.................... moves to amend H. F. No. 297, the delete everything amendment
(A07-0645), as follows:
Page 8, after line 22 insert:
"Sec. ... Minnesota Statutes 2006, section 256J.08, subdivision 65, is amended to read:
Subd. 65. Participant. (a)
means includes any of the following:
a person who is currently receiving cash assistance or the food portion available
. A person who fails to withdraw or access electronically any portion of the
1.8 person's cash and food assistance payment by the end of the payment month, who makes a
1.9 written request for closure before the first of a payment month and repays cash and food
1.10 assistance electronically issued for that payment month within that payment month, or
1.11 who returns any uncashed assistance check and food coupons and withdraws from the
1.12 program is not a participant.;
a person who withdraws a cash or food assistance payment by electronic transfer
or receives and cashes an MFIP assistance check or food coupons and is subsequently
determined to be ineligible for assistance for that period of time is a participant, regardless
whether that assistance is repaid
. The term "participant" includes;
the caregiver relative and the minor child whose needs are included in the
a person in an assistance unit who does not receive a cash and food assistance
payment because the case has been suspended from MFIP
is a participant.;
a person who receives cash payments under the diversionary work program
is a participant
1.23 (6) a person who receives cash payments under the family stabilization services
1.24program under section 256J.575.
1.25 (b) "Participant" does not include a person who fails to withdraw or access
1.26electronically any portion of the person's cash and food assistance payment by the end of
1.27the payment month, who makes a written request for closure before the first of a payment
2.1month and repays cash and food assistance electronically issued for that payment month
2.2within that payment month, or who returns any uncashed assistance check and food
2.3coupons and withdraws from the program.
Page 16, after line 21 insert:
"Sec. ... Minnesota Statutes 2006, section 256J.521, subdivision 1, is amended to read:
Subdivision 1. Assessments.
(a) For purposes of MFIP employment services,
assessment is a continuing process of gathering information related to employability
for the purpose of identifying both participant's strengths and strategies for coping with
issues that interfere with employment. The job counselor must use information from the
assessment process to develop and update the employment plan under subdivision 2 or 3,
to determine whether the participant qualifies for a family violence
waiver including an employment plan under subdivision 3, and to determine whether the
2.13participant should be referred to the family stabilization services program under section
(b) The scope of assessment must cover at least the following areas:
(1) basic information about the participant's ability to obtain and retain employment,
including: a review of the participant's education level; interests, skills, and abilities; prior
employment or work experience; transferable work skills; child care and transportation
(2) identification of personal and family circumstances that impact the participant's
ability to obtain and retain employment, including: any special needs of the children, the
level of English proficiency, family violence issues, and any involvement with social
services or the legal system;
(3) the results of a mental and chemical health screening tool designed by the
commissioner and results of the brief screening tool for special learning needs. Screening
tools for mental and chemical health and special learning needs must be approved by the
commissioner and may only be administered by job counselors or county staff trained in
using such screening tools. The commissioner shall work with county agencies to develop
protocols for referrals and follow-up actions after screens are administered to participants,
including guidance on how employment plans may be modified based upon outcomes
of certain screens. Participants must be told of the purpose of the screens and how the
information will be used to assist the participant in identifying and overcoming barriers to
employment. Screening for mental and chemical health and special learning needs must
be completed by participants who are unable to find suitable employment after six weeks
of job search under subdivision 2, paragraph (b), and participants who are determined to
have barriers to employment under subdivision 2, paragraph (d). Failure to complete the
screens will result in sanction under section
(4) a comprehensive review of participation and progress for participants who have
received MFIP assistance and have not worked in unsubsidized employment during the
past 12 months. The purpose of the review is to determine the need for additional services
and supports, including placement in subsidized employment or unpaid work experience
256J.49, subdivision 13, or referral to the family stabilization services
3.8program under section 256J.575
(c) Information gathered during a caregiver's participation in the diversionary work
program under section
must be incorporated into the assessment process.
(d) The job counselor may require the participant to complete a professional chemical
use assessment to be performed according to the rules adopted under section
, including provisions in the administrative rules which recognize the cultural
background of the participant, or a professional psychological assessment as a component
of the assessment process, when the job counselor has a reasonable belief, based on
objective evidence, that a participant's ability to obtain and retain suitable employment
is impaired by a medical condition. The job counselor may assist the participant with
arranging services, including child care assistance and transportation, necessary to meet
needs identified by the assessment. Data gathered as part of a professional assessment
must be classified and disclosed according to the provisions in section
Page 20, after line 13 insert:
"Sec. ... [256J.575] FAMILY STABILIZATION SERVICES.
3.23 Subdivision 1. Purpose. (a) The family stabilization services serve families who are
3.24not making significant progress within the Minnesota family investment program (MFIP)
3.25due to a variety of barriers to employment.
3.26 (b) The goal of the services is to stabilize and improve the lives of families at risk
3.27of long-term welfare dependency or family instability due to employment barriers such
3.28as physical disability, mental disability, age, or providing care for a disabled household
3.29member. These services promote and support families to achieve the greatest possible
3.30degree of self-sufficiency.
3.31 Subd. 2. Definitions. The terms used in this section have the meanings given them
3.32in paragraphs (a) to (d).
3.33 (a) "Family stabilization services" means the services established under this section.
3.34 (b) "Case management" means the services provided by or through the county
3.35agency or through the employment services agency to participating families, including
4.1assessment, information, referrals, and assistance in the preparation and implementation
4.2of a family stabilization plan under subdivision 5.
4.3 (c) "Family stabilization plan" means a plan developed by a case manager and
4.4the participant, which identifies the participant's most appropriate path to unsubsidized
4.5employment, family stability, and barrier reduction, taking into account the family's
4.7 (d) "Family stabilization services" means programs, activities, and services in this
4.8section that provide participants and their family members with assistance regarding,
4.9but not limited to:
4.10 (1) obtaining and retaining unsubsidized employment;
4.11 (2) family stability;
4.12 (3) economic stability; and
4.13 (4) barrier reduction.
4.14 The goal of the services is to achieve the greatest degree of economic self-sufficiency
4.15and family well-being possible for the family under the circumstances.
4.16 (e) "Case manager" means the county-designated staff person or employment
4.18 Subd. 3. Eligibility. (a) The following MFIP or diversionary work program (DWP)
4.19participants are eligible for the services under this section:
4.20 (1) a participant identified under section 256J.561, subdivision 2, paragraph (d), who
4.21has or is eligible for an employment plan developed under section 256J.521, subdivision
4.222, paragraph (c);
4.23 (2) a participant identified under section 256J.95, subdivision 12, paragraph (b), as
4.24unlikely to benefit from the diversionary work program;
4.25 (3) a participant who meets the requirements for or has been granted a hardship
4.26extension under section 256J.425, subdivision 2 or 3;
4.27 (4) a participant who is applying for supplemental security income or Social Security
4.29 (5) a participant who is a noncitizen who has been in the United States for 12 or
4.30fewer months; and
4.31 (6) a new MFIP participant, for the first 30 days the participant receives assistance or
4.32when the participant's employment plan is completed, whichever is sooner.
4.33 (b) Families must meet all other eligibility requirements for MFIP established in
4.34this chapter. Families are eligible for financial assistance to the same extent as if they
4.35were participating in MFIP.
5.1 (c) A participant under paragraph (a), clause (5), must be provided with English as a
5.2second language opportunities and skills training for up to 12 months. After 12 months,
5.3the case manager and participant must determine whether the participant should continue
5.4with English as a second language classes or skills training, or both, or if the participant
5.5should become an MFIP participant.
5.6 Subd. 4. Universal participation. All caregivers must participate in family
5.7stabilization services as defined in subdivision 2.
5.8 Subd. 5. Case management; family stabilization plans; coordinated services. (a)
5.9The county agency shall provide family stabilization services to families through a case
5.10management model. A case manager shall be assigned to each participating family within
5.1130 days after the family begins to receive financial assistance as a participant of the family
5.12stabilization services. The case manager, with the full involvement of the participant, shall
5.13recommend, and the county agency shall establish and modify as necessary, a family
5.14stabilization plan for each participating family. If a participant is already assigned to a
5.15county case manager or a county-designated case manager in social services, disability
5.16services, or housing services that case manager already assigned may be the case manager
5.17for purposes of these services.
5.18 (b) The family stabilization plan must include:
5.19 (1) each participant's plan for long-term self-sufficiency, including an employment
5.20goal where applicable;
5.21 (2) an assessment of each participant's strengths and barriers, and any special
5.22circumstances of the participant's family that impact, or are likely to impact, the
5.23participant's progress towards the goals in the plan; and
5.24 (3) an identification of the services, supports, education, training, and
5.25accommodations needed to reduce or overcome any barriers to enable the family to
5.26achieve self-sufficiency and to fulfill each caregiver's personal and family responsibilities.
5.27 (c) The case manager and the participant shall meet within 30 days of the family's
5.28referral to the case manager. The initial family stabilization plan must be completed within
5.2930 days of the first meeting with the case manager. The case manager shall establish a
5.30schedule for periodic review of the family stabilization plan that includes personal contact
5.31with the participant at least once per month. In addition, the case manager shall review
5.32and, if necessary, modify the plan under the following circumstances:
5.33 (1) there is a lack of satisfactory progress in achieving the goals of the plan;
5.34 (2) the participant has lost unsubsidized or subsidized employment;
5.35 (3) a family member has failed or is unable to comply with a family stabilization
6.1 (4) services, supports, or other activities required by the plan are unavailable;
6.2 (5) changes to the plan are needed to promote the well-being of the children; or
6.3 (6) the participant and case manager determine that the plan is no longer appropriate
6.4for any other reason.
6.5 Subd. 6. Cooperation with services requirements. (a) To be eligible, a participant
6.6shall comply with paragraphs (b) to (e).
6.7 (b) Participants shall engage in family stabilization plan services for the appropriate
6.8number of hours per week that the activities are scheduled and available, unless good
6.9cause exists for not doing so, as defined in section 256J.57, subdivision 1. The appropriate
6.10number of hours must be based on the participant's plan.
6.11 (c) The case manager shall review the participant's progress toward the goals in the
6.12family stabilization plan every six months to determine whether conditions have changed,
6.13including whether revisions to the plan are needed.
6.14 (d) When the participant has increased participation in work-related activities
6.15sufficient to meet the federal participation requirements of TANF, the county agency shall
6.16refer the participant to the MFIP program and assign the participant to a job counselor.
6.17The participant and the job counselor shall meet within 15 days of referral to the MFIP
6.18program to develop an employment plan under section 256J.521. No reapplication is
6.19necessary and financial assistance continues without interruption.
6.20 (e) A participant's requirement to comply with any or all family stabilization plan
6.21requirements under this subdivision is excused when the case management services,
6.22training and educational services, and family support services identified in the participant's
6.23family stabilization plan are unavailable for reasons beyond the control of the participant,
6.24including when money appropriated is not sufficient to provide the services.
6.25 Subd. 7. Sanctions. (a) The financial assistance grant of a participating family is
6.26reduced according to section 256J.46, if a participating adult fails without good cause to
6.27comply or continue to comply with the family stabilization plan requirements in this
6.28subdivision, unless compliance has been excused under subdivision 6, paragraph (e).
6.29 (b) Given the purpose of the family stabilization services in this section and the
6.30nature of the underlying family circumstances that act as barriers to both employment and
6.31full compliance with program requirements, sanctions are appropriate only when it is clear
6.32that there is both the ability to comply and willful noncompliance by the participant, as
6.33confirmed by a behavioral health or medical professional.
6.34 (c) Prior to the imposition of a sanction, the county agency shall review the
6.35participant's case to determine if the family stabilization plan is still appropriate and
7.1meet with the participant face-to-face. The participant may bring an advocate to the
7.3 During the face-to-face meeting, the county agency must:
7.4 (1) determine whether the continued noncompliance can be explained and mitigated
7.5by providing a needed family stabilization service, as defined in subdivision 2, paragraph
7.7 (2) determine whether the participant qualifies for a good cause exception under
7.8section 256J.57, or if the sanction is for noncooperation with child support requirements,
7.9determine if the participant qualifies for a good cause exemption under section 256.741,
7.11 (3) determine whether activities in the family stabilization plan are appropriate
7.12based on the family's circumstances;
7.13 (4) explain the consequences of continuing noncompliance;
7.14 (5) identify other resources that may be available to the participant to meet the
7.15needs of the family; and
7.16 (6) inform the participant of the right to appeal under section 256J.40.
7.17 If the lack of an identified activity or service can explain the noncompliance, the
7.18county shall work with the participant to provide the identified activity.
7.19 (d) If the participant fails to come to the face-to-face meeting, the case manager or a
7.20designee shall attempt at least one home visit. If a face-to-face meeting is not conducted,
7.21the county agency shall send the participant a written notice that includes the information
7.22under paragraph (c).
7.23 (e) After the requirements of paragraphs (c) and (d) are met and prior to imposition
7.24of a sanction, the county agency shall provide a notice of intent to sanction under section
7.25256J.57, subdivision 2, and, when applicable, a notice of adverse action under section
7.27 (f) Section 256J.57 applies to this section except to the extent that it is modified
7.28by this subdivision.
7.29 Subd. 8. Funding. (a) The commissioner of human services must treat MFIP
7.30expenditures made to or on behalf of any minor child under section 256J.575, who
7.31is part of a household that meets criteria in subdivision 3, as expenditures under a
7.32separately funded state program. These expenditures shall not count toward the state's
7.33MOE requirements under the federal TANF program.
7.34 (b) A family is no longer part of a separately funded program under this section, if
7.35the caregiver no longer meets the criteria for family stabilization services in subdivision
8.13 or if it is determined at recertification that the caregiver is meeting the federal work
8.2participation rate, whichever occurs sooner.
Sec. ... Minnesota Statutes 2006, section 256J.626, subdivision 1, is amended to read:
Subdivision 1. Consolidated fund.
The consolidated fund is established to support
counties and tribes in meeting their duties under this chapter. Counties and tribes must use
funds from the consolidated fund to develop programs and services that are designed to
improve participant outcomes as measured in section
256J.751, subdivision 2
may use the funds for any allowable expenditures under subdivision 2, and to provide case
8.9management services to participants of the family stabilization services program
may use the funds for any allowable expenditures under subdivision 2, except those in
8.11subdivision 2, paragraph (a),
clauses (1) and (6).
Sec. ... Minnesota Statutes 2006, section 256J.626, subdivision 2, is amended to read:
Subd. 2. Allowable expenditures.
(a) The commissioner must restrict expenditures
under the consolidated fund to benefits and services allowed under title IV-A of the federal
Social Security Act. Allowable expenditures under the consolidated fund may include, but
are not limited to:
(1) short-term, nonrecurring shelter and utility needs that are excluded from the
definition of assistance under Code of Federal Regulations, title 45, section
families who meet the residency requirement in section
256J.12, subdivisions 1 and 1a
Payments under this subdivision are not considered TANF cash assistance and are not
counted towards the 60-month time limit;
(2) transportation needed to obtain or retain employment or to participate in other
approved work activities or activities under a family stabilization plan
(3) direct and administrative costs of staff to deliver employment services for
the diversionary work program, or the family stabilization services program;
to administer financial assistance
and to provide specialized services intended to assist
hard-to-employ participants to transition to work or transition from the family stabilization
8.28services program to MFIP
(4) costs of education and training including functional work literacy and English as
a second language;
(5) cost of work supports including tools, clothing, boots, telephone service,
other work-related expenses;
(6) county administrative expenses as defined in Code of Federal Regulations, title
45, section 260(b);
(7) services to parenting and pregnant teens;
(8) supported work;
(9) wage subsidies;
(10) child care needed for MFIP
diversionary work program, or the family
9.3stabilization services program
participants to participate in social services;
(11) child care to ensure that families leaving MFIP or diversionary work program
will continue to receive child care assistance from the time the family no longer qualifies
for transition year child care until an opening occurs under the basic sliding fee child
(12) services to help noncustodial parents who live in Minnesota and have minor
children receiving MFIP or DWP assistance, but do not live in the same household as the
child, obtain or retain employment; and
9.11 (13) services to help families participating in the family stabilization services
9.12program achieve the greatest possible degree of self-sufficiency
(b) Administrative costs that are not matched with county funds as provided in
subdivision 8 may not exceed 7.5 percent of a county's or 15 percent of a tribe's allocation
under this section. The commissioner shall define administrative costs for purposes of
(c) The commissioner may waive the cap on administrative costs for a county or tribe
that elects to provide an approved supported employment, unpaid work, or community
work experience program for a major segment of the county's or tribe's MFIP population.
The county or tribe must apply for the waiver on forms provided by the commissioner. In
no case shall total administrative costs exceed the TANF limits.
Sec. ... Minnesota Statutes 2006, section 256J.626, subdivision 3, is amended to read:
Subd. 3. Eligibility for services.
Families with a minor child, a pregnant woman,
or a noncustodial parent of a minor child receiving assistance, with incomes below 200
percent of the federal poverty guideline for a family of the applicable size, are eligible
for services funded under the consolidated fund. Counties and tribes must give priority
to families currently receiving MFIP
diversionary work program, or the family
9.28stabilization services program,
and families at risk of receiving MFIP or diversionary
Sec. ... Minnesota Statutes 2006, section 256J.626, subdivision 4, is amended to read:
Subd. 4. County and tribal biennial service agreements.
(a) Effective January 1,
2004, and each two-year period thereafter, each county and tribe must have in place an
approved biennial service agreement related to the services and programs in this chapter.
In counties with a city of the first class with a population over 300,000, the county must
consider a service agreement that includes a jointly developed plan for the delivery of
employment services with the city. Counties may collaborate to develop multicounty,
multitribal, or regional service agreements.
(b) The service agreements will be completed in a form prescribed by the
commissioner. The agreement must include:
(1) a statement of the needs of the service population and strengths and resources
in the community;
(2) numerical goals for participant outcomes measures to be accomplished during
the biennial period. The commissioner may identify outcomes from section
, as core outcomes for all counties and tribes;
(3) strategies the county or tribe will pursue to achieve the outcome targets.
Strategies must include specification of how funds under this section will be used and may
include community partnerships that will be established or strengthened;
(4) strategies the county or tribe will pursue under the family stabilization services
other items prescribed by the commissioner in consultation with counties and
(c) The commissioner shall provide each county and tribe with information needed
to complete an agreement, including: (1) information on MFIP cases in the county or
tribe; (2) comparisons with the rest of the state; (3) baseline performance on outcome
measures; and (4) promising program practices.
(d) The service agreement must be submitted to the commissioner by October 15,
2003, and October 15 of each second year thereafter. The county or tribe must allow
a period of not less than 30 days prior to the submission of the agreement to solicit
comments from the public on the contents of the agreement.
(e) The commissioner must, within 60 days of receiving each county or tribal service
agreement, inform the county or tribe if the service agreement is approved. If the service
agreement is not approved, the commissioner must inform the county or tribe of any
revisions needed prior to approval.
(f) The service agreement in this subdivision supersedes the plan requirements
Sec. ... Minnesota Statutes 2006, section 256J.626, subdivision 5, is amended to read:
Subd. 5. Innovation projects.
Beginning January 1, 2005, no more than $3,000,000
of the funds annually appropriated to the commissioner for use in the consolidated
fund shall be available to the commissioner for projects testing innovative approaches
to improving outcomes for MFIP participants, family stabilization services program
and persons at risk of receiving MFIP as detailed in subdivision 3, and
11.1for providing incentives to counties and tribes that exceed performance
. Projects shall
be targeted to geographic areas with poor outcomes as specified in section
, or to subgroups within the MFIP case load who are experiencing poor
outcomes. For purposes of an incentive, a county or tribe exceeds performance if the
11.5county or tribe is above the top of the county's or tribe's annualized range of expected
11.6performance on the three-year self-support index under section 256J.751, subdivision 2,
11.7clause (7), and achieves a 50 percent TANF participation rate under section 256J.751,
11.8subdivision 2, clause (7), as averaged across the four quarterly measurements for the most
11.9recent year for which the measurements are available.
Page 35, line 27, after "care
" insert "licensed
Page 37, line 34, delete "and
" and insert "(5) except as provided in clause (6),
11.12information from the national crime information system when the commissioner has
11.13reasonable cause as defined under section 245C.05, subdivision 5; and
Page 37, line 35, delete "(5)
" and insert "(6)
Page 43, line 33, delete "chapters 245A and 245C
" and insert "section 245C.33
Page 44, delete lines 8 to 10 and insert "(c) Except for emergency placements
11.17provided for in section 245A.035, a completed background study is required under section
11.18245C.33 before the approval of an adoptive placement in a home.
Page 48, delete section 27
Page 51, line 2, delete "Consistent
Page 51, delete lines 3 to 5 and insert "Consistent with section 245C.33 and Public
11.22Law 109-248, a complete background study is required before the approval of an adoptive
11.23placement in a home.
Page 51, delete section 30
Page 53, line 36, after "or
" insert "the
Page 54, delete lines 4 to 6
Page 55, delete lines 28 to 31, and insert "Except for emergency placement as
11.28provided for in section 245A.035, a completed background study is required under section
11.29245C.08 before the approval of a foster placement in a related or an unrelated home.
Page 63, after line 22 insert:
"Sec. 9. Minnesota Statutes 2006, section 256.969, is amended by adding a subdivision
11.33 Subd. 28. Long-term hospital payment adjustment. For admissions occurring on
11.34or after July 1, 2009, the commissioner shall increase the medical assistance payments
11.35to a long-term hospital with a medical assistance inpatient utilization rate of 17.95
11.36percent of total patient days as of the base year in effect on July 1, 2005, by an amount
12.1equal to 13 percent of the total of the operating and property payment rates. Payments
12.2made to managed care plans shall not reflect this payment increase. For purposes of
12.3this subdivision, medical assistance does not include general assistance medical care.
12.4Payments to a hospital under this subdivision shall be reduced by the amount of any
12.5payments made under subdivision 27.
Page 64, delete section 8
Page 65, delete section 11
Page 67, after line 3, insert:
"Sec. 12. Minnesota Statutes 2006, section 256B.0625, is amended by adding a
subdivision to read:
12.11 Subd. 39a. Influenza vaccine. The commissioner of human services shall reimburse
12.12providers for administration of influenza vaccine to enrollees at the payment rate set by
12.13the Medicare program.
Page 74, line 11, delete everything after "area
Page 74, delete line 12
Page 74, line 13, delete everything before "must
Page 81, after line 17, insert:
"Sec. 24. GRANT FOR TOLL-FREE HEALTH CARE ACCESS NUMBER.
12.19 The commissioner of human services shall award a grant to the Neighborhood
12.20Health Care Network to pay the costs of maintaining and staffing a toll-free telephone
12.21number to provide callers with information on health coverage options, eligibility for
12.22MinnesotaCare and other health care programs, and health care providers that offer free or
12.23reduced-cost health care services.
Page 86, after line 16, insert:
"Sec. .... Minnesota Statutes 2006, section 252.46, is amended by adding a subdivision
12.27 Subd. 22. Provider rate increase; St. Louis County. A day training and
12.28habilitation provider in St. Louis County licensed to provide services to up to 80
12.29individuals shall receive a per diem rate increase that does not exceed 95 percent of the
12.30greater of 125 percent of the current statewide median or 125 percent of the regional
12.31average per diem rate, whichever is higher.
Sec. .... Minnesota Statutes 2006, section 256.01, is amended by adding a subdivision
13.1 Subd. 23. Disability linkage line. The commissioner shall establish the Disability
13.2Linkage Line, a statewide consumer information, referral, and assistance system for
13.3people with disabilities and chronic illnesses that:
13.4 (1) provides information about state and federal eligibility requirements, benefits,
13.5and service options;
13.6 (2) makes referrals to appropriate support entities;
13.7 (3) delivers information and assistance based on national and state standards;
13.8 (4) assists people to make well-informed decisions; and
13.9 (5) supports the timely resolution of service access and benefit issues.
Page 89, after line 18 insert:
"Sec. ... Minnesota Statutes 2006, section 256B.056, subdivision 1a, is amended to
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
13.183, 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
for home and community-based waiver services whose eligibility for medical assistance
is determined without regard to parental income, child support payments, including any
payments made by an obligor in satisfaction of or in addition to a temporary or permanent
order for child support, and Social Security payments are not counted as income. For
families and children, which includes all other eligibility categories, the methodologies
under the state's AFDC plan in effect as of July 16, 1996, as required by the Personal
Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), Public
Law 104-193, shall be used, except that effective October 1, 2003, the earned income
disregards and deductions are limited to those in subdivision 1c. For these purposes, a
"methodology" does not include an asset or income standard, or accounting method, or
method of determining effective dates. "
Page 90, after line 12 insert:
"(f) When a person enrolled in medical assistance under section 256B.057,
13.34subdivision 9, reaches age 65 and has been enrolled during each of the 24 consecutive
13.35months before the person's 65th birthday, the assets owned by the person and the person's
13.36spouse must be disregarded, up to the limits of section 256B.057, subdivision 9, paragraph
14.1(b), when determining eligibility for medical assistance under section 256B.055,
14.2subdivision 7. The income of a spouse of a person enrolled in medical assistance under
14.3section 256B.057, subdivision 9, during each of the 24 consecutive months before the
14.4person's 65th birthday must be disregarded when determining eligibility for medical
14.5assistance under section 256B.055, subdivision 7, when the person reaches age 65. This
14.6paragraph does not apply at the time the person or the person's spouse requests medical
14.7assistance payment for long-term care services.
Page 90, after line 26 insert:
"Sec. ... Minnesota Statutes 2006, section 256B.0621, subdivision 11, is amended to
Subd. 11. Data use agreement; notice of relocation assistance.
execute a data use agreement with the Centers for Medicare and Medicaid Services
14.13 to obtain the long-term care minimum data set data to assist residents of nursing facilities
14.14 who have establish a process with the Centers for Independent Living that allows a person
14.15residing in a Minnesota nursing facility to receive needed information, consultation, and
14.16assistance from one of the centers about the available community support options that may
14.17enable the person to relocate to the community, if the person: (1) is under the age of 65,
indicated a desire to live in the community
. The commissioner shall in turn enter
14.19 into agreements with the Centers for Independent Living to provide information about
14.20 assistance for persons who want to move to the community. The commissioner shall work
14.21 with the Centers for Independent Living on both the content of the information to be
14.22 provided and privacy protections for the individual residents, and (3) has signed a release
14.23of information authorized by the person or the person's appointed legal representative.
14.24The process established under this subdivision shall be coordinated with the long-term
14.25care consultation service activities established in section 256B.0911
Page 96, after line 25 insert:
"Sec. 15. Minnesota Statutes 2006, section 256B.0911, subdivision 3a, is amended to
Subd. 3a. Assessment and support planning.
(a) Persons requesting assessment,
services planning, or other assistance intended to support community-based living,
14.31including persons who need assessment in order to determine waiver or alternative care
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
(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
(c) The long-term care consultation team must assess the health and social needs of
the person, using an assessment form provided by the commissioner.
(d) The team must conduct the assessment in a face-to-face interview with the
person being assessed and the person's legal representative, if applicable.
(e) The team must provide the person, or the person's legal representative, with
written recommendations for facility- or community-based services. The team must
document that the most cost-effective alternatives available were offered to the individual.
For purposes of this requirement, "cost-effective alternatives" means community services
and living arrangements that cost the same as or less than nursing facility care.
(f) If the person chooses to use community-based services, the team must provide
the person or the person's legal representative with a written community support plan,
regardless of whether the individual is eligible for Minnesota health care programs.
The person may request assistance in developing a community support plan without
participating in a complete assessment.
(g) The person has the right to make the final decision between nursing facility
15.18placement and community placement after the screening team's recommendation, except
15.19as provided in subdivision 4a, paragraph (c).
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
15.24selects nursing facility placement
15.25 (2) the role of the long term care consultation assessment and support planning in
15.26waiver and alternative care program eligibility determination;
information about Minnesota health care programs;
the person's freedom to accept or reject the recommendations of the team;
the person's right to confidentiality under the Minnesota Government Data
Practices Act, chapter 13; and
15.31 (6) the long term care consultant's decision regarding the person's need for nursing
15.32facility level of care;
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
256.045, subdivision 3
16.1 (i) Face-to-face assessment completed as part of eligibility determination for
16.2the alternative care, elderly waiver, community alternatives for disabled individuals,
16.3community alternative care, and traumatic brain injury waiver programs under sections
16.4256B.0915, 256B.0917, and 256B.49 is valid to establish service eligibility for no more
16.5than 60 calendar days after the date of assessment. The effective eligibility start date
16.6for these programs can never be prior to the date of assessment. If an assessment was
16.7completed more than 60 days before the effective waiver or alternative care program
16.8eligibility start date, assessment and support plan information must be updated in a
16.9face-to-face visit and documented in the department's Medicaid Management Information
16.10System (MMIS). The effective date of program eligibility in this case cannot be prior to
16.11the date the updated assessment is completed.
Sec. 16. Minnesota Statutes 2006, section 256B.0911, subdivision 3b, is amended to
Subd. 3b. Transition assistance.
(a) A long-term care consultation team shall
provide assistance to persons residing in a nursing facility, hospital, regional treatment
center, or intermediate care facility for persons with developmental disabilities who
request or are referred for assistance. Transition assistance must include assessment,
community support plan development, referrals to Minnesota health care programs,
and referrals to programs that provide assistance with housing. Transition assistance
16.20must also include information about the Centers for Independent Living and about other
16.21organizations that can provide assistance with relocation efforts, and information about
16.22contacting these organizations to obtain their assistance and support.
(b) The county shall develop transition processes with institutional social workers
and discharge planners to ensure that:
(1) persons admitted to facilities receive information about transition assistance
that is available;
(2) the assessment is completed for persons within ten working days of the date of
request or recommendation for assessment; and
(3) there is a plan for transition and follow-up for the individual's return to the
community. The plan must require notification of other local agencies when a person
who may require assistance is screened by one county for admission to a facility located
in another county.
(c) If a person who is eligible for a Minnesota health care program is admitted to a
nursing facility, the nursing facility must include a consultation team member or the case
manager in the discharge planning process."
Page 97, line 6, after the period insert "The consultation is to be performed in a
17.2manner which provides objective and complete information.
Page 97, line 19, after the period insert "Regardless of the consultation, prospective
17.4residents maintain the right to choose housing with services or assisted living, if that is
Page 113, after line 18 insert:
"Sec. ... Minnesota Statutes 2006, section 256B.095, is amended to read:
17.8256B.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,
(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
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
. 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
. The new system
shall establish a quality assurance process under section
. The provisions of
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
17.35 (d) Effective July 1, 2007, the quality assurance system may be expanded to include
17.36programs for persons with disabilities and older adults.
Sec. ... 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
15.059, subdivision 5
, the commission expires on June 30,
Sec. ... [256B.096] QUALITY MANAGEMENT; ASSURANCE; AND
18.16IMPROVEMENT SYSTEM FOR MINNESOTANS RECEIVING DISABILITY
18.18 Subdivision 1. Scope. In order to improve the quality of services provided to
18.19Minnesotans with disabilities and to meet the requirements of the federally approved home
18.20and community-based waivers under section 1915c of the Social Security Act, a statewide
18.21quality assurance and improvement system for Minnesotans receiving disability services
18.22shall be developed. The disability services included are the home and community-based
18.23services waiver programs for persons with developmental disabilities under section
18.24256B.092, subdivision 4, and persons with disabilities under section 256B.49.
18.25 Subd. 2. Stakeholder advisory group. The commissioner shall consult with a
18.26stakeholder advisory group on the development and implementation of the state quality
18.27management, assurance, and improvement system, including representatives from:
18.28disability service recipients, disability service providers, disability advocacy groups,
18.29county human service agencies, and state agency staff from the Departments of Human
18.30Services and Health and ombudsman for mental health and developmental disabilities on
18.31the development of a statewide quality assurance and improvement system.
18.32 Subd. 3. Annual survey of service recipients. The commissioner, in consultation
18.33with the stakeholder advisory group, shall develop and conduct an annual independent
18.34random statewide survey of between five and ten percent of service recipients to determine
18.35the effectiveness and quality of disability services. The survey shall be consistent with
19.1the system performance expectations of the Centers for Medicare and Medicaid Services
19.2quality management requirements and framework. The survey shall analyze whether
19.3desired outcomes have been achieved for persons with different demographic, diagnostic,
19.4health, and functional needs and receiving different types of services, in different settings,
19.5with different costs. The survey shall be field tested during 2008 and implemented by
19.6February 1, 2009. Annual statewide and regional reports of the results shall be published
19.7for use by regions, counties, and providers to plan and measure the impact of quality
19.9 Subd. 4. Improvements for incident reporting, investigation, analysis, and
19.10follow-up. In consultation with the stakeholder group, the commissioner shall identify
19.11the information, data sources, and technology needed to improve the system of incident
19.13 (1) reports made under the Maltreatment of Minors and Vulnerable Adults Acts; and
19.14 (2) investigation, analysis, and follow-up for disability services.
19.15 The commissioner must ensure that the federal home and community-based waiver
19.16requirements are met and that incidents that may have jeopardized safety; health; or
19.17violated service-related assurances, civil and human rights, and other protections designed
19.18to prevent abuse, neglect, and exploitation are reviewed, investigated, and acted upon
19.19in a timely manner.
19.20 Subd. 5. Biennial report. The commissioner shall provide a biennial report to the
19.21chairs of the legislative committees with jurisdiction over health and human services
19.22policy and funding beginning January 15, 2009, on the development and activities of the
19.23quality management, assurance, and improvement system designed to meet the federal
19.24requirements under the home and community-based services waiver programs for persons
19.25with disabilities. By January 15, 2008, the commissioner shall provide a preliminary
19.26report on the priorities for meeting the federal requirements, progress on the annual
19.27survey, recommendations for improvements in the incident reporting system, and a plan
19.28for incorporating the quality assurance efforts under section 256B.095 and other regional
19.29efforts into the statewide system.
Page 114, after line 17, insert:
"Section 25. Minnesota Statutes 2006, section 256B.434, subdivision 4, is amended to
Subd. 4. Alternate rates for nursing facilities.
(a) For nursing facilities which
have their payment rates determined under this section rather than section
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
(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
, 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, 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
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
(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
21.8 (e) Notwithstanding the threshold in section 256B.431, subdivision 16, facilities that
21.9take action to come into compliance with existing or pending requirements of the life
21.10safety code provisions governing sprinkler systems shall receive reimbursement for the
21.11costs associated with compliance if all of the following conditions are met:
21.12 (1) the expenses associated with compliance occurred on or after January 1, 2005,
21.13and before December 31, 2008;
21.14 (2) the costs were not otherwise reimbursed under section 144A.071, 144A.073,
21.15or 256B.434, subdivision 4f; and
21.16 (3) the total allowable costs reported under this paragraph are less than the minimum
21.17threshold established under section 256B.431, subdivision 15, paragraph (e), and
21.19The commissioner shall use funds appropriated for this purpose to provide to qualifying
21.20nursing facilities a rate adjustment beginning October 1, 2007, and ending September
21.2130, 2008. Nursing facilities that have expended funds or anticipate the need to expend
21.22funds to satisfy the most recent life safety code requirements by (1) installing a sprinkler
21.23system or (2) replacing all or portions of an existing sprinkler system may submit to the
21.24commissioner by June 30, 2007, on a form provided by the commissioner the actual
21.25costs of a completed project or the estimated costs, based on a project bid, of a planned
21.26project. The commissioner shall calculate a rate adjustment equal to the allowable costs
21.27of the project divided by the resident days reported for the report year ending September
21.2830, 2006. If the costs from all projects exceed the appropriation for this purpose, the
21.29commissioner shall allocate the funds appropriated on a pro rata basis to the qualifying
21.30facilities by reducing the rate adjustment determined for each facility by an equal
21.31percentage. If the commissioner determines that there are any unexpended funds for the
21.32purposes of this paragraph, the commissioner may allocate the remainder of the funds to
21.33the qualifying facilities on a pro rata basis for other physical plant changes required by the
21.34nursing facility in order to meet the most recent life safety code compliance standards.
21.35Facilities that used estimated costs when requesting the rate adjustment shall report to
21.36the commissioner by January 31, 2009, on the use of these funds on a form provided by
22.1the commissioner. If the nursing facility fails to provide the report, the commissioner
22.2shall recoup the funds appropriated to the facility for this purpose. If the facility reports
22.3expenditures allowable under this subdivision that are less than the amount received in the
22.4facility's annualized rate adjustment, the commissioner shall recoup the difference.
Page 115, after line 32, insert:
"Sec. 30. Minnesota Statutes 2006, section 256B.434, is amended by adding a
subdivision to read:
22.8 Subd. 4i. Facility rate increase. For the rate year beginning July 1, 2007, and for
22.9the rate year beginning October 1, 2007, a nursing facility in Faribault County licensed
22.10for 50 beds as of April 19, 2006, shall receive a rate increase of $2.64 in each case mix
22.11payment rate to offset property tax payments due as a result of the facility's conversion
22.12from nonprofit to for-profit status. The increase under this subdivision shall be added to
22.13the payment rates in effect for the facility on June 30, 2007, and shall be included in
22.14the facility's total payment rates for the purposes of determining future rates under this
22.15section or any other section.
Page 116, line 3, delete "five
" and insert "three
Page 117, after line 22 insert:
"Sec. .... Minnesota Statutes 2006, section 256B.438, subdivision 3, is amended to read:
Subd. 3. Case mix indices.
(a) The commissioner of human services shall assign a
case mix index to each resident class based on the Centers for Medicare and Medicaid
Services staff time measurement study and adjusted for Minnesota-specific wage indices.
The case mix indices assigned to each resident class shall be published in the Minnesota
State Register at least 120 days prior to the implementation of the 34 group, RUG-III
resident classification system.
(b) An index maximization approach shall be used to classify residents.
(c) After implementation of the revised case mix system, the commissioner of
22.27 human services may annually rebase case mix indices and base rates using more current
22.28 data on average wage rates and staff time measurement studies. This rebasing shall be
22.29 calculated under subdivision 7, paragraph (b). The commissioner shall publish in the
22.30 Minnesota State Register adjusted case mix indices at least 45 days prior to the effective
22.31 date of the adjusted case mix indices.
Page 118, after line 11 insert:
"Sec. ... 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
(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
(iii) promote cost-effective options to institutional care; and
(iv) obtain federal financial participation.
(b) The provision of waivered services to medical assistance recipients with
disabilities shall comply with the requirements outlined in the federally approved
applications for home and community-based services and subsequent amendments,
including provision of services according to a service plan designed to meet the needs of
the individual. For purposes of this section, the approved home and community-based
application is considered the necessary federal requirement.
(c) The commissioner shall provide interested persons serving on agency advisory
task forces, the Centers for Independent Living,
, with to be on a list to receive,
notice of, and an opportunity to comment on,
23.19at least 30 days before any effective dates, (1)
any substantive changes to the state's
23.20disability services provider 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. ... Minnesota Statutes 2006, section 256B.49, is amended by adding a subdivision
23.31 Subd. 16a. Medical assistance reimbursement. (a) The commissioner shall
23.32seek federal approval for medical assistance reimbursement of independent living skills
23.33services, foster care waiver service, supported employment, prevocational service,
23.34structured day service, and adult day care under the home and community-based waiver
23.35for persons with a traumatic brain injury, the community alternatives for disabled
23.36individuals waivers, and the community alternative care waivers.
24.1 (b) Medical reimbursement shall be made only when the provider demonstrates
24.2evidence of its capacity to meet basic health, safety, and protection standards through
24.3one of the methods in paragraphs (c) to (e).
24.4 (c) The provider is licensed to provide services under chapter 245B and agrees to
24.5apply these standards to services funded through the traumatic brain injury, community
24.6alternatives for disabled, or community alternative care home and community-based
24.8 (d) The local agency contracting for the services certifies on a form provided by the
24.9commissioner that the provider has the capacity to meet the individual needs as identified
24.10in each person's individual service plan. When certifying that the service provider meets
24.11the necessary provider qualifications, the local agency shall verify that the provider has
24.12policies and procedures governing the following:
24.13 (1) protection of the consumer's rights and privacy;
24.14 (2) risk assessment and planning;
24.15 (3) record keeping and reporting of incidents and emergencies with documentation
24.16of corrective action if needed;
24.17 (4) service outcomes, regular reviews of progress, and periodic reports;
24.18 (5) complaint and grievance procedures;
24.19 (6) service termination or suspension;
24.20 (7) necessary training and supervision of direct care staff that includes:
24.21 (i) documentation in personnel files of 20 hours of orientation training in providing
24.22training related to service provision;
24.23 (ii) training in recognizing the symptoms and effects of certain disabilities, health
24.24conditions, and positive behavioral supports and interventions; and
24.25 (iii) a minimum of five hours of related training annually; and
24.26 (8) when applicable, the local agency shall verify that the provider has policies and
24.27procedures in place governing the following:
24.28 (i) safe medication administration;
24.29 (ii) proper handling of consumer funds; and
24.30 (iii) behavioral interventions that are in compliance with prohibitions and standards
24.31developed by the commissioner to meet federal requirements regarding the use of
24.32restraints and restrictive interventions.
24.33 (e) For foster care waiver services or independent living skills services, the local
24.34agency contracting for the services certifies on a form provided by the commissioner that
24.35the provider meets the following:
25.1 (1) the provider of foster care waiver services is licensed to provide adult foster
25.2care under Minnesota Rules, parts 9555.5105 to 9555.6265, or child foster care under
25.3Minnesota Rules, parts 2960.3000 to 2960.3230;
25.4 (2) the provider of independent living skills services also provides licensed foster
25.5care services and agrees to apply the following foster care standards: Minnesota Rules,
25.6parts 9555.5105; 9555.5705, subpart 2; 9555.6167; 9555.6185; 9555.6195; 9555.6225,
25.7subpart 8; 9555.6245; 9555.6255; and 9555.6265, or parts 2960.3010; 2960.3080, subparts
25.810 and 11; 2960.3210; 2960.3220, subparts 5 to 7; and 2960.3230, for the provision of
25.9those services; and
25.10 (3) the provider has policies and procedures applying to the provision of foster
25.11care waiver services or independent living skills services that govern (i) behavioral
25.12interventions that are in compliance with prohibitions and standards developed by the
25.13commissioner to meet federal requirements regarding the use of restraints and restrictive
25.14interventions and (ii) documentation of service needs and outcomes, regular reviews
25.15of progress, and periodic reports.
25.16 (f) The local agency shall review each provider's continued compliance with
25.17the basic health, safety, and protection standards on a regular basis. For the review
25.18of paragraph (e), the local agency shall coordinate the review with the county review
25.19of foster care licensure.
25.20EFFECTIVE DATE.This section is effective the day following final enactment.
Page 119, after line 19 insert:
"Sec. .... Minnesota Statutes 2006, section 256B.5012, is amended by adding a
subdivision to read:
25.24 Subd. 8. Facility rate increase; Chisholm. Notwithstanding any law or rule to the
25.25contrary, a six-bed ICF/MR in Chisholm, Range Center 3, shall receive an incremental
25.26rate increase to $274.50 for the rate year beginning July 1, 2007.
Sec. .... Minnesota Statutes 2006, section 256B.5012, is amended by adding a
subdivision to read:
25.29 Subd. 9. Facility rate increase; Hibbing. Notwithstanding any law or rule to
25.30the contrary, a six-bed ICF/MR in Hibbing, Range Center Mapleview, shall receive an
25.31incremental rate increase to $250.84 for the rate year beginning July 1, 2007.
Page 121, line 34, strike "January 1, 2008" and insert "July 1, 2009
Page 132, line 27, delete the new language and reinstate the stricken language
Page 132, line 28, reinstate the stricken language
Page 132, line 29, delete the new language
Page 132, delete line 30
Page 132, line 31, delete the new language
Page 133, line 23, delete "1h
" and insert "1n
Page 133, line 26, delete "1h
" and insert "1n
Page 137, after line 7 insert:
"Sec. ... DENTAL ACCESS FOR PERSONS WITH DISABILITIES.
26.7 The commissioner of human services shall study access to dental services for
26.8persons with disabilities, and shall present recommendations for improving access to
26.9dental services to the legislature by January 15, 2008. The study must examine physical
26.10and geographic access, the willingness of dentists to serve persons with disabilities
26.11enrolled in state health care programs, reimbursement rates for dental service providers,
26.12and other factors identified by the commissioner.
Sec. ... COMMISSIONER REQUIRED TO SEEK FEDERAL APPROVAL.
26.14 By October 1, 2007, the commissioner shall seek federal approval to allow persons
26.15who have been eligible for medical assistance for employed persons with disabilities
26.16(MA-EPD) under Minnesota Statutes, section 256B.057, subdivision 9, for each of the 24
26.17consecutive months prior to becoming age 65 to continue using the MA-EPD eligibility
26.18rules as long as they qualify.
Page 138, after line 13 insert:
"Sec. 2. Minnesota Statutes 2006, section 245.50, subdivision 5, is amended to read:
Subd. 5. Special contracts; bordering states.
(a) An individual who is detained,
committed, or placed on an involuntary basis under chapter 253B may be confined or
treated in a bordering state pursuant to a contract under this section. An individual who is
detained, committed, or placed on an involuntary basis under the civil law of a bordering
state may be confined or treated in Minnesota pursuant to a contract under this section. A
peace or health officer who is acting under the authority of the sending state may transport
an individual to a receiving agency that provides services pursuant to a contract under
this section and may transport the individual back to the sending state under the laws
of the sending state. Court orders valid under the law of the sending state are granted
recognition and reciprocity in the receiving state for individuals covered by a contract
under this section to the extent that the court orders relate to confinement for treatment
or care of mental illness or chemical dependency. Such treatment or care may address
other conditions that may be co-occurring with the mental illness or chemical dependency.
These court orders are not subject to legal challenge in the courts of the receiving state.
Individuals who are detained, committed, or placed under the law of a sending state and
who are transferred to a receiving state under this section continue to be in the legal
custody of the authority responsible for them under the law of the sending state. Except
in emergencies, those individuals may not be transferred, removed, or furloughed from
a receiving agency without the specific approval of the authority responsible for them
under the law of the sending state.
(b) While in the receiving state pursuant to a contract under this section, an
individual shall be subject to the sending state's laws and rules relating to length of
confinement, reexaminations, and extensions of confinement. No individual may be sent
to another state pursuant to a contract under this section until the receiving state has
enacted a law recognizing the validity and applicability of this section.
(c) If an individual receiving services pursuant to a contract under this section leaves
the receiving agency without permission and the individual is subject to involuntary
confinement under the law of the sending state, the receiving agency shall use all
reasonable means to return the individual to the receiving agency. The receiving agency
shall immediately report the absence to the sending agency. The receiving state has the
primary responsibility for, and the authority to direct, the return of these individuals
within its borders and is liable for the cost of the action to the extent that it would be
liable for costs of its own resident.
(d) Responsibility for payment for the cost of care remains with the sending agency.
(e) This subdivision also applies to county contracts under subdivision 2 which
include emergency care and treatment provided to a county resident in a bordering state.
27.22 (f) If a Minnesota resident is admitted to a facility in a bordering state under this
27.23chapter, a physician, licensed psychologist who has a doctoral degree in psychology, or
27.24an advance practice registered nurse certified in mental health, who is licensed in the
27.25bordering state, may act as an examiner under sections 253B.07, 253B.08, 253B.092,
27.26253B.12, and 253B.17 subject to the same requirements and limitations in section
27.27253B.02, subdivision 7.
Page 139, after line 25 insert:
"Sec. 6. Minnesota Statutes 2006, section 256B.0625, subdivision 20, is amended to
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
, the Comprehensive Adult and Children's Mental Health Acts, Minnesota
, 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
, excluding subparts 6 and 10.
(c) Medical assistance and MinnesotaCare payment for mental health case
management shall be made on a monthly basis. In order to receive payment for an eligible
child, the provider must document at least a face-to-face contact with the child, the child's
parents, or the child's legal representative. To receive payment for an eligible adult, the
provider must document:
(1) at least a face-to-face contact with the adult or the adult's legal representative; or
(2) at least a telephone contact with the adult or the adult's legal representative and
document a face-to-face contact with the adult or the adult's legal representative within
the preceding two months.
(d) Payment for mental health case management provided by county or state staff
shall be based on the monthly rate methodology under section
256B.094, subdivision 6
paragraph (b), with separate rates calculated for child welfare and mental health, and
within mental health, separate rates for children and adults.
(e) Payment for mental health case management provided by Indian health services
or by agencies operated by Indian tribes may be made according to this section or other
relevant federally approved rate setting methodology.
(f) Payment for mental health case management provided by vendors who contract
with a county or Indian tribe shall be based on a monthly rate negotiated by the host county
or tribe. The negotiated rate must not exceed the rate charged by the vendor for the same
service to other payers. If the service is provided by a team of contracted vendors, the
county or tribe may negotiate a team rate with a vendor who is a member of the team. The
team shall determine how to distribute the rate among its members. No reimbursement
received by contracted vendors shall be returned to the county or tribe, except to reimburse
the county or tribe for advance funding provided by the county or tribe to the vendor.
(g) If the service is provided by a team which includes contracted vendors, tribal
staff, and county or state staff, the costs for county or state staff participation in the team
shall be included in the rate for county-provided services. In this case, the contracted
vendor, the tribal agency, and the county may each receive separate payment for services
provided by each entity in the same month. In order to prevent duplication of services,
each entity must document, in the recipient's file, the need for team case management and
a description of the roles of the team members.
(h) The commissioner shall calculate the nonfederal share of actual medical
assistance and general assistance medical care payments for each county, based on the
higher of calendar year 1995 or 1996, by service date, project that amount forward to 1999,
and transfer one-half of the result from medical assistance and general assistance medical
care to each county's mental health grants under section
for calendar year 1999.
The annualized minimum amount added to each county's mental health grant shall be
$3,000 per year for children and $5,000 per year for adults. The commissioner may reduce
the statewide growth factor in order to fund these minimums. The annualized total amount
transferred shall become part of the base for future mental health grants for each county.
(i) Notwithstanding section
256B.19, subdivision 1
, the nonfederal share of costs
for mental health case management shall be provided by the recipient's county of
responsibility, as defined in sections
, 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
29.15service is paid by the state without a federal share through fee-for-service, 50 percent of
29.16the cost shall be provided by the recipient's county of responsibility.
29.17 (j) Notwithstanding any administrative rule to the contrary, MinnesotaCare includes
29.18mental health case management. When the service is provided through prepaid capitation,
29.19the nonfederal share is paid by the state and the county pays no share.
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
, or, if applicable, the tribal
agency, is responsible for any federal disallowances. The county or tribe may share this
responsibility with its contracted vendors.
The commissioner shall set aside a portion of the federal funds earned under
this section to repay the special revenue maximization account under section
, clause (15). The repayment is limited to:
(1) the costs of developing and implementing this section; and
(2) programming the information systems.
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. Payments to county-contracted vendors shall include
earnings, the state share,
and the county share.
, county payments for the cost of mental
health case management services provided by county or state staff shall not be made
to the commissioner of finance. For the purposes of mental health case management
services provided by county or state staff under this section, the centralized disbursement
of payments to counties under section
consists only of federal earnings from
services provided under this section.
Case management services under this subdivision do not include therapy,
treatment, legal, or outreach services.
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
Payment for case management services under this subdivision shall not
duplicate payments made under other program authorities for the same purpose.
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
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.
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.
The adjustments in paragraphs (s) and (t) shall be calculated separately for
children and adults.
Sec. 7. Minnesota Statutes 2006, section 256B.0625, subdivision 47, is amended to
Subd. 47. Treatment foster care services.
Effective July 1,
, and subject
to federal approval, medical assistance covers treatment foster care services according to
Page 140, after line 7 insert:
"Sec. 8. Minnesota Statutes 2006, section 256B.763, is amended to read:
31.3256B.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,
(1) psychiatrists and advanced practice registered nurses with a psychiatric specialty;
(2) community mental health centers under section
, subdivision 5; and
(3) mental health clinics and centers certified under Minnesota Rules, parts
, or hospital outpatient psychiatric departments that are designated
as essential community providers under section
(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
(c) This increase does not apply to rates that are governed by section
subdivision 30, or
, 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 (a). The prepaid
health plan must pass this rate increase to the providers identified in
(a), (e), and (f)
. The prepaid plan must pass this rate increase to the providers identified in
31.25paragraphs (a), (e), and (f).
31.26 (e) For MinnesotaCare only, payment rates shall be increased by 23.7 percent over
31.27the rates in effect on December 31, 2007, for:
31.28 (1) medication education services provided on or after January 1, 2008, by adult
31.29rehabilitative mental health services providers certified under section 256B.0623; and
31.30 (2) mental health behavioral aide services provided on or after January 1, 2008, by
31.31children's therapeutic services and support providers certified under section 256B.0943.
31.32 (f) For services defined in paragraph (b) and rendered on or after January 1, 2008, by
31.33children's therapeutic services and support providers certified under section 256B.0943
31.34and not already included in paragraph (a), payment rates for MinnesotaCare shall be
31.35increased by 23.7 percent over the rates in effect on December 31, 2007.
Page 140, after line 22 insert:
""Covered health services" also includes intensive mental health outpatient treatment
32.2for dialectical behavioral therapy for adults.
Page 143, after line 21 insert:
"Sec. 13. CASE MANAGEMENT; BEST PRACTICES.
32.5 The commissioner of human services in consultation with consumers, families,
32.6counties, and other interested stakeholders will develop recommendations for changes in
32.7the adult mental health act related to case management, consistent with evidence-based
32.8and best practices.
Sec. 14. REGIONAL CHILDREN'S MENTAL HEALTH INITIATIVE.
32.10 Subdivision 1. Pilot project authorized; purpose. A two-year Regional Children's
32.11Mental Health Initiative pilot project is established to improve children's mental health
32.12service coordination, communication, and processes in Blue Earth, Brown, Faribault,
32.13Freeborn, Le Sueur, Martin, Nicollet, Rice, Sibley, Waseca, and Watonwan Counties. The
32.14purpose of the Regional Children's Mental Health Initiative will be to plan and develop
32.15new programs and services related to children's mental health in South Central Minnesota.
32.16 Subd. 2. Goals. To accomplish its purpose, the Regional Children's Mental Health
32.17Initiative shall have the following goals:
32.18 (1) work to streamline delivery and regional access to services;
32.19 (2) share strategies and resources for the management of out-of-home placements;
32.20 (3) establish standard protocols and operating procedures for functions that are
32.21performed across all counties;
32.22 (4) share information to improve resource allocation and service delivery across
32.24 (5) evaluate outcomes of various treatment alternatives;
32.25 (6) create a network for and provide support to service delivery groups;
32.26 (7) establish a regional process to match children in need of out-of-home placement
32.27with foster homes that can meet their needs; and
32.28 (8) recruit and retain foster homes.
32.29 Subd. 3. Director's Council. The Director's Council shall govern the operations of
32.30the Regional Children's Mental Health Initiative. Members of the Director's Council shall
32.31represent each of the 11 counties participating in the pilot project.
32.32 Subd. 4. Regional Children's Mental Health Initiative Team. The members of the
32.33Regional Children's Mental Health Initiative team shall conduct planning and development
32.34of new and modified children's mental health programs and services in the region.
33.1Members of the team shall reflect the cultural, demographic, and geographic diversity of
33.2the region and shall be composed of representatives from each of the following:
33.3 (1) the medical community;
33.4 (2) human services;
33.5 (3) corrections;
33.6 (4) education;
33.7 (5) mental health providers and vendors;
33.8 (6) advocacy organizations;
33.9 (7) parents; and
33.10 (8) children and youth.
33.11 Subd. 5. Authority. The Regional Children's Mental Health Initiative shall have the
33.12authority to develop and implement the following programs:
33.13 (1) Flexible funding payments. This program will make funds available to respond to
33.14the unique and unpredictable needs of children with mental health issues such as the need
33.15for prescription drugs, transportation, clothing, and assessments not otherwise available.
33.16 (2) Transition to self-sufficiency. This program will help youths between the ages of
33.1714 and 21 establish professional relationships, find jobs, build financial foundations, and
33.18learn to fulfill their roles as productive citizens.
33.19 (3) Crisis response. This program will establish public and private partnerships
33.20to offer a range of options to meet the needs of children in crisis. Methods to meet
33.21these needs may include accessible local services, holistic assessments, urgent care and
33.22stabilization services, and telehealth for specialized diagnosis and therapeutic sessions.
33.23 (4) Integrated services for complex conditions. This program will design, develop,
33.24and implement packages of integrated services to meet the needs of children with specific,
33.26 Subd. 6. Evaluation and report. The Regional Children's Mental Health Initiative
33.27shall develop a method for evaluating the effectiveness of this pilot project focusing on
33.28identifiable goals and outcomes. An interim report on the pilot's effectiveness shall be
33.29submitted to the house and senate finance committees having jurisdiction over mental
33.30health, the commissioner of human services, and the Minnesota Association of County
33.31Social Service Administrators no later than December 31, 2008. A final report is due no
33.32later than December 31, 2009.
Page 144, line 14, delete "two
" and insert "three
" and delete "impact
" and insert
Page 144, line 17, delete "impact
" and insert "effect
Page 160, after line 8, insert:
"Sec. 16. [145.9269] FEDERALLY QUALIFIED HEALTH CENTERS.
34.2 Subdivision 1. Definitions. For purposes of this section, "federally qualified health
34.3center" means an entity that is receiving a grant under United States Code, title 42,
34.4section 254b, or, based on the recommendation of the Health Resources and Services
34.5Administration within the Public Health Service, is determined by the secretary to meet
34.6the requirements for receiving such a grant.
34.7 Subd. 2. Allocation of subsidies. The commissioner of health shall distribute
34.8subsidies to federally qualified health centers operating in Minnesota to continue, expand,
34.9and improve federally qualified health center services to low-income populations. The
34.10commissioner shall distribute the funds appropriated under this section to federally
34.11qualified health centers operating in Minnesota as of January 1, 2007. The amount of
34.12each subsidy shall be in proportion to each federally qualified health center's amount of
34.13discounts granted to patients during calendar year 2006 as reported on the federal Uniform
34.14Data System report in conformance with the Bureau of Primary Health Care Program
34.15Expectations Policy Information Notice 98-23, except that each eligible federally qualified
34.16health center shall receive at least two percent but no more than 30 percent of the total
34.17amount of money available under this section.
Page 163, delete section 1 and insert:
"Sec. .... [62Q.40] LANGUAGE INTERPRETER SERVICES.
34.20 (a) A health plan must cover sign language interpreter services provided to deaf and
34.21hard-of-hearing enrollees and language interpreter services provided to enrollees with
34.22limited English proficiency in order to facilitate the provision of health care services by a
34.23provider. For purposes of this section, "provider" has the meaning given in section 62J.03,
34.24subdivision 8, and includes a health care provider facility; and "health plan" includes
34.25coverage excluded under section 62A.011, subdivision 3, clauses (6), (7), (9), and (10).
34.26Interpreter services may be provided in person, by telephone, facsimile, video or audio
34.27streaming, or by video conference. In accordance with paragraphs (b) and (c), a health
34.28plan company shall reimburse either the party providing interpreter services directly
34.29for the costs of language interpreter services provided to the enrollee or the provider
34.30arranging for the provision of interpreter services. Providers that employ or contract
34.31with interpreters may bill and shall be reimbursed directly by health plan companies for
34.32such services in accordance with paragraph (b). A health plan company shall provide to
34.33enrollees, upon request, the policies and procedures for addressing the needs of deaf and
34.34hard-of-hearing enrollees and enrollees with limited English proficiency. All parties
34.35providing interpreter services must disclose their methods for ensuring competency upon
34.36request of any health plan company, provider, or consumer.
35.1 (b) A health plan company shall pay for interpreter services as required in paragraph
35.2(a) by establishing a network of interpreter service providers and requiring use of its own
35.3network of interpreter services providers. The health plan company shall consider, as part
35.4of its interpreter service provider network, entering into an agreement with a provider for
35.5use of an interpreter service provider employed by or under contract with the provider if:
35.6 (1) the provider accepts as reimbursement for services rendered by the provider's
35.7employed or contracted interpreter service provider the lesser of either the health plan
35.8company's reimbursement rate for its in-network interpreter service providers or the
35.9provider's fee for services rendered by the provider's interpreter service provider; and
35.10 (2) the interpreter service provider meets the published quality standards of the
35.11health plan company.
35.12 (c) If a health plan company's or a provider's employed or contracted interpreter
35.13service provider is unavailable to provide interpreter services, the health plan company
35.14shall reimburse the interpreter service provider at the lesser of the health plan company's
35.15median reimbursement rate for its in-network interpreter service providers or the
35.16interpreter service provider's fee. An interpreter service provider not employed or under
35.17contract with a health plan company or provider who fails to meet the quality standards
35.18of a health plan company or as required by law, shall be ineligible for reimbursement
35.19under this section.
35.20 (d) If the health plan company pays the interpreter service provider directly, it has no
35.21obligation to pay the provider under this section.
35.22 (e) Nothing in this section requires a health plan company to establish a network
35.23of interpreter service providers.
35.24EFFECTIVE DATE.This section is effective July 1, 2008, and applies to plans
35.25issued or renewed to provide coverage to Minnesota residents on or after that date unless
35.26the legislature enacts alternative funding sources based on the recommendations of the
Page 165, after line 18, insert:
"Sec. 5. 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
, 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
36.1of Human Services in mental health facilities for the treatment of psychopathic
36.2personalities, 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 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.
36.12EFFECTIVE DATE.This section is effective the day following final enactment.
Page 169, after line 5 insert:
"Sec. .... [254A.20] CHEMICAL USE ASSESSMENTS; FINANCIAL CONFLICT
36.16 (a) Except as provided in paragraph (b), an assessor conducting a chemical use
36.17assessment under Minnesota Rules, parts 9530.6600 to 9530.6655, may not have any
36.18direct or shared financial interest or referral relationship resulting in shared financial
36.19interest or referral relationship resulting in shared financial gain with a treatment provider.
36.20 (b) A county may contract with an assessor having a conflict described in paragraph
36.21(a) if the county documents that:
36.22 (1) the assessor is employed by a culturally specific service provider or a service
36.23provider with a program designed to treat individuals of a specific age, sex, or sexual
36.25 (2) the county does not employ a sufficient number of qualified assessors and the
36.26only qualified assessors available in the county have a direct or shared financial interest or
36.27a referral relationship resulting in shared financial gain with a treatment provider; or
36.28 (3) the county social service agency has an existing relationship with an assessor
36.29or service provider and elects to enter into a contract with that assessor to provide both
36.30assessment and treatment under circumstances specified in the county's contract, provided
36.31the county retains responsibility for making placement decisions.
36.32EFFECTIVE DATE.This section is effective the day following final enactment.
Page 203, after line 17, insert:
"Sec. 46. [256B.764] REIMBURSEMENT FOR FAMILY PLANNING
37.1 Effective for services rendered on or after July 1, 2007, payment rates for family
37.2planning services shall be increased by 25 percent over the rates in effect July 30, 2007,
37.3when these services are provided by a community clinic as defined in section 145.9268,
Page 205, after line 7 insert:
"Sec. 50. [525A.01] SHORT TITLE.
37.7 This chapter may be cited as the "Darlene Luther Revised Uniform Anatomical
Sec. 51. [525A.02] DEFINITIONS.
37.10 Subdivision 1. Scope. The definitions in this section apply to this chapter.
37.11 Subd. 2. Adult. "Adult" means an individual who is at least 18 years of age.
37.12 Subd. 3. Agent. "Agent" means an individual who is:
37.13 (1) authorized to make health care decisions on the principal's behalf by a power of
37.14attorney for health care; or
37.15 (2) expressly authorized to make an anatomical gift on the principal's behalf by
37.16any other record signed by the principal.
37.17 Subd. 4. Anatomical gift. "Anatomical gift" means a donation of all or part of
37.18a human body to take effect after the donor's death for the purpose of transplantation,
37.19therapy, research, or education.
37.20 Subd. 5. Decedent. "Decedent" means a deceased individual and includes a stillborn
37.21infant or an embryo or fetus that has died of natural causes in utero.
37.22 Subd. 6. Disinterested witness. "Disinterested witness" means a witness other than
37.23the spouse, child, parent, sibling, grandchild, grandparent, or guardian of the individual
37.24who makes, amends, revokes, or refuses to make an anatomical gift, or another adult who
37.25exhibited special care and concern for the individual. The term does not include a person
37.26to which an anatomical gift could pass under section 525A.11.
37.27 Subd. 7. Document of gift. "Document of gift" means a donor card or other record
37.28used to make an anatomical gift. The term includes a statement or symbol on a driver's
37.29license, identification card, or donor registry.
37.30 Subd. 8. Donor. "Donor" means an individual whose body or part is the subject of
37.31an anatomical gift.
37.32 Subd. 9. Donor registry. "Donor registry" means a database that contains records
37.33of anatomical gifts and amendments to or revocations of anatomical gifts.
38.1 Subd. 10. Driver's license. "Driver's license" means a license or permit issued
38.2under chapter 171 to operate a vehicle, whether or not conditions are attached to the
38.3license or permit.
38.4 Subd. 11. Eye bank. "Eye bank" means a person that is licensed, accredited,
38.5or regulated under federal or state law to engage in the recovery, screening, testing,
38.6processing, storage, or distribution of human eyes or portions of human eyes.
38.7 Subd. 12. Guardian. "Guardian" means a person appointed by a court to make
38.8decisions regarding the support, care, education, health, or welfare of an individual. The
38.9term does not include a guardian ad litem.
38.10 Subd. 13. Hospital. "Hospital" means a facility licensed as a hospital under the
38.11law of any state or a facility operated as a hospital by the United States, a state, or a
38.12subdivision of a state.
38.13 Subd. 14. Identification card. "Identification card" means a Minnesota
38.14identification card issued under chapter 171.
38.15 Subd. 15. Know. "Know" means to have actual knowledge.
38.16 Subd. 16. Medical examiner. "Medical examiner" includes coroner.
38.17 Subd. 17. Minor. "Minor" means an individual who is under 18 years of age.
38.18 Subd. 18. Organ procurement organization. "Organ procurement organization"
38.19means a person designated by the secretary of the United States Department of Health and
38.20Human Services as an organ procurement organization.
38.21 Subd. 19. Parent. "Parent" means a parent whose parental rights have not been
38.23 Subd. 20. Part. "Part" means an organ, an eye, or tissue of a human being. The term
38.24does not include the whole body.
38.25 Subd. 21. Person. "Person" means an individual, corporation, business trust, estate,
38.26trust, partnership, limited liability company, association, joint venture, public corporation,
38.27government or governmental subdivision, agency, or instrumentality, or any other legal or
38.29 Subd. 22. Physician. "Physician" means an individual authorized to practice
38.30medicine or osteopathy under the law of any state.
38.31 Subd. 23. Procurement organization. "Procurement organization" means an eye
38.32bank, organ procurement organization, or tissue bank.
39.1 Subd. 24. Prospective donor. "Prospective donor" means an individual who is dead
39.2or near death and has been determined by a procurement organization to have a part that
39.3could be medically suitable for transplantation, therapy, research, or education. The term
39.4does not include an individual who has made a refusal.
39.5 Subd. 25. Reasonably available. "Reasonably available" means able to be
39.6contacted by a procurement organization without undue effort and willing and able to act
39.7in a timely manner consistent with existing medical criteria necessary for the making of
39.8an anatomical gift.
39.9 Subd. 26. Recipient. "Recipient" means an individual into whose body a decedent's
39.10part has been or is intended to be transplanted.
39.11 Subd. 27. Record. "Record" means information that is inscribed on a tangible
39.12medium or that is stored in an electronic or other medium and is retrievable in perceivable
39.14 Subd. 28. Refusal. "Refusal" means a record created under section 525A.07 that
39.15expressly states an intent to bar other persons from making an anatomical gift of an
39.16individual's body or part.
39.17 Subd. 29. Sign. "Sign" means, with the present intent to authenticate or adopt
39.19 (1) to execute or adopt a tangible symbol; or
39.20 (2) to attach to or logically associate with the record an electronic symbol, sound,
39.22 Subd. 30. State. "State" means a state of the United States, the District of Columbia,
39.23Puerto Rico, the United States Virgin Islands, or any territory or insular possession subject
39.24to the jurisdiction of the United States.
39.25 Subd. 31. Technician. "Technician" means an individual determined to be qualified
39.26to remove or process parts by an appropriate organization that is licensed, accredited, or
39.27regulated under federal or state law. The term includes an enucleator.
39.28 Subd. 32. Tissue. "Tissue" means a portion of the human body other than an organ
39.29or an eye. The term does not include blood unless the blood is donated for the purpose
39.30of research or education.
39.31 Subd. 33. Tissue bank. "Tissue bank" means a person that is licensed, accredited,
39.32or regulated under federal or state law to engage in the recovery, screening, testing,
39.33processing, storage, or distribution of tissue.
40.1 Subd. 34. Transplant hospital. "Transplant hospital" means a hospital that
40.2furnishes organ transplants and other medical and surgical specialty services required
40.3for the care of transplant patients.
Sec. 52. [525A.03] APPLICABILITY.
40.5 This chapter applies to an anatomical gift or amendment to, revocation of, or refusal
40.6to make an anatomical gift, whenever made.
Sec. 53. [525A.04] WHO MAY MAKE ANATOMICAL GIFT BEFORE
40.9 Subject to section 525A.08, an anatomical gift of a donor's body or part may be
40.10made during the life of the donor for the purpose of transplantation, therapy, research, or
40.11education in the manner provided in section 525A.05 by:
40.12 (1) the donor, if the donor is an adult or if the donor is a minor and is:
40.13 (i) emancipated; or
40.14 (ii) authorized under state law to apply for a driver's license because the donor is
40.15at least 16 years of age;
40.16 (2) an agent of the donor, unless the power of attorney for health care or other record
40.17prohibits the agent from making an anatomical gift;
40.18 (3) a parent of the donor, if the donor is an unemancipated minor; or
40.19 (4) the donor's guardian.
Sec. 54. [525A.05] MANNER OF MAKING ANATOMICAL GIFT BEFORE
40.22 (a) A donor may make an anatomical gift:
40.23 (1) by authorizing a statement or symbol indicating that the donor has made an
40.24anatomical gift to be imprinted on the donor's driver's license or identification card;
40.25 (2) in a will;
40.26 (3) during a terminal illness or injury of the donor, by any form of communication
40.27addressed to at least two adults, at least one of whom is a disinterested witness; or
40.28 (4) as provided in paragraph (b).
40.29 (b) A donor or other person authorized to make an anatomical gift under section
40.30525A.04 may make a gift by a donor card or other record signed by the donor or other
40.31person making the gift or by authorizing that a statement or symbol indicating that the
40.32donor has made an anatomical gift be included on a donor registry. If the donor or
40.33other person is physically unable to sign a record, the record may be signed by another
40.34individual at the direction of the donor or other person and must:
41.1 (1) be witnessed by at least two adults, at least one of whom is a disinterested
41.2witness, who have signed at the request of the donor or the other person; and
41.3 (2) state that it has been signed and witnessed as provided in clause (1).
41.4 (c) Revocation, suspension, expiration, or cancellation of a driver's license or
41.5identification card upon which an anatomical gift is indicated does not invalidate the gift.
41.6 (d) An anatomical gift made by will takes effect upon the donor's death whether or
41.7not the will is probated. Invalidation of the will after the donor's death does not invalidate
41.9 (e) The making of an anatomical gift shall not itself authorize or direct the denial
41.10of health care.
Sec. 55. [525A.06] AMENDING OR REVOKING ANATOMICAL GIFT
41.12BEFORE DONOR'S DEATH.
41.13 (a) Subject to section 525A.08, a donor or other person authorized to make an
41.14anatomical gift under section 525A.04 may amend or revoke an anatomical gift by:
41.15 (1) a record signed by:
41.16 (i) the donor;
41.17 (ii) the other person; or
41.18 (iii) subject to paragraph (b), another individual acting at the direction of the donor
41.19or the other person if the donor or other person is physically unable to sign; or
41.20 (2) a later-executed document of gift that amends or revokes a previous anatomical
41.21gift or portion of an anatomical gift, either expressly or by inconsistency.
41.22 (b) A record signed pursuant to paragraph (a), clause (1), item (iii), must:
41.23 (1) be witnessed by at least two adults, at least one of whom is a disinterested
41.24witness, who have signed at the request of the donor or the other person; and
41.25 (2) state that it has been signed and witnessed as provided in clause (1).
41.26 (c) Subject to section 525A.08, a donor or other person authorized to make an
41.27anatomical gift under section 525A.04 may revoke an anatomical gift by the destruction or
41.28cancellation of the document of gift, or the portion of the document of gift used to make
41.29the gift, with the intent to revoke the gift.
41.30 (d) A donor may amend or revoke an anatomical gift that was not made in a will
41.31by any form of communication during a terminal illness or injury addressed to at least
41.32two adults, at least one of whom is a disinterested witness.
41.33 (e) A donor who makes an anatomical gift in a will may amend or revoke the gift in
41.34the manner provided for amendment or revocation of wills or as provided in paragraph (a).
Sec. 56. [525A.07] REFUSAL TO MAKE ANATOMICAL GIFT; EFFECT OF
42.1 (a) An individual may refuse to make an anatomical gift of the individual's body
42.2or part by:
42.3 (1) a record signed by:
42.4 (i) the individual; or
42.5 (ii) subject to paragraph (b), another individual acting at the direction of the
42.6individual if the individual is physically unable to sign;
42.7 (2) the individual's will, whether or not the will is admitted to probate or invalidated
42.8after the individual's death; or
42.9 (3) any form of communication made by the individual during the individual's
42.10terminal illness or injury addressed to at least two adults, at least one of whom is a
42.12 (b) A record signed pursuant to paragraph (a), clause (1), item (ii), must:
42.13 (1) be witnessed by at least two adults, at least one of whom is a disinterested
42.14witness, who have signed at the request of the individual; and
42.15 (2) state that it has been signed and witnessed as provided in clause (1).
42.16 (c) An individual who has made a refusal may amend or revoke the refusal:
42.17 (1) in the manner provided in paragraph (a) for making a refusal;
42.18 (2) by subsequently making an anatomical gift pursuant to section 525A.05 that is
42.19inconsistent with the refusal; or
42.20 (3) by destroying or canceling the record evidencing the refusal, or the portion of the
42.21record used to make the refusal, with the intent to revoke the refusal.
42.22 (d) Except as otherwise provided in section 525A.08, paragraph (h), in the absence
42.23of an express, contrary indication by the individual set forth in the refusal, an individual's
42.24unrevoked refusal to make an anatomical gift of the individual's body or part bars all other
42.25persons from making an anatomical gift of the individual's body or part.
Sec. 57. [525A.08] PRECLUSIVE EFFECT OF ANATOMICAL GIFT,
42.27AMENDMENT, OR REVOCATION.
42.28 (a) Except as otherwise provided in paragraph (g) and subject to paragraph (f), in the
42.29absence of an express, contrary indication by the donor, a person other than the donor is
42.30barred from making, amending, or revoking an anatomical gift of a donor's body or part if
42.31the donor made an anatomical gift of the donor's body or part under section 525A.05 or an
42.32amendment to an anatomical gift of the donor's body or part under section 525A.06. An
42.33anatomical gift made in a will, a designation on a driver's license or identification card, or
42.34a health care directive under chapter 145C, and not revoked, establishes the intent of the
42.35person making the designation and may not be overridden by any other person.
43.1 (b) A donor's revocation of an anatomical gift of the donor's body or part under
43.2section 525A.06 is not a refusal and does not bar another person specified in section
43.3525A.04 or 525A.09 from making an anatomical gift of the donor's body or part under
43.4section 525A.05 or 525A.10.
43.5 (c) If a person other than the donor makes an unrevoked anatomical gift of the
43.6donor's body or part under section 525A.05 or an amendment to an anatomical gift of the
43.7donor's body or part under section 525A.06, another person may not make, amend, or
43.8revoke the gift of the donor's body or part under section 525A.10.
43.9 (d) A revocation of an anatomical gift of a donor's body or part under section
43.10525A.06 by a person other than the donor does not bar another person from making an
43.11anatomical gift of the body or part under section 525A.05 or 525A.10.
43.12 (e) In the absence of an express, contrary indication by the donor or other person
43.13authorized to make an anatomical gift under section 525A.04, an anatomical gift of a part
43.14is neither a refusal to give another part nor a limitation on the making of an anatomical gift
43.15of another part at a later time by the donor or another person.
43.16 (f) In the absence of an express, contrary indication by the donor or other person
43.17authorized to make an anatomical gift under section 525A.04, an anatomical gift of a
43.18part for one or more of the purposes set forth in section 525A.04 is not a limitation on
43.19the making of an anatomical gift of the part for any of the other purposes by the donor
43.20or any other person under section 525A.05 or 525A.10.
43.21 (g) If a donor who is an unemancipated minor dies, a parent of the donor who is
43.22reasonably available may revoke or amend an anatomical gift of the donor's body or part.
43.23 (h) If an unemancipated minor who signed a refusal dies, a parent of the minor who
43.24is reasonably available may revoke the minor's refusal.
Sec. 58. [525A.09] WHO MAY MAKE ANATOMICAL GIFT OF DECEDENT'S
43.26BODY OR PART.
43.27 (a) Subject to paragraphs (b) and (c) and unless barred by section 525A.07 or
43.28525A.08, an anatomical gift of a decedent's body or part for the purpose of transplantation,
43.29therapy, research, or education may be made by any member of the following classes of
43.30persons who is reasonably available, in the order of priority listed:
43.31 (1) an agent of the decedent at the time of death who could have made an anatomical
43.32gift under section 525A.04, clause (2), immediately before the decedent's death;
43.33 (2) the spouse of the decedent;
43.34 (3) adult children of the decedent;
43.35 (4) parents of the decedent;
43.36 (5) adult siblings of the decedent;
44.1 (6) adult grandchildren of the decedent;
44.2 (7) grandparents of the decedent;
44.3 (8) an adult who exhibited special care and concern for the decedent;
44.4 (9) the persons who were acting as the guardians of the person of the decedent
44.5at the time of death; and
44.6 (10) any other person having the authority to dispose of the decedent's body.
44.7 (b) If there is more than one member of a class listed in paragraph (a), clause (1),
44.8(3), (4), (5), (6), (7), or (9), entitled to make an anatomical gift, an anatomical gift may
44.9be made by a member of the class unless that member or a person to which the gift may
44.10pass under section 525A.11 knows of an objection by another member of the class. If
44.11an objection is known, the gift may be made only by a majority of the members of the
44.12class who are reasonably available.
44.13 (c) A person may not make an anatomical gift if, at the time of the decedent's death,
44.14a person in a prior class under paragraph (a) is reasonably available to make or to object to
44.15the making of an anatomical gift.
Sec. 59. [525A.10] MANNER OF MAKING, AMENDING, OR REVOKING
44.17ANATOMICAL GIFT OF DECEDENT'S BODY OR PART.
44.18 (a) A person authorized to make an anatomical gift under section 525A.09 may
44.19make an anatomical gift by a document of gift signed by the person making the gift or by
44.20that person's oral communication that is electronically recorded or is contemporaneously
44.21reduced to a record and signed by the individual receiving the oral communication.
44.22 (b) Subject to paragraph (c), an anatomical gift by a person authorized under section
44.23525A.09 may be amended or revoked orally or in a record by any member of a prior class
44.24who is reasonably available. If more than one member of the prior class is reasonably
44.25available, the gift made by a person authorized under section 525A.09 may be:
44.26 (1) amended only if a majority of the reasonably available members agree to the
44.27amending of the gift; or
44.28 (2) revoked only if a majority of the reasonably available members agree to the
44.29revoking of the gift or if they are equally divided as to whether to revoke the gift.
44.30 (c) A revocation under paragraph (b) is effective only if, before an incision has been
44.31made to remove a part from the donor's body or before invasive procedures have begun to
44.32prepare the recipient, the procurement organization, transplant hospital, or physician or
44.33technician knows of the revocation.
Sec. 60. [525A.11] PERSONS THAT MAY RECEIVE ANATOMICAL GIFT;
44.35PURPOSE OF ANATOMICAL GIFT.
45.1 (a) An anatomical gift may be made to the following persons named in the document
45.3 (1) a hospital; accredited medical school, dental school, college, or university; organ
45.4procurement organization; or nonprofit organization in medical education or research,
45.5for research or education;
45.6 (2) subject to paragraph (b), an individual designated by the person making the
45.7anatomical gift if the individual is the recipient of the part; and
45.8 (3) an eye bank or tissue bank.
45.9 (b) If an anatomical gift to an individual under paragraph (a), clause (2), cannot be
45.10transplanted into the individual, the part passes in accordance with paragraph (g) in the
45.11absence of an express, contrary indication by the person making the anatomical gift.
45.12 (c) If an anatomical gift of one or more specific parts or of all parts is made in a
45.13document of gift that does not name a person described in paragraph (a) but identifies the
45.14purpose for which an anatomical gift may be used, the following rules apply:
45.15 (1) if the part is an eye and the gift is for the purpose of transplantation or therapy,
45.16the gift passes to the appropriate eye bank;
45.17 (2) if the part is tissue and the gift is for the purpose of transplantation or therapy, the
45.18gift passes to the appropriate tissue bank;
45.19 (3) if the part is an organ and the gift is for the purpose of transplantation or therapy,
45.20the gift passes to the appropriate organ procurement organization as custodian of the
45.22 (4) if the part is an organ, an eye, or tissue and the gift is for the purpose of research
45.23or education, the gift passes to the appropriate procurement organization.
45.24 (d) For the purpose of paragraph (c), if there is more than one purpose of an
45.25anatomical gift set forth in the document of gift but the purposes are not set forth in any
45.26priority, the gift must be used for transplantation or therapy, if suitable. If the gift cannot
45.27be used for transplantation or therapy, the gift may be used for research or education.
45.28 (e) If an anatomical gift of one or more specific parts is made in a document of gift
45.29that does not name a person described in paragraph (a) and does not identify the purpose
45.30of the gift, the gift may be used only for transplantation or therapy, and the gift passes in
45.31accordance with paragraph (g).
45.32 (f) If a document of gift specifies only a general intent to make an anatomical gift
45.33by words such as "donor," "organ donor," or "body donor," or by a symbol or statement
45.34of similar import, the gift may be used only for transplantation or therapy, and the gift
45.35passes in accordance with paragraph (g).
45.36 (g) For purposes of paragraphs (b), (e), and (f), the following rules apply:
46.1 (1) if the part is an eye, the gift passes to the appropriate eye bank;
46.2 (2) if the part is tissue, the gift passes to the appropriate tissue bank; and
46.3 (3) if the part is an organ, the gift passes to the appropriate organ procurement
46.4organization as custodian of the organ.
46.5 (h) An anatomical gift of an organ for transplantation or therapy, other than
46.6an anatomical gift under paragraph (a), clause (2), passes to the organ procurement
46.7organization as custodian of the organ.
46.8 (i) If an anatomical gift does not pass pursuant to paragraphs (a) to (h) or the
46.9decedent's body or part is not used for transplantation, therapy, research, or education,
46.10custody of the body or part passes to the person under obligation to dispose of the body or
46.12 (j) A person may not accept an anatomical gift if the person knows that the gift was
46.13not effectively made under section 525A.05 or 525A.10 or if the person knows that the
46.14decedent made a refusal under section 525A.07 that was not revoked. For purposes of
46.15this paragraph, if a person knows that an anatomical gift was made on a document of gift,
46.16the person is deemed to know of any amendment or revocation of the gift or any refusal
46.17to make an anatomical gift on the same document of gift.
46.18 (k) Except as otherwise provided in paragraph (a), clause (2), nothing in this chapter
46.19affects the allocation of organs for transplantation or therapy.
Sec. 61. [525A.12] SEARCH AND NOTIFICATION.
46.21 (a) The following persons shall make a reasonable search of an individual who
46.22the person reasonably believes is dead or near death for a document of gift or other
46.23information identifying the individual as a donor or as an individual who made a refusal:
46.24 (1) a law enforcement officer, firefighter, paramedic, or other emergency rescuer
46.25finding the individual; and
46.26 (2) if no other source of the information is immediately available, a hospital, as soon
46.27as practical after the individual's arrival at the hospital.
46.28 (b) If a document of gift or a refusal to make an anatomical gift is located by the
46.29search required by paragraph (a), clause (1), and the individual or deceased individual to
46.30whom it relates is taken to a hospital, the person responsible for conducting the search
46.31shall send the document of gift or refusal to the hospital. If a body is transferred to
46.32the custody of the medical examiner, the person who discovered the body must notify
46.33the person's dispatcher. A dispatcher notified under this section must notify the state's
46.34federally designated organ procurement organization and inform the organization of the
46.35deceased's name, donor status, and location.
47.1 (c) A person is not subject to criminal or civil liability for failing to discharge the
47.2duties imposed by this section but may be subject to administrative sanctions.
Sec. 62. [525A.13] DELIVERY OF DOCUMENT OF GIFT NOT REQUIRED;
47.4RIGHT TO EXAMINE.
47.5 (a) A document of gift need not be delivered during the donor's lifetime to be
47.7 (b) Upon or after an individual's death, a person in possession of a document of
47.8gift or a refusal to make an anatomical gift with respect to the individual shall allow
47.9examination and copying of the document of gift or refusal by a person authorized to
47.10make or object to the making of an anatomical gift with respect to the individual or by a
47.11person to which the gift could pass under section 525A.11.
Sec. 63. [525A.14] RIGHTS AND DUTIES OF PROCUREMENT
47.13ORGANIZATION AND OTHERS.
47.14 (a) When a hospital refers an individual at or near death to a procurement
47.15organization, the organization shall make a reasonable search of the records of the
47.16Department of Public Safety and any donor registry that it knows exists for the
47.17geographical area in which the individual resides to ascertain whether the individual has
47.18made an anatomical gift.
47.19 (b) A procurement organization must be allowed reasonable access to information
47.20in the records of the Department of Public Safety to ascertain whether an individual at
47.21or near death is a donor.
47.22 (c) When a hospital refers an individual at or near death to a procurement
47.23organization, the organization may conduct any reasonable examination necessary to
47.24ensure the medical suitability of a part that is or could be the subject of an anatomical gift
47.25for transplantation, therapy, research, or education from a donor or a prospective donor.
47.26During the examination period, measures necessary to ensure the medical suitability of the
47.27part may not be withdrawn unless the hospital or procurement organization knows that
47.28the individual expressed a contrary intent.
47.29 (d) Unless prohibited by law other than this chapter, at any time after a donor's death,
47.30the person to which a part passes under section 525A.11 may conduct any reasonable
47.31examination necessary to ensure the medical suitability of the body or part for its intended
47.33 (e) Unless prohibited by law other than this chapter, an examination under paragraph
47.34(c) or (d) may include an examination of all medical and dental records of the donor or
48.1 (f) Upon the death of a minor who was a donor or had signed a refusal, unless a
48.2procurement organization knows the minor is emancipated, the procurement organization
48.3shall conduct a reasonable search for the parents of the minor and provide the parents with
48.4an opportunity to revoke or amend the anatomical gift or revoke the refusal.
48.5 (g) Upon referral by a hospital under paragraph (a), a procurement organization shall
48.6make a reasonable search for any person listed in section 525A.09 having priority to make
48.7an anatomical gift on behalf of a prospective donor. If a procurement organization receives
48.8information that an anatomical gift to any other person was made, amended, or revoked, it
48.9shall promptly advise the other person of all relevant information.
48.10 (h) Subject to sections 525A.11, paragraph (i), and 525A.23, the rights of the person
48.11to which a part passes under section 525A.11 are superior to the rights of all others with
48.12respect to the part. The person may accept or reject an anatomical gift in whole or in part.
48.13Subject to the terms of the document of gift and this chapter, a person that accepts an
48.14anatomical gift of an entire body may allow embalming, burial, or cremation, and use of
48.15remains in a funeral service. If the gift is of a part, the person to which the part passes
48.16under section 525A.11, upon the death of the donor and before embalming, burial, or
48.17cremation, shall cause the part to be removed without unnecessary mutilation.
48.18 (i) Neither the physician who attends the decedent at death nor the physician who
48.19determines the time of the decedent's death may participate in the procedures for removing
48.20or transplanting a part from the decedent.
48.21 (j) A physician or technician may remove a donated part from the body of a donor
48.22that the physician or technician is qualified to remove.
Sec. 64. [525A.15] COORDINATION OF PROCUREMENT AND USE.
48.24 Each hospital in this state shall enter into agreements or affiliations with procurement
48.25organizations for coordination of procurement and use of anatomical gifts.
Sec. 65. [525A.16] SALE OR PURCHASE OF PARTS PROHIBITED; FELONY.
48.27 (a) Except as otherwise provided in paragraph (b), a person that for valuable
48.28consideration, knowingly purchases or sells a part for transplantation or therapy if removal
48.29of a part from an individual is intended to occur after the individual's death, commits a
48.30felony and upon conviction is subject to a fine not exceeding $10,000 or imprisonment
48.31not exceeding five years, or both.
48.32 (b) A person may charge a reasonable amount for the removal, processing,
48.33preservation, quality control, storage, transportation, implantation, or disposal of a part.
Sec. 66. [525A.17] PROHIBITED ACTS; FELONY.
49.1 A person that, in order to obtain a financial gain, intentionally falsifies, forges,
49.2conceals, defaces, or obliterates a document of gift, an amendment or revocation of a
49.3document of gift, or a refusal commits a felony and upon conviction is subject to a fine not
49.4exceeding $10,000 or imprisonment not exceeding five years, or both.
Sec. 67. [525A.18] IMMUNITY.
49.6 (a) A person that acts in accordance with this chapter or with the applicable
49.7anatomical gift law of another state, or attempts in good faith to do so, is not liable for the
49.8act in a civil action, criminal prosecution, or administrative proceeding.
49.9 (b) Neither the person making an anatomical gift nor the donor's estate is liable for
49.10any injury or damage that results from the making or use of the gift.
49.11 (c) In determining whether an anatomical gift has been made, amended, or revoked
49.12under this chapter, a person may rely upon representations of an individual listed in
49.13section 525A.09, paragraph (a), clause (2), (3), (4), (5), (6), (7), or (8), relating to the
49.14individual's relationship to the donor or prospective donor unless the person knows that
49.15the representation is untrue.
49.16 (d) An anatomical gift under this chapter is not a sale of goods as that term is defined
49.17in section 336.2-105, paragraph (1), or the sale of a product.
Sec. 68. [525A.19] LAW GOVERNING VALIDITY; CHOICE OF LAW AS TO
49.19EXECUTION OF DOCUMENT OF GIFT; PRESUMPTION OF VALIDITY.
49.20 (a) A document of gift is valid if executed in accordance with:
49.21 (1) this chapter;
49.22 (2) the laws of the state or country where it was executed; or
49.23 (3) the laws of the state or country where the person making the anatomical gift
49.24was domiciled, has a place of residence, or was a national at the time the document of
49.25gift was executed.
49.26 (b) If a document of gift is valid under this section, the law of this state governs
49.27the interpretation of the document of gift.
49.28 (c) A person may presume that a document of gift or amendment of an anatomical
49.29gift is valid unless that person knows that it was not validly executed or was revoked.
Sec. 69. [525A.20] DONOR REGISTRY.
49.31 (a) The Department of Health may establish or contract for the establishment of a
49.33 (b) The Department of Public Safety shall cooperate with a person that administers
49.34any donor registry that this state establishes, contracts for, or recognizes for the purpose
50.1of transferring to the donor registry all relevant information regarding a donor's making,
50.2amendment to, or revocation of an anatomical gift.
50.3 (c) A donor registry must:
50.4 (1) allow a donor or other person authorized under section 525A.04 to include on
50.5the donor registry a statement or symbol that the donor has made, amended, or revoked
50.6an anatomical gift;
50.7 (2) be accessible to a procurement organization to allow it to obtain relevant
50.8information on the donor registry to determine, at or near death of the donor or a
50.9prospective donor, whether the donor or prospective donor has made, amended, or revoked
50.10an anatomical gift; and
50.11 (3) be accessible, for purposes of clauses (1) and (2), seven days a week on a
50.13 (d) Personally identifiable information on a donor registry about a donor or
50.14prospective donor may not be used or disclosed without the express consent of the donor,
50.15prospective donor, or person that made the anatomical gift for any purpose other than
50.16to determine, at or near death of the donor or prospective donor, whether the donor or
50.17prospective donor has made, amended, or revoked an anatomical gift.
50.18 (e) This section does not prohibit any person from creating or maintaining a donor
50.19registry that is not established by or under contract with the state. Any such registry
50.20must comply with paragraphs (c) and (d).
Sec. 70. [525A.21] EFFECT OF ANATOMICAL GIFT ON ADVANCE HEALTH
50.23 (a) In this section:
50.24 (1) "advance health care directive" means a power of attorney for health care
50.25or a record signed by a prospective donor containing the prospective donor's direction
50.26concerning a health care decision for the prospective donor;
50.27 (2) "declaration" means a record signed by a prospective donor specifying the
50.28circumstances under which a life support system may be withheld or withdrawn from
50.29the prospective donor; and
50.30 (3) "health care decision" means any decision made regarding the health care of the
50.32 (b) If a prospective donor has a declaration or advance health care directive,
50.33measures necessary to ensure the medical suitability of an organ for transplantation
50.34or therapy may not be withheld or withdrawn from the prospective donor, unless the
50.35declaration expressly provides to the contrary.
Sec. 71. [525A.22] COOPERATION BETWEEN MEDICAL EXAMINER AND
51.3 (a) A medical examiner shall cooperate with procurement organizations to maximize
51.4the opportunity to recover anatomical gifts for the purpose of transplantation, therapy,
51.5research, or education.
51.6 (b) If a medical examiner receives notice from a procurement organization that an
51.7anatomical gift might be available or was made with respect to a decedent whose body is
51.8under the jurisdiction of the medical examiner and a postmortem examination is going to
51.9be performed, unless the medical examiner denies recovery in accordance with section
51.10525A.23, the medical examiner or designee shall conduct a postmortem examination of
51.11the body or the part in a manner and within a period compatible with its preservation for
51.12the purposes of the gift.
51.13 (c) A part may not be removed from the body of a decedent under the jurisdiction
51.14of a medical examiner for transplantation, therapy, research, or education unless the part
51.15is the subject of an anatomical gift. The body of a decedent under the jurisdiction of the
51.16medical examiner may not be delivered to a person for research or education unless the
51.17body is the subject of an anatomical gift. This paragraph does not preclude a medical
51.18examiner from performing the medicolegal investigation upon the body or parts of a
51.19decedent under the jurisdiction of the medical examiner.
Sec. 72. [525A.23] FACILITATION OF ANATOMICAL GIFT FROM
51.21DECEDENT WHOSE BODY IS UNDER JURISDICTION OF MEDICAL
51.23 (a) Upon request of a procurement organization, a medical examiner shall release to
51.24the procurement organization the name, contact information, and available medical and
51.25social history of a decedent whose body is under the jurisdiction of the medical examiner.
51.26If the decedent's body or part is medically suitable for transplantation, therapy, research,
51.27or education, the medical examiner shall release postmortem examination results to
51.28the procurement organization. The procurement organization may make a subsequent
51.29disclosure of the postmortem examination results or other information received from the
51.30medical examiner only if relevant to transplantation or therapy.
51.31 (b) The medical examiner may conduct a medicolegal examination by reviewing
51.32all medical records, laboratory test results, x-rays, other diagnostic results, and other
51.33information that any person possesses about a donor or prospective donor whose body is
51.34under the jurisdiction of the medical examiner which the medical examiner determines
51.35may be relevant to the investigation.
52.1 (c) A person that has any information requested by a medical examiner pursuant
52.2to paragraph (b) shall provide that information as expeditiously as possible to allow the
52.3medical examiner to conduct the medicolegal investigation within a period compatible
52.4with the preservation of parts for the purpose of transplantation, therapy, research, or
52.6 (d) If an anatomical gift has been or might be made of a part of a decedent whose
52.7body is under the jurisdiction of the medical examiner and a postmortem examination
52.8is not required, or the medical examiner determines that a postmortem examination is
52.9required but that the recovery of the part that is the subject of an anatomical gift will
52.10not interfere with the examination, the medical examiner and procurement organization
52.11shall cooperate in the timely removal of the part from the decedent for the purpose of
52.12transplantation, therapy, research, or education.
52.13 (e) If an anatomical gift of a part from the decedent under the jurisdiction of
52.14the medical examiner has been or might be made, but the medical examiner initially
52.15believes that the recovery of the part could interfere with the postmortem investigation
52.16into the decedent's cause or manner of death, the medical examiner shall consult with
52.17the procurement organization or physician or technician designated by the procurement
52.18organization about the proposed recovery. After consultation, the medical examiner may
52.19allow the recovery.
52.20 (f) Following the consultation under paragraph (e), in the absence of mutually
52.21agreed-upon protocols to resolve conflict between the medical examiner and the
52.22procurement organization, if the medical examiner intends to deny recovery of an organ
52.23for transplantation, the medical examiner or designee, at the request of the procurement
52.24organization, shall attend the removal procedure for the part before making a final
52.25determination not to allow the procurement organization to recover the part. During
52.26the removal procedure, the medical examiner or designee may allow recovery by the
52.27procurement organization to proceed, or, if the medical examiner or designee reasonably
52.28believes that the part may be involved in determining the decedent's cause or manner of
52.29death, deny recovery by the procurement organization.
52.30 (g) If the medical examiner or designee denies recovery under paragraph (f), the
52.31medical examiner or designee shall:
52.32 (1) explain in a record the specific reasons for not allowing recovery of the part;
52.33 (2) include the specific reasons in the records of the medical examiner; and
52.34 (3) provide a record with the specific reasons to the procurement organization.
52.35 (h) If the medical examiner or designee allows recovery of a part under paragraph
52.36(d), (e), or (f), the procurement organization, upon request, shall cause the physician
53.1or technician who removes the part to provide the medical examiner with a record
53.2describing the condition of the part, a biopsy, a photograph, and any other information and
53.3observations that would assist in the postmortem examination.
53.4 (i) If a medical examiner or designee is required to be present at a removal procedure
53.5under paragraph (f), upon request the procurement organization requesting the recovery
53.6of the part shall reimburse the medical examiner or designee for the additional costs
53.7incurred in complying with paragraph (f).
Sec. 73. [525A.24] RELATION TO ELECTRONIC SIGNATURES IN GLOBAL
53.9AND NATIONAL COMMERCE ACT.
53.10 This chapter modifies, limits, and supersedes the Electronic Signatures in Global and
53.11National Commerce Act, United States Code, title 15, section 7001 et seq., but does not
53.12modify, limit, or supersede section 101(a) of that act, United States Code, title 15, section
53.137001, or authorize electronic delivery of any of the notices described in section 103(b)
53.14of that act, United States Code, title 15, section 7003(b).
Page 207, after line 13 insert:
"Section 1. STUDY; SOBER HOUSING.
53.17 (a) The commissioner of human services shall convene a work group to study ways
53.18to regulate sober housing. The work group must include:
53.19 (1) sober housing landlords;
53.20 (2) sober housing residents;
53.21 (3) community members with knowledge about sober housing;
53.22 (4) representatives of cities and counties;
53.23 (5) a representative from the League of Minnesota Cities;
53.24 (6) a representative from the Association of Minnesota Counties;
53.25 (7) a representative from the Department of Human Services Chemical Health
53.27 (8) a representative from the Department of Human Services Licensing Division; and
53.28 (9) a representative from the Minnesota Department of Health.
53.29 (b) The group shall make a report to the house and senate committees that have
53.30jurisdiction over human services licensing no later than January 1, 2008. The report must
53.31include recommendations for rules and regulations on the following:
53.32 (1) qualifications and training of sober house providers;
53.33 (2) minimum housing standards and spacing requirements;
53.34 (3) the power of the sober house provider to enforce sobriety rules;
53.35 (4) client rights, especially against arbitrary evictions;
54.1 (5) conflicts of interest when the sober house landlord is also a treatment provider or
54.3 (6) ways to ensure transition to safe housing for vulnerable evicted tenants.
Page 207, delete section 54 and insert:
"Sec. 54. INTERPRETER SERVICES WORK GROUP.
54.6 (a) The commissioner of health shall, in consultation with the commissioners of
54.7commerce, human services, and employee relations, convene a work group to study the
54.8provision of interpreter services to patients in medical and dental care settings. The work
54.9group shall include one representative from each of the following groups:
54.10 (1) consumers;
54.11 (2) interpreters;
54.12 (3) interpreter service providers or agencies;
54.13 (4) health plan companies;
54.14 (5) self-insured purchasers;
54.15 (6) hospitals;
54.16 (7) health care providers;
54.17 (8) dental providers;
54.18 (9) clinic administrators;
54.19 (10) state agency staff from the Departments of Health, Human Services, and
54.21 (11) Minnesota Registry of Interpreters for the Deaf;
54.22 (12) local county social services agencies;
54.23 (13) local public health agencies; and
54.24 (14) three members from the interpreting stakeholders group.
54.25 (b) The work group shall develop findings and recommendations on the following:
54.26 (1) assuring access to interpreter services;
54.27 (2) compliance with requirements of federal law and guidance;
54.28 (3) developing a quality assurance program to ensure the quality of health care
54.29interpreting services, including requirements for training and establishing a certification
54.31 (4) identifying broad-based funding mechanisms for interpreter services.
54.32 (c) Based on the discussions of the work group, the commissioner shall make
54.33recommendations to the chairs of the health policy and finance committees in the house
54.34and senate by January 15, 2008, on how to ensure high quality interpreter services for
54.35patients in medical and dental settings, and for a broad-based funding mechanism for
54.36delivering these services.
55.1EFFECTIVE DATE.This section is effective the day following final enactment.
Page 208, after line 31 insert:
"(c) Minnesota Statutes 2006, sections 525.921; 525.9211; 525.9212; 525.9213;
55.4525.9214; 525.9215; 525.9216; 525.9217; 525.9218; 525.9219; 525.9221; 525.9222;
55.5525.9223; and 525.9224, are repealed.
Page 230, after line 19 insert:
"$700,000 in fiscal year 2008 and $700,000
55.8in fiscal year 2009 are appropriated to the
55.9commissioner of human services to fund the
55.10Regional Children's Mental Health Initiative
55.11pilot project. This is a onetime appropriation.
55.12$7500,000 in fiscal year 2008 and $750,000
55.13in fiscal year 2009 are appropriated to
55.14counties based on their population of
55.15residents under age 18. Funds are to be
55.16used to maintain and improve child safety
55.17services. By February 1, 2008, each county
55.18shall submit a report regarding current child
55.19safety efforts, child safety funding, and
55.20unmet needs including investments needed.
55.21The report shall also include methods and
55.22community partners available to ensure
55.23early identification of at risk families. The
55.24Association of Minnesota Counties and
55.25county agencies shall develop a uniform
55.26report structure so that statewide data can
55.27be easily summarized. This is a onetime
Page 235, after line 25 insert:
"$3,000,000 in fiscal year 2008 and
55.31$3,900,000 in fiscal year 2009 is
55.32appropriated from the general fund for
55.33subsidies to federally qualified health centers
55.34under Minnesota Statutes, section 145.9269.
Page 237, line 15, delete "1,000,000
" and insert "$330,000
Page 237, line 16, delete "$1,000,000
" and insert "$850,000
Page 237, after line 29, insert:
"$300,000 for the fiscal year ending June
56.430, 2008, is appropriated from the general
56.5fund to the commissioner of human services
56.6to provide a grant to a research center
56.7associated with a safety net hospital and
56.8county-affiliated health system to develop
56.9the capabilities necessary for evaluating the
56.10effects of changes in state health policies
56.11on low-income and uninsured individuals,
56.12including the impact on state health care
56.13program costs, health outcomes, cost-shifting
56.14to different units and levels of government,
56.15and utilization patterns including use of
56.16emergency room care and hospitalization
56.18$150,000 in fiscal year 2008 and $150,000
56.19is fiscal year 2009 from the general fund is
56.20for a grant to the Neighborhood Health Care
56.21Network to maintain and staff a toll-free
56.22health care access telephone number.
Page 238, after line 18 insert:
"Dental Access for Persons with
56.25Disabilities. Of the general fund
56.26appropriation, $82,000 in fiscal year 2008 is
56.27for a study on access to dental services with
Page 240, after line 19 insert:
"$76,000 in fiscal year 2008 and $62,000
56.31in fiscal year 2009 is for increased staff for
56.32the Ombudsman for Older Minnesotans and
57.1$150,000 in fiscal year 2008 and $150,000 in
57.2fiscal year 2009 is to increase the base of the
57.3Senior LinkAge line program.
Page 241, after line 28 insert:
"$2,000,000 in fiscal year 2008 from the
57.6general fund is for payments to nursing
57.7facilities for life safety code compliance
57.8under Minnesota Statutes, section 256B.434,
57.9subdivision 4, paragraph (e). This is a
57.10onetime appropriation and available until
Page 243, delete lines 5 to 15
Page 245, line 10, delete "2007
" and insert "2008
Page 245, line 11, delete "2008
" and insert "2009
Page 245, line 33, delete "2007
" and insert "2008
Page 245, line 34, delete "2008
" and insert "2009
Page 246, line 8, delete "2007
" and insert "2008
Page 246, after line 31 insert:
"Remembering with Dignity Project.
57.20$200,000 is appropriated from the general
57.21fund to the commissioner of human services,
57.22to be available until September 30, 2008, to
57.23make a grant to Advocating Change Together
57.24for the purposes of the Remembering With
57.25Dignity project in paragraph (b).
57.26(b) As part of the Remembering With Dignity
57.27project, the grant recipient shall:
57.28(1) conduct necessary research on persons
57.29buried in state cemeteries who were residents
57.30of state hospital or regional treatment centers
57.31and buried in numbered or unmarked graves;
57.32(2) purchase and install headstones that are
57.33properly inscribed with their names on the
57.34graves of those persons; and
58.1(3) collaborate with community groups
58.2and state and local government agencies to
58.3build community involvement and public
58.4awareness, ensure public access to the
58.5graves, and ensure appropriate perpetual
58.6maintenance of state cemeteries.
58.7(c) This rider is effective the day following
Page 247, after line 29 insert:
"Quality Management; Assurance; and
58.11Improvement System for Minnesotans
58.12Receiving Disability Services. Of the
58.13general fund appropriation, $300,000 is
58.14appropriated to the commissioner for the
58.15biennium beginning July 1, 2007, for
58.16the purposes of the quality management,
58.17assurance, and improvement system for
58.18Minnesotans receiving disability services.
58.19Federal Medicaid matching funds obtained
58.20for this purpose shall be dedicated to the
58.21commissioner for this purpose.
Page 247, after line 32, insert:
"Disability Linkage Line. Of the general
58.24fund appropriation, $650,000 in fiscal year
58.252008 and $626,000 in fiscal year 2009 is to
58.26establish and maintain the Disability Linkage
Page 251, after line 9 insert:
"Uncompensated Care Fund. $65,000 in
58.30fiscal year 2008 is appropriated from the
58.31general fund for the commissioner of health
58.32to study and present recommendations to
58.33the governor and the legislature by January
58.3415, 2008, on the design, operation, and
58.35funding of an uncompensated care fund to
59.1be used to provide subsidies to hospitals,
59.2community clinics, federally qualified health
59.3centers, community mental health centers,
59.4and other health care providers that serve
59.5a disproportionately large percentage of
59.6uninsured patients. An organization must not
59.7provide or perform abortion services under
Page 251, after line 15 insert:
"$146,000 in fiscal year 2008 from the
59.11general fund is for development of uniform
59.12electronic transactions and implementation
59.13guide standards under Minnesota Statutes,
Renumber the sections in sequence and correct the internal references
Amend the title accordingly
Adjust agency and fund totals accordingly