centers.

 

Integrated Service Projects. $2,500,000 in fiscal year 2008 and $2,500,000 in fiscal year 2009 are appropriated from the TANF fund to the commissioner to fund the integrated services project for MFIP families.

 

Base Adjustment. The TANF base for fiscal year 2010 is $115,902,000 and for fiscal year 2011 is $115,152,000.

 

(c) MFIP Child Care Assistance Grants

 

General                                 74,672,000                              72,173,000

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                                                                                                                                                             APPROPRIATIONS

                                                                                                                                                            Available for the Year

                                                                                                                                                                  Ending June 30

                                                                                                                                                   2008                                      2009

 

(d) Basic Sliding Fee Child Care Assistance Grants

 

General                                 46,398,000                              48,548,000

 

Base Adjustment. The general fund base is $46,400,000 for fiscal year 2010 and $45,535,000 for fiscal year 2011.

 

At-Home Infant Care Program. No funding shall be allocated to or spent on the at-home infant care program under Minnesota Statutes, section 119B.035.

 

(e) Child Care Development Grants

 

General                                   4,365,000                                4,365,000

 

Child Care Services Grants. $1,000,000 each year is appropriated from the general fund to the commissioner of human services for the biennium beginning July 1, 2007, for purposes of providing child care services grants under Minnesota Statutes, section 119B.21, subdivision 5. This appropriation is for the 2008-2009 biennium only, and does not increase the base funding.

 

Early Childhood Professional Development System. $1,000,000 each year is appropriated from the general fund to the commissioner of human services for the biennium beginning July 1, 2007, for purposes of the early childhood professional development system, which increases the quality and continuum of professional development opportunities for child care practitioners. This appropriation is for the 2008-2009 biennium only, and does not increase the base funding.

 

Family, Friend, and Neighbor Grant Program. $750,000 in fiscal year 2008 and $750,000 in fiscal year 2009 are appropriated from the general fund to the commissioner of human services for the family, friend, and neighbor grant program in article 1, section 94. Any balance in the first year does not cancel but is available in the second year. This appropriation is for the 2008-2009 biennium only, and does not increase the base funding.

 

(f) Increased Child Care Provider Connections. (1) $200,000 is appropriated from the general fund to the commissioner of human services for the biennium beginning July 1, 2007, for the following purposes: $50,000 each year is for a grant to Hennepin County, and $50,000 each year is for a grant to Ramsey County. The two counties shall each contract with a nonprofit organization to work with the contracting county and county-based licensed family child

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                                                                                                                                                             APPROPRIATIONS

                                                                                                                                                            Available for the Year

                                                                                                                                                                  Ending June 30

                                                                                                                                                   2008                                      2009

 

care providers to facilitate county-based information regarding family and children's resources and to make training and peer support available to licensed family child care providers consistent with clause (2). These appropriations are available until June 30, 2009, and shall not become part of base level funding for the biennium beginning July 1, 2009.

 

(2) Programs to improve child care provider connections to county services shall be established in Hennepin and Ramsey counties to:

 

(i) improve county contact activities with county-licensed family child care providers that facilitate utilization of county educational, social service, public health, and economic assistance services by eligible families, parents, and children using licensed family child care; and

 

(ii) support licensed family child care providers to qualify as quality-rated child care providers through peer support and coaching networks.

 

Hennepin and Ramsey Counties shall contract with a nonprofit organization under clause (1) that utilizes licensed family child care providers as contacts for families using licensed family child care and to provide peer support to licensed family child care providers.

 

(3) Hennepin and Ramsey Counties must evaluate (i) successful strategies for increasing contact with county-based licensed family child care providers and (ii) the effect of that increased contact and report their findings to the appropriate legislative committees by February 15, 2010.

 

Base Adjustment. The general fund base is $1,515,000 for each of fiscal years 2010 and 2011.

 

(g) Child Support Enforcement Grants

 

General                                 11,038,000                                3,705,000

 

Child Support Enforcement. $7,333,000 for fiscal year 2008 is to make grants to counties for child support enforcement programs to make up for the loss under the 2005 federal Deficit Reduction Act of federal matching funds for federal incentive funds passed on to the counties by the state.

 

This appropriation is available until June 30, 2009.

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                                                                                                                                                             APPROPRIATIONS

                                                                                                                                                            Available for the Year

                                                                                                                                                                  Ending June 30

                                                                                                                                                   2008                                      2009

 

(h) Children's Services Grants

 

                                        Appropriations by Fund

 

General                                 66,659,000                              83,359,000

 

Health Care Access                250,000                                           -0-

 

TANF                                        250,000                                   730,000

 

County Allocations for Rate Increases. County Children and Community Services Act allocations shall be increased by $321,000 effective October 1, 2007, and $980,000 effective October 1, 2008, to help counties pay for the rate adjustments to day training and habilitation providers for participants paid by county social service funds. Notwithstanding the provisions of Minnesota Statutes, section 256M.40, the allocation to a county shall be based on the county's proportion of social services spending for day training and habilitation services as determined in the most recent social services expenditure and grant reconciliation report.

 

Privatized Adoption Grants. Federal reimbursement for privatized adoption grant and foster care recruitment grant expenditures is appropriated to the commissioner for adoption grants and foster care and adoption administrative purposes.

 

Adoption Assistance Incentive Grants. Federal funds available during fiscal year 2008 and fiscal year 2009 for the adoption incentive grants are appropriated to the commissioner for these purposes.

 

Adoption Assistance and Relative Custody Assistance. The commissioner may transfer unencumbered appropriation balances for adoption assistance and relative custody assistance between fiscal years and between programs.

 

Adoption Assistance and Relative Custody Assistance Subsidy Payment Increase. Notwithstanding Minnesota Rules, part 9560.0083, subparts 5 and 6, the commissioner shall increase the payment schedules for basic and supplemental maintenance needs subsidies by 3.95 percent effective July 1, 2007. The commissioner may make cost-neutral adjustments between schedules and between brackets within schedules to allow for whole-dollar bracket levels and account for differential cost increases in caring for children with special needs. Counties have until December 31, 2007, to implement the relative custody assistance payment increases and shall make payment adjustments retroactive to July 1, 2007.

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                                                                                                                                                             APPROPRIATIONS

                                                                                                                                                            Available for the Year

                                                                                                                                                                  Ending June 30

                                                                                                                                                   2008                                      2009

 

Crisis Nurseries. $1,100,000 in fiscal year 2008 and $1,100,000 in fiscal year 2009 are appropriated from the general fund for the crisis nurseries program. Of this amount, $100,000 each year is to be made available for capacity development and technical support for crisis nurseries.

 

Children's Mental Health Grants. Of this general fund appropriation, $6,700,000 in fiscal year 2008 and $13,500,000 in fiscal year 2009 are to the commissioner of human services for children's mental health grants. The purpose of these grants is to increase and maintain the state's children's mental health service capacity, especially for school-based mental health services. The commissioner shall require grantees to utilize all available third party reimbursement sources as a condition of using state grant funds. At least 15 percent of these funds will be used to encourage efficiencies through early intervention services. At least another 15 percent shall be used to provide respite care services for children with severe emotional disturbance at risk of out-of-home placement.

 

Mental Health Crisis Services. Of this general fund appropriation, $1,500,000 in fiscal year 2008 and $3,500,000 in fiscal year 2009 are to the commissioner of human services for statewide funding of children's mental health crisis services. Providers must utilize all available funding streams.

 

Children's Mental Health Evidence-Based and Best Practices. Of this general fund appropriation, $750,000 in fiscal year 2008 and $1,500,000 in fiscal year 2009 are to the commissioner of human services for children's mental health evidence-based and best practices including, but not limited to: Adolescent Integrated Dual Diagnosis Treatment services; school-based mental health services; co-location of mental health and physical health care, and; the use of technological resources to better inform diagnosis and development of treatment plan development by mental health professionals. The commissioner shall require grantees to utilize all available third-party reimbursement sources as a condition of using state grant funds.

 

Culturally Specific Mental Health Treatment Grants. Of this general fund appropriation, $150,000 in fiscal year 2008 and $600,000 in fiscal year 2009 are to the commissioner of human services for children's mental health grants to support increased availability of mental health services for persons from cultural and ethnic minorities within the state. The commissioner shall use at least 20 percent of these funds to help members of cultural and

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                                                                                                                                                             APPROPRIATIONS

                                                                                                                                                            Available for the Year

                                                                                                                                                                  Ending June 30

                                                                                                                                                   2008                                      2009

 

ethnic minority communities to become qualified mental health professionals and practitioners. The commissioner shall assist grantees to meet third-party credentialing requirements and require them to utilize all available third-party reimbursement sources as a condition of using state grant funds.

 

Mental Health Services for Children with Special Treatment Needs. Of this general fund appropriation, $225,000 in fiscal year 2008 and $550,000 in fiscal year 2009 are to the commissioner of human services for children's mental health grants to support increased availability of mental health services for children with special treatment needs. These shall include, but not be limited to: victims of trauma, including children subjected to abuse or neglect, veterans and their families, and refugee populations; persons with complex treatment needs, such as eating disorders; and those with low incidence disorders. Of this amount, $150,000 in fiscal year 2008 and $250,000 in fiscal year 2009 must be directed to programs serving victims of trauma.

 

MFIP and Children's Mental Health Pilot Project. Of the TANF fund appropriation, $100,000 in fiscal year 2008 and $200,000 in fiscal year 2009 are to the commissioner of human services to fund the MFIP and children's mental health pilot project. Of these amounts, up to $100,000 may be expended on evaluation of this pilot.

 

Regional Children's Mental Health Initiative. $700,000 in fiscal year 2008 and $700,000 in fiscal year 2009 are appropriated to the commissioner of human services to fund the Regional Children's Mental Health Initiative pilot project. This is a onetime appropriation.

 

Fetal Alcohol Syndrome. Of the general fund appropriation, $75,000 in fiscal year 2008 and $75,000 in fiscal year 2009 are to the commissioner to transfer as grants to three programs that provide services to reduce fetal alcohol syndrome under Minnesota Statutes, section 254A.171. The three program grantees are the University of Minnesota, the Meeker-McLeod-Sibley Community, and the American Indian Family Center. This appropriation shall become part of the base appropriation.

 

Prenatal Alcohol or Drug Use. Of the general fund appropriation, $75,000 each year is to award grants beginning July 1, 2007, to programs that provide services under Minnesota Statutes, section 254A.171, in Pine, Kanabec, and Carlton Counties. This appropriation shall become part of the base appropriation.

Journal of the House - 63rd Day - Monday, May 7, 2007 - Top of Page 6076

                                                                                                                                                             APPROPRIATIONS

                                                                                                                                                            Available for the Year

                                                                                                                                                                  Ending June 30

                                                                                                                                                   2008                                      2009

 

Base Adjustment. The general fund base is $81,424,000 in fiscal year 2010 and $81,427,000 in fiscal year 2011.

 

The TANF fund base is $722,000 in each year of the 2010-2011 biennium.

 

(i) Children and Community Services Grants

 

General                               104,936,000                              64,419,000

 

Base Adjustment. The general fund base is $69,666,000 in each of fiscal years 2010 and 2011.

 

Targeted Case Management Temporary Funding. Of the general fund appropriation, $36,134,000 in fiscal year 2008 is allocated to counties and tribes affected by reductions in targeted case management federal Medicaid revenue as a result of the provisions in the federal Deficit Reduction Act of 2005, Public Law 109-171. The commissioner shall distribute the funds proportionate to each affected county or tribe's targeted case management federal earnings for calendar year 2005. Prior to distribution of funds, the commissioner shall estimate and certify the amount by which the federal regulations will reduce case management revenue over the 2008-2009 biennium. The commissioner may provide grants up to the amount of the estimated reduction, not to exceed $36,134,000 for the biennium. The commissioner may determine the timing and frequency of payments to counties. These funds are available in either year of the biennium. Counties shall use these funds to pay for social service-related costs, but the funds are not subject to provisions of the Children and Community Services Act grant under Minnesota Statutes, chapter 256M.

 

Child Welfare Project. Of this appropriation, $10,000 in fiscal year 2008 and $390,000 in fiscal year 2009 from the TANF fund and $720,000 in fiscal year 2009 from the general fund are for expanding the American Indian child welfare project under Minnesota Statutes, section 256.01, subdivision 14b, to include the Red Lake Band of Chippewa Indians Tribe, provided the tribe meets the criteria in Minnesota Statutes, section 256.01, subdivision 14b.

 

(j) General Assistance Grants

 

General                                 37,876,000                              38,253,000

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                                                                                                                                                             APPROPRIATIONS

                                                                                                                                                            Available for the Year

                                                                                                                                                                  Ending June 30

                                                                                                                                                   2008                                      2009

 

General Assistance Standard. The commissioner shall set the monthly standard of assistance for general assistance units consisting of an adult recipient who is childless and unmarried or living apart from parents or a legal guardian at $203. The commissioner may reduce this amount according to Laws 1997, chapter 85, article 3, section 54.

 

Emergency General Assistance. The amount appropriated for emergency general assistance funds is limited to no more than $7,889,812 in fiscal year 2008 and $7,889,812 in fiscal year 2009. Funds to counties must be allocated by the commissioner using the allocation method specified in Minnesota Statutes, section 256D.06.

 

(k) Minnesota Supplemental Aid Grants

 

General                                 30,505,000                              30,812,000

 

Emergency Minnesota Supplemental Aid Funds. The amount appropriated for emergency Minnesota supplemental aid funds is limited to no more than $1,100,000 in fiscal year 2008 and $1,100,000 in fiscal year 2009. Funds to counties must be allocated by the commissioner using the allocation method specified in Minnesota Statutes, section 256D.46.

 

(l) Group Residential Housing Grants

 

General                                 90,949,000                              98,456,000

 

People Incorporated. $403,000 in fiscal year 2008 and $403,000 in fiscal year 2009 are appropriated from the general fund to the commissioner of human services to augment community support and mental health services provided to individuals residing in facilities under Minnesota Statutes, section 256I.05, subdivision 1h.

 

(m) Other Children and Economic Assistance Grants

 

General                                 21,672,000                              19,558,000

 

Federal TANF                       1,500,000                                1,500,000

 

Base Adjustment. The general fund base shall be $19,833,000 in fiscal year 2010 and $19,333,000 in fiscal year 2011.

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                                                                                                                                                             APPROPRIATIONS

                                                                                                                                                            Available for the Year

                                                                                                                                                                  Ending June 30

                                                                                                                                                   2008                                      2009

 

Grants for Programs Serving Young Parents. Of the TANF fund appropriation, $140,000 each year is for a grant to a program or programs that provide comprehensive services through a private, nonprofit agency to young parents in Hennepin County who have dropped out of school and are receiving public assistance. The program administrator shall report annually to the commissioner on skills development, education, job training, and job placement outcomes for program participants.

 

Alcohol and Drug Intervention. Of this appropriation, $300,000 each year from the general fund and $150,000 each year from the TANF fund are to the commissioner for the purposes of a program in Ramsey County that provides early intervention efforts designed to discourage pregnant women from using alcohol and illegal drugs. The appropriation shall not become part of base level funding and is available until spent.

 

Homeless and Runaway Youth. $1,764,000 in the first year and $1,500,000 in the second year are for the Runaway and Homeless Youth Act under Minnesota Statutes, section 256K.45. Funds shall be spent in each area of the continuum of care to ensure that programs are meeting the greatest need. The base is decreased by $425,000 each year in fiscal year 2010 and fiscal year 2011.

 

Transitional Housing and Emergency Services.

 

(1) $750,000 the first year from the general fund is for transitional housing programs under Minnesota Statutes, section 256E.33. Up to ten percent of this appropriation may be used for housing and services which extend beyond 24 months; and

 

(2) $600,000 the first year from the general fund is added to the base for emergency services grants under Laws 1997, chapter 162, article 3, section 7.

 

Foodshelf Programs. $325,000 each year from the general fund is for foodshelf programs under Minnesota Statutes, section 256E.34.

 

Minnesota Community Action Grants. (a) Of the general fund appropriation, $250,000 each year is for the purposes of Minnesota community action grants under Minnesota Statutes, sections 256E.30 to 256E.32.

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                                                                                                                                                             APPROPRIATIONS

                                                                                                                                                            Available for the Year

                                                                                                                                                                  Ending June 30

                                                                                                                                                   2008                                      2009

 

(b) Of the TANF appropriation, $1,500,000 each year is for community action agencies for auto repairs, auto loans, and auto purchase grants to individuals who receive benefits under Minnesota Statutes, chapter 256J.

 

(c) Money appropriated under paragraphs (a) and (b) that is not spent in the first year does not cancel but is available for the second year.

 

Tenant Hotline Services Program. $50,000 each year is for a grant to HOME Line for the tenant hotline services program. This is a onetime appropriation.

 

      Subd. 5. Children and Economic Assistance Management

 

The amounts that may be spent from the appropriation for each purpose are as follows:

 

(a) Children and Economic Assistance Administration

 

                                        Appropriations by Fund

 

General                                   9,888,000                                9,956,000

 

Federal TANF                       1,196,000                                1,196,000

 

Base Adjustment. The general fund base is $9,829,000 in fiscal year 2010 and $9,741,000 in fiscal year 2011.

 

(b) Children and Economic Assistance Operations

 

                                        Appropriations by Fund

 

General                                 35,667,000                              36,023,000

 

Health Care Access                350,000                                   361,000

 

Financial Institution Data Match and Payment of Fees. The commissioner is authorized to allocate up to $310,000 each year in fiscal years 2008 and 2009 from the PRISM special revenue account to make payments to financial institutions in exchange for performing data matches between account information held by financial institutions and the public authority's database of child support obligors as authorized by Minnesota Statutes, section 13B.06, subdivision 7.

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                                                                                                                                                             APPROPRIATIONS

                                                                                                                                                            Available for the Year

                                                                                                                                                                  Ending June 30

                                                                                                                                                   2008                                      2009

 

Base Adjustment. The general fund base is $35,967,000 in each of fiscal years 2010 and 2011.

 

      Subd. 6. Basic Health Care Grants

 

The amounts that may be spent from the appropriation for each purpose are as follows:

 

(a) MinnesotaCare Grants

 

Health Care Access         391,818,000                            470,951,000

 

HealthMatch Delay. Of this appropriation, $2,560,000 the first year and $21,735,000 the second year are for the MinnesotaCare program costs related to a six-month delay in implementation of the HealthMatch program.

 

(b) MA Basic Health Care - Families and Children

 

                                        Appropriations by Fund

 

General                               740,771,000                            843,211,000

 

Health Care Access             1,672,000                                           -0-

 

(c) MA Basic Health Care - Elderly and Disabled

 

General                               998,640,000                         1,107,432,000

 

Provider-Directed Care Coordination. In addition to medical assistance reimbursement under Minnesota Statutes, sections 256B.0625 and 256B.76, clinics participating in provider-directed care coordination under Minnesota Statutes, section 256B.0625, also receive a monthly payment per client when the clinic serves an eligible client. The payments across the program must average $50 per month per client.

 

The commissioner must serve: an additional 100 persons in the MR/RC waiver program; an additional 100 persons in fiscal year 2008 and 200 persons in fiscal year 2009 in the family support grant program under Minnesota Statutes, section 252.32; and an additional 100 persons in fiscal year 2008 and 200 persons in fiscal year 2009 in the semi-independent living services program under Minnesota Statutes, section 252.275.

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                                                                                                                                                             APPROPRIATIONS

                                                                                                                                                            Available for the Year

                                                                                                                                                                  Ending June 30

                                                                                                                                                   2008                                      2009

 

County CADI allocation adjustment. (1) The commissioner shall adjust 2007 home and community-based allocations under Minnesota Statutes, section 256B.49, to qualifying counties that transferred persons to the community alternatives for disabled individuals (CADI) waiver program under Laws 2006, chapter 282, article 20, section 35. The adjustment shall reflect the amount that county-authorized funding for CADI waiver services exceeded the allowable amount as shown in the Medicaid Management Information System (MMIS) on March 1, 2007.

 

(2) A county that may qualify under paragraph (1) shall apply to the commissioner by June 10, 2007. Following a review of the county request and the MMIS documentation, the commissioner shall adjust the county allocation, as appropriate, by June 25, 2007.

 

(3) The amounts provided to a county under this section shall become part of the county's base level state allocation for the CADI waiver for the biennium beginning July 1, 2007.

 

(4) This rider is effective the day following final enactment.

 

(d) General Assistance Medical Care Grants

 

General                               239,216,000                            251,730,000

 

(e) Other Health Care Grants

 

General                                   1,721,000                                1,671,000

 

Health Care Access                150,000                                   150,000

 

Community-Based Health Care Demonstration Project. Of the general fund appropriation, $212,000 in fiscal year 2007 and $212,000 in fiscal year 2008 are to the commissioner to be transferred to the commissioner of health for the demonstration project grant described in Minnesota Statutes, section 62Q.80, subdivision 1a. This appropriation shall remain part of base level funding until June 30, 2012. Notwithstanding any contrary provision in this article, this rider expires July 1, 2012.

 

Health Care Payment Reform Pilot. Of the general fund appropriation, $750,000 in fiscal year 2009 is for the health care payment reform pilot project. Base level funding for this program is $750,000 in 2010 and $0 in 2011.

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                                                                                                                                                             APPROPRIATIONS

                                                                                                                                                            Available for the Year

                                                                                                                                                                  Ending June 30

                                                                                                                                                   2008                                      2009

 

Patient Incentive Programs. Of the general fund appropriation, $500,000 in fiscal year 2008 and $500,000 in fiscal year 2009 are for patient incentive programs.

 

Base Adjustment. The general fund base is $1,671,000 in fiscal year 2010 and $921,000 in fiscal year 2011.

 

Oral Health Care Innovations Grants. (a) Of the general fund appropriation, $500,000 for the fiscal year beginning July 1, 2007, is to award competitive oral health care innovations grants to organizations described in Minnesota Statutes, section 256B.76, paragraph (b), clause (4), or coalitions of such organizations, providing access to oral health services for low-income and uninsured persons. The commissioner shall award one grant for a project to develop a nonprofit dental clinic serving public program recipients and uninsured persons in Beltrami County; one grant for the maintenance of nonprofit dental clinics providing oral health care services to children ages birth to 18 in St. Louis County; one grant for the bright smiles program to increase access to oral health care for low-income and immigrant children, ages birth to five years, and their families in underserved areas in Minneapolis; and one grant to coordinate dental referrals from collaborative practice hygienists working with Head Start programs in underserved areas of the state outside the seven-county metropolitan area.

 

(b) This grant shall not become part of base level funding.

 

State Health Policies Grant. Of the general fund appropriation, $300,000 in fiscal year 2008 is to provide a grant to a research center associated with a safety net hospital and county-affiliated health system to develop the capabilities necessary for evaluating the effects of changes in state health policies on low-income and uninsured individuals, including the impact on state health care program costs, health outcomes, cost-shifting to different units and levels of government, and utilization patterns including use of emergency room care and hospitalization rates. The center shall report on the use of this money by December 1, 2008, to the chairs of the senate and house of representatives committees with relevant jurisdiction.

 

      Subd. 7. Health Care Management

 

The amounts that may be spent from the appropriation for each purpose are as follows:

 

(a) Health Care Policy Administration

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                                                                                                                                                             APPROPRIATIONS

                                                                                                                                                            Available for the Year

                                                                                                                                                                  Ending June 30

                                                                                                                                                   2008                                      2009

 

                                        Appropriations by Fund

 

General                                 10,993,000                              11,370,000

 

Health Care Access             2,335,000                                2,871,000

 

Minnesota Senior Health Options Reimbursement. Federal administrative reimbursement resulting from the Minnesota senior health options project is appropriated to the commissioner for this activity.

 

Disproportionate Share Hospital Payment Formulas. The commissioner is prohibited from altering formulas for disbursement of disproportionate share hospital funds under the disproportionate share hospital program by rule, bulletin, or any other administrative method without explicit legislative authority.

 

Utilization Review. Federal administrative reimbursement resulting from prior authorization and inpatient admission certification by a professional review organization is dedicated to the commissioner for these purposes. A portion of these funds must be used for activities to decrease unnecessary pharmaceutical costs in medical assistance.

 

Base Adjustment. The health care access fund base is $3,409,000 in fiscal year 2010 and $3,354,000 in fiscal year 2011, for health care administration.

 

Base Adjustment. The general fund base is $11,164,000 in fiscal year 2010 and $10,770,000 in fiscal year 2011.

 

(b) Health Care Operations

 

                                        Appropriations by Fund

 

General                                 21,941,000                              21,874,000

 

Health Care Access           22,492,000                              23,114,000

 

Base Adjustment. The general fund base is $21,839,000 in each of fiscal years 2010 and 2011. The health care access fund base is $24,024,000 in fiscal year 2010 and $23,627,000 in fiscal year 2011.

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                                                                                                                                                             APPROPRIATIONS

                                                                                                                                                            Available for the Year

                                                                                                                                                                  Ending June 30

                                                                                                                                                   2008                                      2009

 

Outreach Funding. The following appropriations are to the commissioner for the Minnesota health care outreach program under Minnesota Statutes, section 256.962:

 

(1) $950,000 the first year and $1,000,000 the second year from the health care access fund for a statewide outreach campaign under Minnesota Statutes, section 256.962, subdivision 1;

 

(2) $700,000 each year from the general fund and $300,000 each year from the health care access fund for the incentive program under Minnesota Statutes, section 256.962, subdivision 5; and

 

(3) $150,000 each year from the health care access fund for a grant to a nonprofit organization to provide a statewide toll-free number under Minnesota Statutes, section 256.962, subdivision 4.

 

      Subd. 8. Continuing Care Grants

 

The amounts that may be spent from the appropriation for each purpose are as follows:

 

(a) Aging and Adult Services Grants

 

General                                 15,225,000                              15,675,000

 

Information and Assistance Reimbursement. Federal administrative reimbursement obtained from information and assistance services provided by the Senior LinkAge Line to people who are identified as eligible for medical assistance is appropriated to the commissioner for this activity.

 

Senior Companion Program. Of the general fund appropriation, $166,000 each year is for the senior companion program under Minnesota Statutes, section 256.977.

 

Volunteer Senior Citizens. Of the general fund appropriation, $167,000 each year is for the volunteer programs for retired senior citizens under Minnesota Statutes, section 256.9753.

 

Foster Grandparent Program. Of the general fund appropriation, $166,000 each year is for the foster grandparent program in Minnesota Statutes, section 256.976.

 

Senior Nutrition. Of the general fund appropriation, $250,000 in fiscal year 2008 and $250,000 in fiscal year 2009 are for the senior nutrition programs under Minnesota Statutes, section 256.9752.

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                                                                                                                                                             APPROPRIATIONS

                                                                                                                                                            Available for the Year

                                                                                                                                                                  Ending June 30

                                                                                                                                                   2008                                      2009

 

The commissioner shall give priority to increase services to: (1) persons facing language or cultural barriers, (2) persons with special diets, (3) persons living in isolated rural areas, and (4) other hard-to-serve populations.

 

Kinship Navigator Program. Of the general fund appropriation, $175,000 in fiscal year 2008 and $175,000 in fiscal year 2009 is to the commissioner for a two-year demonstration grant, to be transferred to a nonprofit statewide organization advocating for, supporting, and providing information and resources to individuals raising their grandchildren, other related children, or children of friends for purposes of providing support to grandparents or relatives who are raising kinship children. The demonstration grant sites must include a central site in the metropolitan area and another site in the Bemidji region. The support must provide a one-stop services program. The services that may be provided include, but are not limited to, legal services, education, information, family activities, support groups, mental health access, advocacy, mentors, and information related to foster care licensing. The funds may also be used for a media campaign to inform kinship families about available information and services, support sites, and other program development. For the biennium beginning July 1, 2009, base level funding for these grants shall be $160,000 each year.

 

Reverse Mortgage Incentive Program. Of the general fund appropriation to the commissioner for the biennium beginning July 1, 2007, the following amounts are for the purposes listed:

 

(1) $120,000 the first year and $120,000 the second year are for costs associated with the reverse mortgage incentive program; and

 

(2) $39,000 each year is to be transferred to the commissioner of the Minnesota Housing Finance Agency for the purposes of Minnesota Statutes, section 462A.05.

 

Base Adjustment. The general fund base is $15,840,000 in each of fiscal years 2010 and 2011.

 

(b) Alternative Care Grants

 

General                                 50,063,000                              52,200,000

 

Alternative Care Transfer. Any money allocated to the alternative care program that is not spent for the purposes indicated does not cancel but is transferred to the medical assistance account.

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                                                                                                                                                             APPROPRIATIONS

                                                                                                                                                            Available for the Year

                                                                                                                                                                  Ending June 30

                                                                                                                                                   2008                                      2009

 

Base Adjustment. The general fund base is $53,058,000 in fiscal year 2010 and $53,295,000 in fiscal year 2011 for alternative care grants.

 

(c) Medical Assistance Grants - Long-Term Care Facilities

 

General                               500,957,000                            509,347,000

 

Long-Term Care Consultation Funding Increase. For the rate year beginning October 1, 2008, the county long-term care consultation allocations in Minnesota Statutes, section 256B.0911, subdivision 6, must be increased based on the number of transitional long-term care consultation visits projected by the commissioner in each county. For the rate year beginning October 1, 2009, final allocations must be determined based on the average between the actual number of transitional long-term care visits that were conducted in the prior 12-month period and the projected number of consultations that will be provided in the rate year beginning October 1, 2009. Notwithstanding any contrary provision in this article, this paragraph expires June 30, 2010.

 

Nursing Facility Sprinkler Systems. Of the general fund appropriation, $3,000,000 the first year is to reimburse the costs of nursing facility sprinkler systems under Minnesota Statutes, section 256B.434, subdivision 4, paragraph (e).

 

Nursing Home Moratorium Exceptions. During fiscal year 2008, the commissioner of health may approve moratorium exception projects under Minnesota Statutes, section 144A.073, for which the full annualized state share of medical assistance costs does not exceed $3,000,000. During fiscal year 2009, the commissioner of health may approve moratorium exception projects under Minnesota Statutes, section 144A.073, for which the full annualized state share of medical assistance costs does not exceed $3,000,000 less the amount approved during the first year. Priority shall be given to proposals that entail:

 

(1) complete building replacement in conjunction with reductions in the number of beds in a county, with greater weight given to projects in counties with a greater than average number of beds per 1,000 elderly;

 

(2) technology improvements;

 

(3) improvements in life safety;

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                                                                                                                                                            Available for the Year

                                                                                                                                                                  Ending June 30

                                                                                                                                                   2008                                      2009

 

 (4) construction of nursing facilities that are part of senior services campuses; and

 

(5) improvements in the work environment.

 

(d) Medical Assistance Grants - Long-Term Care Waivers and Home Care Grants

 

General                               964,179,000                         1,087,867,000

 

(e) Mental Health Grants

 

                                        Appropriations by Fund

 

General                                 59,156,000                              65,760,000

 

Health Care Access                750,000                                   750,000

 

Lottery Prize                          1,933,000                                1,633,000

 

Mental Health Crisis Services. Of this general fund appropriation, $1,500,000 in fiscal year 2008 and $3,500,000 in fiscal year 2009 are to the commissioner of human services for statewide funding of adult mental health crisis services. Providers must utilize all available funding streams.

 

Adult Mental Health Evidence-Based and Best Practices. Of this general fund appropriation, $750,000 in fiscal year 2008 and $1,500,000 in fiscal year 2009 are to the commissioner of human services for adult mental health evidence-based and best practices including, but not limited to, Assertive Community Treatment and Integrated Dual Diagnosis Treatment services. The commissioner shall require grantees to utilize all available third-party reimbursement sources as a condition of using state grant funds.

 

Culturally Specific Mental Health Treatment Grants. Of this general fund appropriation, $150,000 in fiscal year 2008 and $600,000 in fiscal year 2009 are to the commissioner of human services for adult mental health grants to support increased availability of mental health services for persons from cultural and ethnic minorities within the state. The commissioner shall use at least 20 percent of these funds to help members of cultural and ethnic minority communities to become qualified mental health professionals and practitioners. The commissioner shall assist grantees to meet third-party credentialing requirements and require them to utilize all available third-party reimbursement sources as a condition of using state grant funds.

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                                                                                                                                                             APPROPRIATIONS

                                                                                                                                                            Available for the Year

                                                                                                                                                                  Ending June 30

                                                                                                                                                   2008                                      2009

 

Mental Health Services for Adults with Special Treatment Needs. Of this general fund appropriation, $100,000 in fiscal year 2008 and $400,000 in fiscal year 2009 are to the commissioner of human services for adult mental health grants to support increased availability of mental health services for adults with special treatment needs. These shall include, but not be limited to: victims of trauma, including persons subjected to abuse or neglect, veterans and their families, and refugee populations; person's with complex treatment needs, such as eating disorders; and those with low incidence disorders.

 

Supportive Housing Services for Adults with Mental Illness. Of this general fund appropriation, $1,500,000 in fiscal year 2008 and $3,000,000 in fiscal year 2009 are to the commissioner of human services for adult mental health grants to support increased availability of a range of housing options with supports for persons with serious mental illness.

 

Base Adjustment. Effective fiscal year 2009, the general fund base for adult mental health grants is increased by $750,000 and the health care access fund base for adult mental health grants is reduced by $750,000.

 

National Council on Problem Gambling. (1) $225,000 in fiscal year 2008 and $225,000 in fiscal year 2009 are appropriated from the lottery prize fund to the commissioner of human services for a grant to the state affiliate recognized by the National Council on Problem Gambling. The affiliate must provide services to increase public awareness of problem gambling, education, and training for individuals and organizations providing effective treatment services to problem gamblers and their families, and research relating to problem gambling. These services must be complementary to and not duplicative of the services provided through the problem gambling program administered by the commissioner of human services. This grant does not prevent the commissioner from regular monitoring and oversight of the grant or the ability to reallocate the funds to other services within the problem gambling program for nonperformance of duties by the grantee.

 

(2) Of this appropriation, $100,000 in fiscal year 2008 and $100,000 in fiscal year 2009 are contingent on the contribution of nonstate matching funds. Matching funds may be either cash or qualifying in-kind contributions. The commissioner of finance may disburse the state portion of the matching funds in increments of $25,000 upon receipt of a commitment for an equal amount of matching nonstate funds. The general fund base shall be $100,000 in fiscal year 2010 and $100,000 in fiscal year 2011.

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                                                                                                                                                             APPROPRIATIONS

                                                                                                                                                            Available for the Year

                                                                                                                                                                  Ending June 30

                                                                                                                                                   2008                                      2009

 

 (3) $100,000 in fiscal year 2008 is appropriated from the lottery prize fund to the commissioner of human services for a grant or grants to be awarded competitively to develop programs and services for problem gambling treatment, prevention, and education in immigrant communities. This appropriation is available until June 30, 2009, at which time the project must be completed and final products delivered, unless an earlier completion date is specified in the work program.

 

Compulsive Gambling. $300,000 in fiscal year 2008 and $100,000 in fiscal year 2009 are appropriated from the lottery prize fund to the commissioner of human services for purposes of compulsive gambling education, assessment, and treatment under Minnesota Statutes, section 245.98.

 

Compulsive Gambling Study. $100,000 in fiscal year 2008 is to continue the study currently being done on compulsive gambling treatment effectiveness and long-term effects of gambling.

 

Base Adjustment. The general fund base is $62,940,000 in each of fiscal years 2010 and 2011.

 

Base Adjustment. The lottery prize fund base is $1,508,000 in each of fiscal years 2010 and 2011.

 

(f) Deaf and Hard-of-Hearing Grants

 

General                                   1,932,000                                2,368,000

 

Hearing Loss Mentors. Of the general fund appropriation, $40,000 each year is to provide mentors who have a hearing loss to parents of newly identified infants and children with hearing loss.

 

Base Adjustment. The general fund base is $2,387,000 in each of fiscal years 2010 and 2011.

 

(g) Chemical Dependency Entitlement Grants

 

General                                 78,749,000                              89,201,000

 

(h) Chemical Dependency Nonentitlement Grants

 

General                                   1,605,000                                1,805,000

 

TANF                                        150,000                                   150,000

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                                                                                                                                                             APPROPRIATIONS

                                                                                                                                                            Available for the Year

                                                                                                                                                                  Ending June 30

                                                                                                                                                   2008                                      2009

 

Methamphetamine Abuse Grants. Of the general fund appropriation, $175,000 in the first year and $375,000 in the second year are for grants to existing programs that treat methamphetamine abuse, and the abuse of other substances in Carlton, Faribault, Martin, Olmsted, and Anoka Counties, that received grant funds under Laws 2005, chapter 136, article 1, section 9, subdivision 6. The commissioner shall administer the grants to programs that the commissioner deems successful, and may discontinue grants to programs after an evaluation of the program and a determination by the commissioner that the program should no longer receive funds. This appropriation shall not become part of base level funding.

 

Base Adjustment. The general fund base is $1,055,000 in each of fiscal years 2010 and 2011.

 

(i) Other Continuing Care Grants

 

General                                 22,253,000                              18,580,000

 

Native American Juvenile Treatment Center. Of the general fund appropriation, $50,000 is to conduct a feasibility study of and to predesign a Native American juvenile treatment center on or near the White Earth Reservation. The facility must house and treat Native American juveniles and provide culturally specific programming to juveniles placed in the treatment center. The commissioner of human services may contract with parties who have experience in the design and construction of juvenile treatment centers to assist in the feasibility study and predesign. On or before January 15, 2008, the commissioner shall present the results of the feasibility study and the predesign of the facility to the chairs of house of representatives and senate committees having jurisdiction over human services finance, public safety finance, and capital investment.

 

Leech Lake Youth Treatment Center. Of the general fund appropriation, $75,000 in fiscal year 2008 and $75,000 in fiscal year 2009 are for a grant to the Leech Lake Youth Treatment Center project partners, in order to pay the salaries and other directly related costs associated with the development of this project. This is a onetime appropriation.

 

Repayment. For the fiscal year ending June 30, 2008, $4,302,000 is appropriated to the commissioner of human services to repay the amount of overspending in the waiver program for persons with developmental disabilities incurred by Fillmore, Steele, and St. Louis Counties in calendar years 2004 and 2005.

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                                                                                                                                                             APPROPRIATIONS

                                                                                                                                                            Available for the Year

                                                                                                                                                                  Ending June 30

                                                                                                                                                   2008                                      2009

 

Department of Employment and Economic Development Transfer. For fiscal year 2008, the commissioner of finance shall transfer $200,000 from the methamphetamine abatement loan fund to the commissioner of human services for methamphetamine treatment programs.

 

Base Adjustment. The general fund base is $18,956,000 in fiscal year 2010 and $19,012,000 in fiscal year 2011 for other continuing care grants.

 

      Subd. 9. Continuing Care Management

 

General                                 19,722,000                              19,914,000

 

State Government

Special Revenue                      122,000                                   125,000

 

Health Care Access                293,000                                           -0-

 

Lottery Prize                             252,000                                   157,000

 

Quality Assurance System Expansion. Of the general fund appropriation, $200,000 in fiscal year 2008 and $200,000 in fiscal year 2009 are to develop a statewide quality assurance and improvement system under Minnesota Statutes, section 256B.096, for persons receiving disability services. Any unspent portion of the appropriation for the first year shall not cancel but shall be available for the second year. These are onetime appropriations.

 

Base Adjustment. The general fund base is $19,745,000 in fiscal year 2010 and $19,835,000 in fiscal year 2011.

 

Disability Linkage Line. Of the general fund appropriation, $469,000 in fiscal year 2008 and $626,000 in fiscal year 2009 are to establish and maintain the disability linkage line.

 

Home Health Reimbursement Study. (1) Of the general fund appropriation, $100,000 in fiscal year 2008 is to the commissioner to contract with a Minnesota-based, nonprofit quality improvement organization that collaborates with providers and consumers in health improvement activities, for the purpose of conducting an independent analysis of the reimbursement methodologies for home health services provided to enrollees in the Minnesota senior health options and Minnesota disability health options programs.

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                                                                                                                                                            Available for the Year

                                                                                                                                                                  Ending June 30

                                                                                                                                                   2008                                      2009

 

 (2) The analysis of reimbursement methodologies shall include, at a minimum, a review of:

 

(i) any limitations on flexibility in services or technology for the home health provider;

 

(ii) the Medicare program reimbursement methodologies, including possible alternatives, and Medicare benefits;

 

(iii) potential access issues raised by current reimbursement methodologies; and

 

(iv) incentives, including episodic care reimbursement methodologies, to promote best practices and achieve identified clinical outcomes.

 

(3) The analysis and any supporting recommendations shall be presented to the commissioner by December 1, 2007, and to the chairs of the appropriate legislative committees by December 15, 2007. In no event shall the study disclose any specific reimbursement amount or methodologies attributable to an individual health carrier.

 

(4) In conducting its analysis, the organization described in paragraph (a) shall consult with the commissioner, the Minnesota Home Care Association, managed care organizations, and other interested home health entities and advocates, and shall convene the parties to discuss pertinent issues.

 

      Subd. 10. State-Operated Services

 

Remembering With Dignity Project. (1) $200,000 is appropriated from the general fund to the commissioner of human services to be available until June 30, 2009, to make a grant to Advocating Change Together for the purposes of the Remembering With Dignity project in paragraph (2).

 

(2) As part of the Remembering With Dignity project, the grant recipient shall:

 

(i) conduct necessary research on persons buried in state cemeteries who were residents of state hospitals or regional treatment centers and buried in numbered or unmarked graves;

 

(ii) purchase and install headstones that are properly inscribed with their names on the graves of those persons; and

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                                                                                                                                                             APPROPRIATIONS

                                                                                                                                                            Available for the Year

                                                                                                                                                                  Ending June 30

                                                                                                                                                   2008                                      2009

 

 (iii) collaborate with community groups and state and local government agencies to build community involvement and public awareness, ensure public access to the graves, and ensure appropriate perpetual maintenance of state cemeteries.

 

Transfer Authority Related to State-Operated Services. Money appropriated to finance state-operated services programs and administrative services may be transferred between fiscal years of the biennium with the approval of the commissioner of finance.

 

(a) Mental Health Services

 

General                               116,185,000                            119,507,000

 

Appropriation Limitation. No part of the appropriation in this article to the commissioner for mental health treatment services at the regional treatment centers shall be used for the Minnesota sex offender program.

 

Community Behavioral Health Hospitals. Notwithstanding Minnesota Statutes, section 246.51, subdivision 1, a determination order for clients in a community behavioral health hospital operated by the commissioner is only required when a client's third-party coverage has been exhausted.

 

(b) Minnesota Sex Offender Services

 

General                                 67,614,000                              62,569,000

 

(c) Minnesota Security Hospital and METO Services

 

General                                 82,495,000                              84,505,000

 

Minnesota Security Hospital. For the purposes of enhancing the safety of the public, improving supervision, and enhancing community-based mental health treatment, state-operated services may establish additional community capacity for providing treatment and supervision of clients who have been ordered into less restrictive alternative care from the state-operated services transitional services program consistent with Minnesota Statutes, section 246.014.

 

      Sec. 4. COMMISSIONER OF HEALTH

 

      Subdivision 1. Total Appropriation                                                                          $170,604,000               $157,130,000

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                                                                                                                                                             APPROPRIATIONS

                                                                                                                                                            Available for the Year

                                                                                                                                                                  Ending June 30

                                                                                                                                                   2008                                      2009

 

                                        Appropriations by Fund

 

                                                        2008                                        2009

 

General                                 94,762,000                              82,467,000

 

State Government

Special Revenue                 43,796,000                              42,799,000

 

Health Care Access           20,628,000                              20,135,000

 

Federal TANF                     11,418,000                              11,733,000

 

Pay for Performance. (a) For the biennium beginning July 1, 2009, of the general fund appropriation, $91,000 each year shall be made available to the commissioner of health on January 1, 2011, only after notification by the commissioner of health to the commissioner of finance and to the chairs of the relevant house of representatives and senate finance and policy committees that the state has met by that date the health disparity elimination goals established in Minnesota Statutes, section 145.928, subdivision 1.

 

(b) Regardless of whether these appropriations are made available to the commissioner of health, they shall be part of base level funding for the biennium beginning July 1, 2011.

 

(c) Notwithstanding any contrary provision of this article, this rider shall not expire.

 

Transfer from the State Government Special Revenue Fund. During the fiscal year beginning July 1, 2007, the commissioner of finance shall transfer $7,200,000 from the state government special revenue fund to the general fund.

 

      Subd. 2. Community and Family Health Promotion

 

                                        Appropriations by Fund

 

General                                 45,467,000                              45,211,000

 

State Government

Special Revenue                      870,000                                   875,000

 

Health Care Access             3,550,000                                3,586,000

 

Federal TANF                       8,735,000                                8,735,000

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                                                                                                                                                             APPROPRIATIONS

                                                                                                                                                            Available for the Year

                                                                                                                                                                  Ending June 30

                                                                                                                                                   2008                                      2009

 

TANF Appropriations. (a) $3,579,000 of the TANF funds is appropriated in each year of the biennium to the commissioner for home visiting and nutritional services listed under Minnesota Statutes, section 145.882, subdivision 7, clauses (6) and (7). Funding shall be distributed to community health boards based on Minnesota Statutes, section 145A.131, subdivision 1.

 

(b) $4,000,000 in the first year and $4,000,000 in the second year are appropriated to the commissioner of health for the family home visiting grant program according to Minnesota Statutes, section 145A.17. The commissioner may use five percent of the funds appropriated in each fiscal year to conduct the ongoing evaluations required under Minnesota Statutes, section 145A.17, subdivision 7, and may use ten percent of the funds appropriated each fiscal year to provide training and technical assistance as required under Minnesota Statutes, section 145A.17, subdivisions 4 and 5.

 

TANF Carryforward. Any unexpended balance of the TANF appropriation in the first year of the biennium does not cancel but is available for the second year.

 

Loan Forgiveness. $400,000 in fiscal year 2010 and $400,000 in fiscal year 2011 from the state government special revenue fund are to the commissioner for the loan forgiveness program under Minnesota Statutes, section 144.1501. This appropriation shall not become part of base level funding for the biennium beginning July 1, 2011. Notwithstanding any contrary provision in this article, this rider expires December 31, 2011.

 

MN ENABL. Base level funding for the MN ENABL program, under Minnesota Statutes, section 145.9255, is reduced by $220,000 each year of the biennium beginning July 1, 2007.

 

Fetal Alcohol Spectrum Disorder. $900,000 each year is added to the base for fetal alcohol spectrum disorder.

 

(1) On July 1 of each fiscal year, the portion of the general fund appropriation to the commissioner of health for fetal alcohol spectrum disorder administration and grants shall be transferred to a statewide organization that focuses solely on prevention of and intervention with fetal alcohol spectrum disorder as follows:

 

(i) on July 1, 2007, $2,090,000; and

 

(ii) on July 1, 2008, $2,090,000.

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                                                                                                                                                             APPROPRIATIONS

                                                                                                                                                            Available for the Year

                                                                                                                                                                  Ending June 30

                                                                                                                                                   2008                                      2009

 

 (2) The money shall be used for prevention and intervention services and programs, including, but not limited to, community grants, professional education, public awareness, and diagnosis. The organization may retain $60,000 of the transferred money for administrative costs. The organization shall report to the commissioner annually by January 15 on the services and programs funded by the appropriation.

 

(3) Notwithstanding any contrary provision in this article, this rider shall not expire.

 

Deaf or Hearing Loss Support. $100,000 for the first year and $100,000 for the second year is for the purpose of providing family support and assistance to families with children who are deaf or have a hearing loss. The family support provided must include direct parent-to-parent assistance and information on communication, educational, and medical options. The commissioner may contract with a nonprofit organization that has the ability to provide these services throughout the state.

 

Heart Disease and Stroke Prevention. $200,000 is appropriated in the first year for the heart disease and stroke prevention unit of the Department of Health to fund data collection and other activities to improve cardiovascular health and reduce the burden of heart disease and stroke in Minnesota. This is a onetime appropriation.

 

Family Planning Grants. Of the TANF appropriation, $1,156,000 each year is for family planning grants under Minnesota Statutes, section 145.925.

 

Suicide prevention programs. $355,000 in fiscal year 2008 and $145,000 in fiscal year 2009 are to fund the suicide prevention program.

 

Hearing Aid and Instrument Loan Bank. Of the general fund appropriation, $70,000 each year is to the commissioner for the purpose of providing a grant to cover administrative costs for a statewide hearing aid and instrument loan bank to families with children newly diagnosed with hearing loss from birth to the age of ten.

 

Medical Home Learning Collaborative. Of the general fund appropriation, $500,000 in fiscal year 2008 and $500,000 in fiscal year 2009 are to expand the medical home learning collaborative initiative in collaboration with the commissioner of human

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                                                                                                                                                            Available for the Year

                                                                                                                                                                  Ending June 30

                                                                                                                                                   2008                                      2009

 

services. Services provided under this funding must support a medical home model for children with special health care needs. The collaborative shall report back to the legislature on use of the funds by January 15, 2010. This appropriation shall not become part of the base funding for the 2010-2011 biennium.

 

Community Collaboratives. Of the general fund appropriation, $300,000 in fiscal year 2008 is to provide planning grants to community collaboratives to cover the uninsured. This is a onetime appropriation.

 

Base Adjustment. General fund base is $44,711,000 in each of fiscal years 2010 and 2011. State government special revenue base is $1,275,000 in each fiscal years 2010 and 2011.

 

      Subd. 3. Policy, Quality, and Compliance

 

                                        Appropriations by Fund

 

General                                 18,802,000                              12,700,000

 

State Government

Special Revenue                 13,451,000                              13,597,000

 

Health Care Access           17,078,000                              16,549,000

 

Health Care Access Survey. Of the health care access fund appropriation, $600,000 in fiscal year 2008 is appropriated to the commissioner to conduct a health insurance survey of Minnesota households, in partnership with the State Health Access Data Assistance Center at the University of Minnesota. The commissioner shall contract with the State Health Access Data Assistance Center to conduct a survey that provides information on the characteristics of the uninsured in Minnesota and the reasons for changing patterns of insurance coverage and access to health care services. This appropriation shall become part of the agency's base budget for even-numbered fiscal years.

 

MERC Federal Compliance. Of the general fund appropriation, $7,000,000 each year is to the commissioner to distribute to the Mayo Clinic for the purpose of providing transition funding while federal compliance changes are made to the medical education and research cost funding distribution formula in Minnesota Statutes, section 62J.692.

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                                                                                                                                                             APPROPRIATIONS

                                                                                                                                                            Available for the Year

                                                                                                                                                                  Ending June 30

                                                                                                                                                   2008                                      2009

 

The base level funding for 2010 and 2011 is $2,500,000 each year.

 

Notwithstanding any contrary provision of this article, this rider expires June 30, 2012.

 

Health Information Technology. Of the health care access fund appropriation, $6,750,000 each fiscal year is to implement Minnesota Statutes, section 144.3345. Up to $350,000 each fiscal year is available for grant administration and health information technology technical assistance and $6,400,000 each year is to establish a revolving loan account under Minnesota Statutes, section 62J.496. This appropriation shall not be included in the agency's base budget for the fiscal year beginning July 1, 2009.

 

Health Insurance Exchange. Of the health care access fund appropriation, $5,650,000 in fiscal year 2008 is appropriated to the commissioner to establish the health insurance exchange in Minnesota Statutes, section 62A.76. Up to $50,000 in fiscal year 2008 is available for administrative costs incurred by the Department of Health in establishing and providing grant funding to the legal entity responsible for implementing the health insurance exchange. This is a onetime appropriation.

 

Uniform Electronic Transactions. Of the general fund appropriation, $146,000 in fiscal year 2008 is for development of uniform electronic transactions and implementation guide standards under Minnesota Statutes, section 62J.536.

 

Federally Qualified Health Centers. Of the general fund appropriation, $2,000,000 in each fiscal year is for subsidies to federally qualified health centers under Minnesota Statutes, section 145.9269.

 

Base Adjustment. The general fund base is $8,346,000 in each of fiscal years 2010 and 2011. The health care access fund base is $3,503,000 in fiscal year 2010 and $2,903,000 in fiscal year 2011.

 

      Subd. 4. Health Protection

 

                                        Appropriations by Fund

 

General                                 16,949,000                              11,016,000

 

State Government

Special Revenue                 27,475,000                              28,327,000

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                                                                                                                                                             APPROPRIATIONS

                                                                                                                                                            Available for the Year

                                                                                                                                                                  Ending June 30

                                                                                                                                                   2008                                      2009

 

Pandemic Influenza Preparedness. Of the general fund appropriation, $500,000 in fiscal year 2008 and $500,000 in fiscal year 2009 are for grants to local public health and tribal governments for planning, exercises, and preparedness for pandemic influenza, and $115,000 in fiscal year 2008 and $115,000 in fiscal year 2009 are for department activities of epidemiology, laboratory services, exercises, and planning. This appropriation shall not become part of base level funding for the biennium beginning July 1, 2009.

 

Pandemic Influenza Preparedness. $4,805,000 is to prepare for and respond to a pandemic influenza outbreak. Of this appropriation, $2,402,000 is to purchase antiviral medications and $2,403,000 is to prepare and manage a stockpile of health care supplies.

 

AIDS Prevention Initiative Focusing on Foreign-born Residents. $300,000 in 2008 is for an AIDS prevention initiative focusing on foreign-born residents. This appropriation is a onetime appropriation and shall not become part of the base level funding for the 2010-2011 biennium.

 

The commissioner of health shall award grants in accordance with Minnesota Statutes, section 145.924, paragraph (b), for a public education and awareness campaign targeting communities of foreign-born Minnesota residents. The grants shall be designed to promote knowledge and understanding about HIV and to increase knowledge in order to eliminate and reduce the risk for HIV infection; to encourage screening and testing for HIV; and to link individuals to public health and health care resources. The grants must be awarded to collaborative efforts that bring together nonprofit community-based groups with demonstrated experience in addressing the public health, health care, and social service needs of foreign-born communities.

 

Lead Abatement. $550,000 in each fiscal year is for the lead abatement program in Minnesota Statutes, section 144.9512.

 

Water Treatment. $40,000 in fiscal year 2008 is to augment any appropriation from the remediation fund to conduct an evaluation of point of use water treatment units at removing perfluorooctanoic acid, perfluorooctane sulfonate, and perfluorobutanoic acid from known concentrations of these compounds in drinking water. The evaluation shall be completed by December 31, 2007, and the commissioner may contract for services to complete the evaluation. This is a onetime appropriation.

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                                                                                                                                                             APPROPRIATIONS

                                                                                                                                                            Available for the Year

                                                                                                                                                                  Ending June 30

                                                                                                                                                   2008                                      2009

 

HIV Information. $80,000 each year is to fund a community-based nonprofit organization with demonstrated capacity to operate a statewide HIV information and referral service using telephone, Internet, and other appropriate technologies. This appropriation shall become part of base level funding for the biennium beginning July 1, 2009.

 

Minnesota Birth Defects Information System. $375,000 each year is to maintain the birth defects information system that was established by Minnesota Statutes, section 144.2215.

 

Base Adjustment. The general fund base is $10,751,000 in each of the fiscal years 2010 and 2011.

 

      Subd. 5. Minority and Multicultural Health

 

                                        Appropriations by Fund

 

General                                   5,047,000                                5,012,000

 

Federal TANF                       2,683,000                                2,998,000

 

TANF Appropriations. (a) $2,421,000 of the TANF funds is appropriated in each year of the biennium to the commissioner for home visiting and nutritional services listed under Minnesota Statutes, section 145.882, subdivision 7, clauses (6) and (7). Funding shall be distributed to tribal governments based on Minnesota Statutes, section 145A.14, subdivision 2a, paragraph (b).

 

TANF Appropriations. (a) $2,000,000 of the TANF funds is appropriated in each year of the biennium to the commissioner for decreasing racial and ethnic disparities in infant mortality rates under Minnesota Statutes, section 145.928, subdivision 7.

 

(b) $683,000 the first year and $998,000 the second year of the TANF funds is appropriated to the commissioner for the family home visiting and grant program under Minnesota Statutes, section 145A.17. Funding shall be distributed to tribal governments based on Minnesota Statutes, section 145A.14, subdivision 2a, paragraph (b).

 

TANF Carryforward. Any unexpended balance of the TANF appropriation in the first year of the biennium does not cancel but is available for the second year.

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                                                                                                                                                             APPROPRIATIONS

                                                                                                                                                            Available for the Year

                                                                                                                                                                  Ending June 30

                                                                                                                                                   2008                                      2009

 

      Subd. 6. Administrative Support Services

 

                                        Appropriations by Fund

 

General                                   8,497,000                                8,524,000

 

State Government

Special Revenue                   2,000,000                                           -0-

 

Disease Surveillance. Of the state government special revenue fund appropriation, $2,000,000 the first year is for redesigning and implementing coordinated and modern disease surveillance systems for the department. This is a onetime appropriation.

 

      Sec. 5. VETERANS NURSING HOMES BOARD                                                    $43,934,000                 $45,956,000

 

Veterans Homes Special Revenue Account. The general fund appropriations made to the board may be transferred to a veterans homes special revenue account in the special revenue fund in the same manner as other receipts are deposited according to Minnesota Statutes, section 198.34, and are appropriated to the board for the operation of board facilities and programs.

 

Repair and Betterment. Of this appropriation, $4,000,000 in fiscal year 2008 and $4,000,000 in fiscal year 2009 are to be used for repair, maintenance, rehabilitation, and betterment activities at facilities statewide. This is a onetime appropriation.

 

Base Adjustment. The general fund base is $41,956,000 in each year of the fiscal 2010 and 2011 biennium.

 

Pay for Performance. (a) For fiscal year 2008, $50,000 shall be made available to the board on January 1, 2009, only after notification by the board to the commissioner of finance and to the chairs of the relevant house of representatives and senate finance and policy committees that during the period October 1, 2007, to September 30, 2008, the Department of Health has not issued any penalty assessments under the provisions of Minnesota Statutes, section 144.653 or 144A.10, or any correction orders under the provisions of Minnesota Statutes, section 144.653 or 144A.10, that the Department of Health deems equivalent to findings of either immediate jeopardy or substandard quality of care, as defined in Code of Federal Regulations, title 42, section 488.301.

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                                                                                                                                                             APPROPRIATIONS

                                                                                                                                                            Available for the Year

                                                                                                                                                                  Ending June 30

                                                                                                                                                   2008                                      2009

 

 (b) Regardless of whether this appropriation is made available to the board, it shall be part of base level funding for the biennium beginning July 1, 2009.

 

      Sec. 6. HEALTH-RELATED BOARDS

 

      Subdivision 1. Total Appropriation; State Government Special Revenue Fund                                                                                  $14,654,000  $14,527,000

 

The amounts that may be spent for each purpose are specified in the following subdivisions.

 

      Subd. 2. Board of Chiropractic Examiners                 450,000                                           447,000

 

      Subd. 3. Board of Dentistry                                                                                                    987,000                        1,009,000

 

      Subd. 4. Board of Dietetic and Nutrition Practice                                                             103,000                           119,000

 

Base Adjustment. Of this appropriation in fiscal year 2009, $14,000 is onetime.

 

      Subd. 5. Board of Marriage and Family Therapy                                                               134,000                           154,000

 

Base Adjustment. Of this appropriation in fiscal year 2009, $17,000 is onetime.

 

      Subd. 6. Board of Medical Practice                                                                                   4,120,000                        3,674,000

 

      Subd. 7. Board of Nursing                                                                                                   3,985,000                        4,146,000

 

      Subd. 8. Board of Nursing Home Administrators                                                             633,000                           647,000

 

Administrative Services Unit. Of this appropriation, $430,000 in fiscal year 2008 and $439,000 in fiscal year 2009 are for the administrative services unit. The administrative services unit may receive and expend reimbursements for services performed by other agencies.

 

      Subd. 9. Board of Optometry                                                                                                    98,000                           114,000

 

Base Adjustment. Of this appropriation in fiscal year 2009, $13,000 is onetime.

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                                                                                                                                                             APPROPRIATIONS

                                                                                                                                                            Available for the Year

                                                                                                                                                                  Ending June 30

                                                                                                                                                   2008                                      2009

 

      Subd. 10. Board of Pharmacy                                                                                              1,375,000                        1,442,000

 

Base Adjustment. Of this appropriation in fiscal year 2009, $29,000 is onetime.

 

      Subd. 11. Board of Physical Therapy                                                                                   306,000                           295,000

 

      Subd. 12. Board of Podiatry                                                                                                      54,000                             63,000

 

Base Adjustment. Of this appropriation in fiscal year 2009, $7,000 is onetime.

 

      Subd. 13. Board of Psychology                                                                                                88,000                           806,000

 

      Subd. 14. Board of Social Work                                                                                            997,000                        1,022,000

 

      Subd. 15. Board of Veterinary Medicine                                                                               30,000                           195,000

 

      Subd. 16. Board of Behavioral Health and Therapy                                                           394,000                           394,000

 

      Sec. 7. EMERGENCY MEDICAL SERVICES BOARD                                                4,421,000                   $4,467,000

 

                                        Appropriations by Fund

 

                                                        2008                                        2009

 

General                                   3,734,000                                3,763,000

 

State Government

Special Revenue                      687,000                                   704,000

 

Regional Grants. Of the general fund appropriation, $400,000 in fiscal year 2008 and $400,000 in fiscal year 2009 are to the board for regional emergency medical services programs, to be distributed equally to the eight emergency medical service regions. This amount shall not become part of base level funding. Notwithstanding Minnesota Statutes, section 144E.50, 100 percent of the appropriation shall be passed on to the emergency medical service regions.

 

Longevity Award and Incentive Program. (a) Of the general fund appropriation, $700,000 in fiscal year 2008 and $700,000 in fiscal year 2009 are to the board for the ambulance service personnel longevity award and incentive program, under Minnesota Statutes, section 144E.40.

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                                                                                                                                                             APPROPRIATIONS

                                                                                                                                                            Available for the Year

                                                                                                                                                                  Ending June 30

                                                                                                                                                   2008                                      2009

 

 (b) In fiscal year 2008, $800,000 shall be transferred from the ambulance service personnel longevity award and incentive trust to the general fund.

 

Health Professional Services Program. $687,000 in fiscal year 2008 and $704,000 in fiscal year 2009 from the state government special revenue fund are for the health professional services program.

 

Base Adjustment. The general fund base is $3,363,000 in each year of the fiscal 2010 and 2011 biennium.

 

      Sec. 8. COUNCIL ON DISABILITY                                                                                 $812,000                       $524,000

 

Assistive Technology. Of the general fund appropriation to the Council on Disability in fiscal year 2008, $100,000 is to provide financial support to the Minnesota Regional Assistive Technology Collaborative, and $200,000 is for a transfer to the commissioner of administration for the purposes of completing the state's remaining share of the local match required to access the federal Technology Related Assistance Act for Persons with Disabilities, Title III, Alternative Financing Project 2003 grant award, which provides microloans to individuals for the purpose of acquiring assistive technology devices and services.

 

      Sec. 9. OMBUDSMAN FOR MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES                                                                $1,584,000                             $1,655,000

 

      Sec. 10. OMBUDSMAN FOR FAMILIES                $255,000                                       $265,000

 

Sec. 11. Minnesota Statutes 2006, section 16A.724, is amended by adding a subdivision to read:

 

Subd. 3. MinnesotaCare federal receipts. Receipts received as a result of federal participation pertaining to administrative costs of the Minnesota health care reform waiver shall be deposited as nondedicated revenue in the health care access fund. Receipts received as a result of federal participation pertaining to grants shall be deposited in the federal fund and shall offset health care access funds for payments to providers.

 

Sec. 12. Minnesota Statutes 2006, section 16A.724, is amended by adding a subdivision to read:

 

Subd. 4. MinnesotaCare funding. The commissioner of human services may expend money appropriated from the health care access fund for MinnesotaCare in either year of the biennium.

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Sec. 13. Minnesota Statutes 2006, section 69.021, subdivision 11, is amended to read:

 

Subd. 11. Excess police state-aid holding account. (a) The excess police state-aid holding account is established in the general fund. The excess police state-aid holding account must be administered by the commissioner.

 

(b) Excess police state aid determined according to subdivision 10, must be deposited in the excess police state-aid holding account.

 

(c) From the balance in the excess police state-aid holding account, $900,000 is appropriated to and must be transferred canceled annually to the ambulance service personnel longevity award and incentive suspense account established by section 144E.42, subdivision 2 to the general fund.

 

(d) If a police officer stress reduction program is created by law and money is appropriated for that program, an amount equal to that appropriation must be transferred to the administrator of that program from the balance in the excess police state-aid holding account.

 

(e) On October 1 of each year, one-half of the balance of the excess police state-aid holding account remaining after the deductions under paragraphs (c) and (d) is appropriated for additional amortization aid under section 423A.02, subdivision 1b.

 

(f) Annually, the remaining balance in the excess police state-aid holding account, after the deductions under paragraphs (c), (d), and (e), cancels to the general fund.

 

Sec. 14. Minnesota Statutes 2006, section 245.771, is amended by adding a subdivision to read:

 

Subd. 4. Food stamp bonus awards. In the event that Minnesota qualifies for the United States Department of Agriculture Food and Nutrition Services Food Stamp Program performance bonus awards, the funding is appropriated to the commissioner. The commissioner shall retain 25 percent of the funding and distribute the other 75 percent among the counties according to a formula that takes into account each county's impact on state performance in the applicable bonus categories.

 

Sec. 15. Minnesota Statutes 2006, section 256.01, is amended by adding a subdivision to read:

 

Subd. 23. Nonstate funding for program costs. Notwithstanding sections 16A.013 to 16A.016, the commissioner may accept, on behalf of the state, additional funding from sources other than state funds for the purpose of financing the cost of assistance program grants or nongrant administration. All additional funding is appropriated to the commissioner for use as designated by the grantor of funding.

 

Sec. 16. Minnesota Statutes 2006, section 256.01, is amended by adding a subdivision to read:

 

Subd. 24. Systems continuity. In the event of disruption of technical systems or computer operations, the commissioner may use available grant appropriations to ensure continuity of payments for maintaining the health, safety, and well-being of clients served by programs administered by the Department of Human Services. Grant funds must be used in a manner consistent with the original intent of the appropriation.

 

Sec. 17. Minnesota Statutes 2006, section 256J.02, is amended by adding a subdivision to read:

 

Subd. 6. TANF funds appropriated to other entities. Any expenditures from the TANF block grant shall be expended in accordance with the requirements and limitations of part A of Title IV of the Social Security Act, as amended, and any other applicable federal requirement or limitation. Prior to any expenditure of these funds, the

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commissioner shall ensure that funds are expended in compliance with the requirements and limitations of federal law and that any reporting requirements of federal law are met. It shall be the responsibility of any entity to which these funds are appropriated to implement a memorandum of understanding with the commissioner that provides the necessary assurance of compliance prior to any expenditure of funds. The commissioner shall receipt TANF funds appropriated to other state agencies and coordinate all related interagency accounting transactions necessary to implement these appropriations. Unexpended TANF funds appropriated to any state, local, or nonprofit entity cancel at the end of the state fiscal year unless appropriating or statutory language permits otherwise.

 

Sec. 18. Minnesota Statutes 2006, section 256J.77, is amended to read:

 

256J.77 AGING OF CASH BENEFITS.

 

Cash benefits under chapters 256D, 256J, and 256K, except food stamp benefits under chapter 256D, by warrants or electronic benefit transfer that have not been accessed within 90 days of issuance shall be canceled. Cash benefits may be replaced after they are canceled, for up to one year after the date of issuance, if failure to do so would place the client or family at risk. For purposes of this section, "accessed" means cashing a warrant or making at least one withdrawal from benefits deposited in an electronic benefit account.

 

Sec. 19. Minnesota Statutes 2006, section 518A.56, is amended by adding a subdivision to read:

 

Subd. 13. Child support payment center. Payments to the commissioner from other governmental units, private enterprises, and individuals for services performed by the child support payment center must be deposited in the state systems account authorized under section 256.014. These payments are appropriated to the commissioner for the operation of the child support payment center or system, according to section 256.014.

 

Sec. 20. COMPENSATION INCREASES.

 

The appropriations in this article, and any statutory appropriations from which state employee compensation is paid from any fund, include an amount sufficient to fund compensation increases of at least three percent of the 2007 compensation base for the first year, compounded at the rate of three percent for the second year. This amount must be used for that purpose and no other.

 

Sec. 21. NONGRANT OPERATING CARRYFORWARD.

 

For the biennium ending June 30, 2007, any remaining nongrant operating balances in the Department of Human Services, Minnesota Department of Health, veterans homes, health-related boards, emergency medical services boards, Council on Disability, the ombudsman for mental health and developmental disabilities, and the ombudsman for families direct appropriated accounts may be transferred, with the approval of the commissioner of finance, to a special revenue account. Funds in those accounts are appropriated for costs associated with onetime technology, infrastructure, and systems development projects. Remaining nongrant operating balances in fiscal year 2007 in the Minnesota sex offender program and the Minnesota security hospital shall not be transferred.

 

(a) Transfers to a special revenue account shall be reported to the chairs and the ranking members of the senate Health and Human Services Budget Division and the house of representatives Health Care and Human Services Finance Division.

 

(b) When these balances originate in nongeneral funds, the transfers shall be made to separate accounts within the same funds and may only be used to support projects relevant to the original funding source.

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(c) Uses of these special revenue account funds shall be reported annually by each agency to the commissioner of finance, and to the chairs and ranking members of the senate Health and Human Services Budget Division and the house of representatives Health Care and Human Services Finance Division.

 

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

 

Sec. 22. TRANSFERS.

 

Subdivision 1. Grants. The commissioner of human services, with the approval of the commissioner of finance and after notifying the chairs of the senate and house committees with jurisdiction, may transfer unencumbered appropriation balances for the biennium ending June 30, 2009, within fiscal years among the MFIP; general assistance; general assistance medical care; medical assistance; MFIP child care assistance under Minnesota Statutes, section 119B.05; Minnesota supplemental aid and group residential housing programs; and the entitlement portion of the chemical dependency consolidated treatment fund and between fiscal years of the biennium.

 

Subd. 2. Administration. Positions, salary money, and nonsalary administrative money may be transferred within the Departments of Human Services and Health and within the programs operated by the Veterans Nursing Homes Board as the commissioners and the board consider necessary, with the advance approval of the commissioner of finance. The commissioner or the board shall inform the chairs of the house and senate committees with jurisdiction quarterly about transfers made under this provision.

 

Sec. 23. INDIRECT COSTS NOT TO FUND PROGRAMS.

 

The commissioners of health and of human services shall not use indirect cost allocations to pay for the operational costs of any program for which they are responsible.

 

Sec. 24. SUNSET OF UNCODIFIED LANGUAGE.

 

All uncodified language contained in this article expires on June 30, 2009, unless a different expiration date is explicit.

 

Sec. 25. EFFECTIVE DATE.

 

The provisions in this article are effective July 1, 2007, unless a different effective date is specified."

 

Delete the title and insert:

 

      "A bill for an act relating to state government; making changes to health and human services programs; changing children and family provisions; amending child welfare provisions; modifying licensing provisions; amending health care programs and policy; modifying continuing care programs and policy; amending mental and chemical health provisions; changing Department of Health provisions and policy; establishing a children's health program; changing public health provisions and policy; amending MinnesotaCare, medical assistance, and general assistance medical care; instituting health care reform; establishing the Minnesota Health Insurance Exchange; requiring Section 125 Plans; modifying health insurance provisions; establishing family supportive services; providing rate increases for certain providers and nursing facilities; changing health records information provisions; making technical changes; providing penalties; establishing task forces; changing certain fees; requiring reports; making forecast adjustments; appropriating money for human services and health; appropriating money for various state boards and councils; amending Minnesota Statutes 2006, sections 13.381, by adding a subdivision; 13.46, subdivision 2; 16A.10, by adding a subdivision; 16A.724, subdivision 2, by adding subdivisions; 16B.61, by adding a subdivision; 16D.13, subdivision 3; 47.58, subdivision 8; 62E.02, subdivision 7; 62E.141; 62H.02; 62J.07,

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subdivisions 1, 2, 3; 62J.17, subdivisions 2, 4a, 6a, 7; 62J.41, subdivision 1; 62J.495; 62J.52, subdivisions 1, 2; 62J.60, subdivisions 2, 3; 62J.692, subdivisions 1, 4, 5, 8; 62J.81, subdivision 1; 62J.82; 62L.02, subdivision 11; 62L.12, subdivisions 2, 4; 62Q.165, subdivisions 1, 2; 62Q.80, subdivisions 3, 4, 13, 14, by adding a subdivision; 69.021, subdivision 11; 103I.101, subdivision 6; 103I.208, subdivisions 1, 2; 103I.235, subdivision 1; 119B.011, by adding a subdivision; 119B.035, subdivision 1; 119B.05, subdivision 1; 119B.09, subdivisions 1, 7, by adding subdivisions; 119B.12; 119B.125, subdivision 2; 119B.13, subdivisions 1, 3a, 6, 7; 119B.21, subdivision 5; 144.05, by adding a subdivision; 144.123; 144.125; 144.2215, subdivision 1; 144.3345; 144.565; 144.651, subdivisions 9, 10, 26; 144.698, subdivision 1; 144.9507, by adding a subdivision; 144.9512; 144A.073, subdivision 4; 144A.351; 144D.03, subdivision 1; 144E.101, subdivision 6; 144E.127; 144E.35, subdivision 1; 145A.17; 145C.05; 145C.07, by adding a subdivision; 148.235, by adding a subdivision; 148.6445, subdivisions 1, 2; 148B.53, subdivision 3; 148C.11, subdivision 1; 149A.52, subdivision 3; 149A.97, subdivision 7; 151.19, subdivision 2; 151.37, subdivision 2; 152.11, by adding a subdivision; 157.16, subdivision 1; 169A.70, subdivision 4; 179A.03, subdivision 7; 198.075; 245.462, subdivision 20; 245.465, by adding a subdivision; 245.4712, subdivision 1; 245.4874; 245.50, subdivision 5; 245.771, by adding a subdivision; 245.98, subdivision 2; 245A.035; 245A.10, subdivision 2; 245A.16, subdivisions 1, 3; 245C.02, by adding a subdivision; 245C.04, subdivision 1; 245C.05, subdivisions 1, 4, 5, 7, by adding a subdivision; 245C.08, subdivisions 1, 2; 245C.10, by adding a subdivision; 245C.11, subdivisions 1, 2; 245C.12; 245C.16, subdivision 1; 245C.17, by adding a subdivision; 245C.21, by adding a subdivision; 245C.23, subdivision 2; 246.54, subdivisions 1, 2; 252.27, subdivision 2a; 252.32, subdivision 3; 253B.185, subdivision 2, by adding a subdivision; 254A.03, subdivision 3; 254A.16, subdivision 2; 254B.02, subdivisions 1, 5; 254B.03, subdivisions 1, 3; 254B.06, subdivision 3; 256.01, subdivisions 2, 2b, 4, by adding subdivisions; 256.015, subdivision 7; 256.017, subdivisions 1, 9; 256.476, subdivisions 1, 2, 3, 4, 5, 10; 256.969, subdivisions 3a, 9, 27, by adding a subdivision; 256.974; 256.9741, subdivisions 1, 3; 256.9742, subdivisions 3, 4, 6; 256.9744, subdivision 1; 256.975, subdivision 7, by adding a subdivision; 256.984, subdivision 1; 256B.04, subdivision 14, by adding a subdivision; 256B.055, subdivision 14; 256B.056, subdivisions 1a, 3, 10, by adding a subdivision; 256B.057, by adding a subdivision; 256B.0621, subdivision 11; 256B.0622, subdivision 2; 256B.0623, subdivision 5; 256B.0625, subdivisions 3f, 5a, 5k, 13c, 13d, 18a, 20, 23, 47, by adding subdivisions; 256B.0631, subdivisions 1, 3; 256B.0644; 256B.0651, subdivision 7; 256B.0655, subdivisions 1b, 1f, 3, 8, by adding subdivisions; 256B.0911, subdivisions 1a, 3a, 3b, 4b, 4c, 6, 7, by adding subdivisions; 256B.0913, subdivisions 4, 5, 5a, 8, 9, 10, 11, 12, 13, 14, by adding a subdivision; 256B.0915; 256B.0919, subdivision 3; 256B.0943, subdivisions 6, 8, 9, 11, 12; 256B.0945, subdivision 4; 256B.095; 256B.0951, subdivision 1; 256B.15, by adding a subdivision; 256B.199; 256B.27, subdivision 2a; 256B.431, subdivisions 1, 2e, 3f, 17a, 17e, 41; 256B.434, subdivision 4, by adding subdivisions; 256B.437, by adding a subdivision; 256B.441, subdivisions 1, 2, 5, 6, 10, 11, 13, 14, 17, 20, 24, 30, 31, 34, 38, by adding subdivisions; 256B.49, subdivision 11, by adding a subdivision; 256B.5012, by adding a subdivision; 256B.69, subdivisions 4, 5g, 5h, 23; 256B.75; 256B.76; 256B.763; 256D.03, subdivisions 3, 4; 256E.35, subdivision 2; 256I.04, subdivision 3; 256I.05, by adding subdivisions; 256J.01, by adding a subdivision; 256J.02, subdivisions 1, 4, by adding a subdivision; 256J.021; 256J.08, subdivision 65; 256J.20, subdivision 3; 256J.21, subdivision 2; 256J.32, subdivision 6; 256J.37, subdivision 3a; 256J.42, subdivision 1; 256J.46, by adding a subdivision; 256J.49, subdivision 13; 256J.521, subdivisions 1, 2; 256J.53, subdivision 2; 256J.55, subdivision 1; 256J.626, subdivisions 1, 2, 3, 4, 5, 6, 7; 256J.751, subdivisions 2, 5; 256J.77; 256J.95, subdivision 3; 256K.45, by adding a subdivision; 256L.01, subdivisions 1, 4; 256L.03, subdivisions 1, 3, 5; 256L.04, subdivisions 1, 7, 12; 256L.05, subdivisions 1, 1b, 2, 3a; 256L.07, subdivisions 1, 2, 6, by adding a subdivision; 256L.09, subdivision 4; 256L.11, subdivision 7; 256L.12, subdivision 9a; 256L.15, subdivisions 1, 2, 3, 4; 256L.17, subdivisions 2, 3, 7; 259.20, subdivision 2; 259.24, subdivision 3; 259.29, subdivision 1; 259.41; 259.53, subdivisions 1, 2; 259.57, subdivisions 1, 2; 259.67, subdivisions 4, 7; 259.75, subdivision 8; 260.012; 260.755, subdivisions 12, 20; 260.761, subdivision 7; 260.765, subdivision 5; 260.771, subdivisions 1, 2; 260B.157, subdivision 1; 260C.152, subdivision 5; 260C.163, subdivision 1; 260C.201, subdivision 11; 260C.209; 260C.212, subdivisions 1, 2, 4, 9; 260C.317, subdivision 3; 260C.331, subdivision 1; 270B.14, subdivision 1; 462A.05, by adding a subdivision; 471.59, subdivision 1; 518A.56, by adding a subdivision; 609.115, subdivisions 8, 9; 626.556, subdivisions 2, 3, 10, 10a, 10c, 10f, by adding subdivisions; Laws 2000, chapter 340, section 19; Laws 2005, chapter 98, article 3, section 25; Laws 2005, First

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Special Session chapter 4, article 9, section 3, subdivision 2; Laws 2006, chapter 282, article 20, section 37; proposing coding for new law in Minnesota Statutes, chapters 16C; 62A; 62J; 62Q; 144; 145; 148; 149A; 151; 152; 156; 245; 245A; 245C; 252; 254A; 256; 256B; 256C; 256D; 256F; 256J; 256L; 260; repealing Minnesota Statutes 2006, sections 62A.301; 62J.052, subdivision 1; 62J.692, subdivision 10; 119B.08, subdivision 4; 144.335; 252.21; 252.22; 252.23; 252.24; 252.25; 252.261; 252.275, subdivision 5; 254A.02, subdivisions 7, 9, 12, 14, 15, 16; 254A.085; 254A.086; 254A.12; 254A.14; 254A.15; 254A.16, subdivision 5; 254A.175; 254A.18; 256.9743; 256B.0631, subdivision 4; 256B.0913, subdivisions 5b, 5c, 5d, 5e, 5f, 5g, 5h; 256B.441, subdivisions 12, 16, 21, 26, 28, 42, 45; 256J.24, subdivision 6; 256J.29; 256J.37, subdivision 3b; 256J.561, subdivision 1; 256J.62, subdivision 9; 256J.626, subdivision 9; 256J.65; 256L.035; 256L.07, subdivision 2a; Laws 1997, chapter 8, section 1; Laws 2004, chapter 288, article 6, section 27; Laws 2006, chapter 249, section 6; Minnesota Rules, parts 4610.2800; 9503.0035, subpart 2; 9560.0102, subpart 2, item C; 9585.0030."

 

 

      We request the adoption of this report and repassage of the bill.

 

      Senate Conferees: Linda Berglin, Ann Lynch, Tony Lourey, John P. Doll and Yvonne Prettner Solon.

 

      House Conferees: Thomas Huntley, Paul Thissen, Karen Clark and Neva Walker.

 

 

      Huntley moved that the report of the Conference Committee on S. F. No. 2171 be adopted and that the bill be repassed as amended by the Conference Committee.

 

 

      Seifert moved that the House refuse to adopt the Conference Committee Report on S. F. No. 2171, and that the bill be returned to the Conference Committee.

 

 

      A roll call was requested and properly seconded.

 

 

      Atkins; Erhardt; Peterson, N., and Tingelstad were excused for the remainder of today's session.

 

 

CALL OF THE HOUSE

 

      On the motion of Dean and on the demand of 10 members, a call of the House was ordered. The following members answered to their names:

 

Abeler

Anderson, B.

Anderson, S.

Anzelc

Beard

Benson

Berns

Bigham

Bly

Brod

Brown

Brynaert

Buesgens

Bunn

Carlson

Clark

Cornish

Davnie

Dean

DeLaForest

Dettmer

Dill

Dittrich

Dominguez

Doty

Eastlund

Eken

Emmer

Erickson

Faust

Finstad

Fritz

Gardner

Garofalo

Gottwalt

Greiling

Gunther

Hackbarth

Hamilton

Hansen

Haws

Heidgerken

Hilstrom

Hilty

Holberg

Hoppe

Hornstein

Hortman

Hosch

Huntley

Jaros

Johnson

Juhnke

Kahn

Knuth

Koenen

Kohls

Kranz

Laine

Lanning

Lenczewski

Lesch

Liebling

Lieder

Lillie

Loeffler

Madore

Magnus

Mahoney

Mariani

Marquart

Masin

Journal of the House - 63rd Day - Monday, May 7, 2007 - Top of Page 6110

McFarlane

McNamara

Moe

Morgan

Morrow

Mullery

Murphy, E.

Murphy, M.

Nelson

Nornes

Norton

Olin

Olson

Otremba

Paulsen

Paymar

Peppin

Peterson, A.

Peterson, S.

Poppe

Rukavina

Ruth

Ruud

Sailer

Scalze

Seifert

Sertich

Severson

Shimanski

Simon

Simpson

Slocum

Smith

Solberg

Sviggum

Swails

Thao

Thissen

Tillberry

Tschumper

Urdahl

Wagenius

Walker

Ward

Wardlow

Welti

Westrom

Winkler

Wollschlager

Zellers

Spk. Kelliher

 

 

      Sertich moved that further proceedings of the roll call be suspended and that the Sergeant at Arms be instructed to bring in the absentees. The motion prevailed and it was so ordered.

 

 

      The question recurred on the Seifert motion and the roll was called. There were 44 yeas and 83 nays as follows:

 

      Those who voted in the affirmative were:

 

Abeler

Anderson, B.

Anderson, S.

Beard

Berns

Brod

Buesgens

Cornish

Dean

DeLaForest

Dettmer

Eastlund

Emmer

Erickson

Finstad

Garofalo

Gottwalt

Gunther

Hackbarth

Hamilton

Heidgerken

Holberg

Hoppe

Kohls

Lanning

Magnus

McFarlane

McNamara

Nornes

Olson

Ozment

Paulsen

Peppin

Ruth

Seifert

Severson

Shimanski

Simpson

Smith

Sviggum

Urdahl

Wardlow

Westrom

Zellers

 

 

      Those who voted in the negative were:

 

Anzelc

Benson

Bigham

Bly

Brown

Brynaert

Bunn

Carlson

Clark

Davnie

Dill

Dittrich

Dominguez

Doty

Eken

Faust

Fritz

Gardner

Greiling

Hansen

Hausman

Haws

Hilstrom

Hilty

Hornstein

Hortman

Hosch

Huntley

Jaros

Johnson

Juhnke

Kahn

Kalin

Knuth

Koenen

Kranz

Laine

Lenczewski

Lesch

Liebling

Lieder

Lillie

Loeffler

Madore

Mahoney

Mariani

Marquart

Masin

Moe

Morgan

Morrow

Mullery

Murphy, E.

Murphy, M.

Nelson

Norton

Olin

Otremba

Paymar

Peterson, A.

Peterson, S.

Poppe

Rukavina

Ruud

Sailer

Scalze

Sertich

Simon

Slawik

Slocum

Solberg

Swails

Thao

Thissen

Tillberry

Tschumper

Wagenius

Walker

Ward

Welti

Winkler

Wollschlager

Spk. Kelliher

 

 

      The motion did not prevail.

 

 

CALL OF THE HOUSE LIFTED

 

      Seifert moved that the call of the House be lifted. The motion prevailed and it was so ordered.

 

 

      Slawik was excused for the remainder of today's session.

 

 

      The question recurred on the Huntley motion that the report of the Conference Committee on S. F. No. 2171 be adopted and that the bill be repassed as amended by the Conference Committee. The motion prevailed.

Journal of the House - 63rd Day - Monday, May 7, 2007 - Top of Page 6111

      S. F. No. 2171, A bill for an act relating to state government; making changes to health and human services programs; modifying health policy; changing licensing provisions; altering provisions for mental and chemical health; modifying child care provisions; amending children and family services provisions; changing continuing care provisions; amending MinnesotaCare; adjusting child care assistance eligibility; establishing family stabilization services; enacting federal compliance requirements; expanding medical assistance coverage; providing rate increases for certain providers; modifying fees; appropriating money for human services, health, veterans nursing homes boards, the Emergency Medical Services Regulatory Board; health care boards, the Council on Disability, the ombudsman for mental health and developmental disabilities, and the ombudsman for families; requiring reports; amending Minnesota Statutes 2006, sections 13.381, by adding a subdivision; 16A.724, subdivision 2, by adding subdivisions; 47.58, subdivision 8; 62E.02, subdivision 7; 62J.07, subdivisions 1, 3; 62J.495; 62J.692, subdivisions 1, 4, 5, 8; 62J.82; 62L.02, subdivision 11; 62Q.165, subdivisions 1, 2; 62Q.80, subdivisions 3, 4, 13, 14, by adding a subdivision; 69.021, subdivision 11; 103I.101, subdivision 6; 103I.208, subdivisions 1, 2; 103I.235, subdivision 1; 119B.011, by adding a subdivision; 119B.035, subdivision 1; 119B.05, subdivision 1; 119B.09, subdivision 1; 119B.12, by adding a subdivision; 119B.13, subdivisions 1, 7; 144.123; 144.125, subdivisions 1, 2; 144.3345; 144D.03, subdivision 1; 148.5194, by adding a subdivision; 148.6445, subdivisions 1, 2; 148C.11, subdivision 1; 149A.52, subdivision 3; 149A.97, subdivision 7; 153A.14, subdivision 4a; 153A.17; 169A.70, subdivision 4; 245.465, by adding a subdivision; 245.4874; 245.771, by adding a subdivision; 245.98, subdivision 2; 245A.035; 245A.10, subdivision 2; 245A.16, subdivisions 1, 3; 245C.02, by adding a subdivision; 245C.04, subdivision 1; 245C.05, subdivisions 1, 4, 5, 7, by adding a subdivision; 245C.08, subdivisions 1, 2; 245C.10, by adding a subdivision; 245C.11, subdivisions 1, 2; 245C.12; 245C.16, subdivision 1; 245C.17, by adding a subdivision; 245C.21, by adding a subdivision; 245C.23, subdivision 2; 246.54, subdivisions 1, 2; 252.27, subdivision 2a; 252.32, subdivision 3; 253B.185, by adding a subdivision; 254B.02, subdivision 3; 256.01, subdivision 2b, by adding subdivisions; 256.482, subdivisions 1, 8; 256.969, subdivisions 3a, 9, 27, by adding a subdivision; 256.975, subdivision 7; 256B.04, subdivision 14, by adding a subdivision; 256B.056, subdivision 10; 256B.0621, subdivision 11; 256B.0622, subdivision 2; 256B.0623, subdivision 5; 256B.0625, subdivisions 17, 18a, 20, 30, by adding subdivisions; 256B.0631, subdivisions 1, 3; 256B.0655, subdivision 8; 256B.0911, subdivisions 1a, 3a, 3b, by adding a subdivision; 256B.0913, by adding a subdivision; 256B.0915, by adding a subdivision; 256B.0943, subdivision 8; 256B.0945, subdivision 4; 256B.095; 256B.0951, subdivision 1; 256B.15, by adding a subdivision; 256B.199; 256B.431, subdivisions 2e, 41; 256B.434, subdivision 4, by adding a subdivision; 256B.437, by adding a subdivision; 256B.441, subdivisions 1, 2, 5, 6, 10, 11, 13, 14, 17, 20, 24, 30, 31, 34, 38, by adding subdivisions; 256B.49, subdivisions 11, 16; 256B.5012, by adding a subdivision; 256B.69, subdivisions 2, 4, 5g, 5h; 256B.75; 256B.76; 256B.763; 256D.03, subdivisions 3, 4; 256I.04, subdivision 3; 256I.05, by adding subdivisions; 256J.01, by adding a subdivision; 256J.02, by adding a subdivision; 256J.021; 256J.08, subdivision 65; 256J.20, subdivision 3; 256J.32, subdivision 6; 256J.425, subdivisions 3, 4; 256J.49, subdivision 13; 256J.521, subdivisions 1, 2; 256J.53, subdivision 2; 256J.55, subdivision 1; 256J.626, subdivisions 1, 2, 3, 4, 5, 6; 256L.01, subdivisions 1, 4; 256L.03, subdivisions 1, 3, 5; 256L.035; 256L.04, subdivisions 1, 1a, 7, 10; 256L.05, subdivisions 1, 1b, 2, 3a; 256L.07, subdivisions 1, 2, 3, 6; 256L.09, subdivision 4; 256L.11, subdivision 7; 256L.12, subdivision 9a; 256L.15, subdivisions 1, 2, 4; 256L.17, subdivisions 2, 3, 7; 259.20, subdivision 2; 259.29, subdivision 1; 259.41; 259.53, subdivision 2; 259.57, subdivision 2; 259.67, subdivision 4; 260C.209; 260C.212, subdivision 2; 462A.05, by adding a subdivision; 518A.56, by adding a subdivision; 609.115, subdivisions 8, 9; Laws 2005, chapter 98, article 3, section 25; Laws 2005, First Special Session chapter 4, article 9, section 3, subdivision 2; proposing coding for new law in Minnesota Statutes, chapters 16C; 62J; 144; 145; 149A; 152; 156; 245; 245C; 252; 254A; 256; 256B; 256C; 256J; 256L; repealing Minnesota Statutes 2006, sections 62A.301; 62J.692, subdivision 10; 256B.0631, subdivision 4; 256B.441, subdivisions 12, 16, 21, 26, 28, 42, 45; 256J.24, subdivision 6; 256J.29; 256J.37, subdivisions 3a, 3b; 256J.626, subdivisions 7, 9; 256L.035; 256L.07, subdivision 2a; Laws 2004, chapter 288, article 6, section 27; Minnesota Rules, parts 4610.2800; 9585.0030.

 

 

      The bill was read for the third time, as amended by Conference, and placed upon its repassage.

Journal of the House - 63rd Day - Monday, May 7, 2007 - Top of Page 6112

      The question was taken on the repassage of the bill and the roll was called. There were 82 yeas and 44 nays as follows:

 

      Those who voted in the affirmative were:

 

Anzelc

Benson

Bigham

Bly

Brown

Brynaert

Bunn

Carlson

Clark

Davnie

Dill

Dittrich

Dominguez

Doty

Eken

Faust

Fritz

Gardner

Greiling

Hansen

Hausman

Haws

Hilstrom

Hilty

Hornstein

Hortman

Hosch

Huntley

Jaros

Johnson

Juhnke

Kahn

Kalin

Knuth

Koenen

Kranz

Laine

Lenczewski

Lesch

Liebling

Lieder

Lillie

Loeffler

Madore

Mahoney

Mariani

Marquart

Masin

Moe

Morgan

Morrow

Mullery

Murphy, E.

Murphy, M.

Nelson

Norton

Olin

Otremba

Paymar

Peterson, A.

Peterson, S.

Poppe

Rukavina

Ruud

Sailer

Scalze

Sertich

Simon

Slocum

Solberg

Swails

Thao

Thissen

Tillberry

Tschumper

Wagenius

Walker

Ward

Welti

Winkler

Wollschlager

Spk. Kelliher

 

 

      Those who voted in the negative were:

 

Abeler

Anderson, B.

Anderson, S.

Beard

Berns

Brod

Buesgens

Cornish

Dean

DeLaForest

Dettmer

Eastlund

Emmer

Erickson

Finstad

Garofalo

Gottwalt

Gunther

Hackbarth

Hamilton

Heidgerken

Holberg

Hoppe

Kohls

Lanning

Magnus

McFarlane

McNamara

Nornes

Olson

Ozment

Paulsen

Peppin

Ruth

Seifert

Severson

Shimanski

Simpson

Smith

Sviggum

Urdahl

Wardlow

Westrom

Zellers

 

 

      The bill was repassed, as amended by Conference, and its title agreed to.

 

 

ADJOURNMENT

 

      Sertich moved that when the House adjourns today it adjourn until 10:00 a.m., Tuesday, May 8, 2007. The motion prevailed.

 

      Sertich moved that the House adjourn. The motion prevailed, and the Speaker declared the House stands adjourned until 10:00 a.m., Tuesday, May 8, 2007.

 

 

Albin A. Mathiowetz, Chief Clerk, House of Representatives