The House of Representatives convened at 1:30 p.m. and was called to order by Phil Carruthers, Speaker of the House.
Prayer was offered by the Reverend Emory Searey, Jr., Call to Renewal Church, Washington, D. C.
The roll was called and the following members were present:
Abrams | Dorn | Johnson, A. | Mahon | Pelowski | Sykora |
Anderson, B. | Entenza | Johnson, R. | Mares | Peterson | Tingelstad |
Anderson, I. | Erhardt | Juhnke | Marko | Pugh | Trimble |
Bakk | Erickson | Kahn | McCollum | Rest | Tuma |
Bettermann | Evans | Kalis | McElroy | Reuter | Tunheim |
Biernat | Finseth | Kelso | Molnau | Rifenberg | Van Dellen |
Bishop | Garcia | Kielkucki | Mulder | Rostberg | Vandeveer |
Boudreau | Goodno | Knight | Mullery | Rukavina | Wagenius |
Bradley | Greenfield | Knoblach | Munger | Schumacher | Weaver |
Broecker | Greiling | Koskinen | Murphy | Seagren | Wejcman |
Carlson | Gunther | Kraus | Ness | Seifert | Wenzel |
Chaudhary | Haas | Krinkie | Nornes | Sekhon | Westfall |
Clark, J. | Harder | Kubly | Olson, M. | Skare | Westrom |
Clark, K. | Hasskamp | Kuisle | Opatz | Skoglund | Winter |
Commers | Hausman | Larsen | Osskopp | Slawik | Wolf |
Daggett | Hilty | Leighton | Osthoff | Smith | Workman |
Davids | Holsten | Leppik | Otremba, M. | Solberg | Spk. Carruthers |
Dawkins | Huntley | Lieder | Ozment | Stanek | |
Dehler | Jaros | Lindner | Paulsen | Stang | |
Delmont | Jefferson | Long | Pawlenty | Sviggum | |
Dempsey | Jennings | Macklin | Paymar | Swenson, H. | |
A quorum was present.
Folliard; Kinkel; Luther; Mariani; McGuire; Milbert; Olson, E.; Orfield; Rhodes; Tomassoni and Tompkins were excused.
The Chief Clerk proceeded to read the Journal of the preceding day. Mares moved that further reading of the Journal be suspended and that the Journal be approved as corrected by the Chief Clerk. The motion prevailed.
S. F. No. 1151 and H. F. No. 1414, which had been referred to the Chief Clerk for comparison, were examined and found to be identical.
Leighton moved that S. F. No. 1151 be substituted for H. F. No. 1414 and that the House File be indefinitely postponed. The motion prevailed.
Solberg from the Committee on Ways and Means to which was referred:
S. F. No. 3345, A bill for an act relating to criminal justice; appropriating money for the judicial branch, public safety, corrections, criminal justice, crime prevention programs, and related purposes; modifying various fees, assessments, and surcharges; implementing, clarifying, and modifying certain criminal and juvenile provisions; prescribing, clarifying, and modifying certain penalty provisions; establishing, clarifying, expanding, and making permanent various pilot programs, grant programs, task forces, working groups, reports, and studies; providing for the collection, maintenance, and reporting of certain data; expanding, clarifying, and modifying the powers of the commissioner of corrections; making various changes to the 1997 omnibus criminal justice funding bill; providing for the coordination of services for disasters; clarifying and modifying certain laws involving public defenders; appropriating public defender reimbursements to the board of public defense; requesting the supreme court to amend the Rules of Criminal Procedure; accelerating the repeal of the automobile theft prevention program; limiting the entities that must have an affirmative action plan approved by the commissioner of human rights; conveying state land to the city of Faribault; amending Minnesota Statutes 1996, sections 3.739, subdivision 1; 12.09, by adding a subdivision; 13.99, by adding a subdivision; 168.042, subdivisions 12 and 15; 169.121, subdivision 5a; 171.16, subdivision 3; 241.01, subdivision 7, and by adding a subdivision; 242.32, subdivision 1; 244.05, subdivision 7; 299C.06; 299C.09; 299F.04, by adding a subdivision; 357.021, by adding subdivisions; 488A.03, subdivision 11; 588.01, subdivision 3; 609.3241; 611.14; 611.20, subdivision 3; 611.26, subdivisions 2 and 3; and 611.27, subdivisions 1 and 7; Minnesota Statutes 1997 Supplement, sections 97A.065, subdivision 2; 168.042, subdivision 11a; 171.29, subdivision 2; 241.277, subdivisions 6, 9, and by adding a subdivision; 357.021, subdivision 2; 363.073, subdivision 1; 401.13; 609.101, subdivision 5; 609.113, subdivision 3; and 611.25, subdivision 3; amending Laws 1996, chapter 408, article 2, section 16; and Laws 1997, chapter 239, article 1, sections 7 and 12; proposing coding for new law in Minnesota Statutes, chapters 169; 241; 299C; 609; and 611A; repealing Minnesota Statutes 1996, sections 609.101, subdivision 1; 609.563, subdivision 2; 611.216, subdivision 1a; 611.26, subdivision 9; 611.27, subdivision 2; and 626.861; Minnesota Statutes 1997 Supplement, section 611.27, subdivision 4.
Reported the same back with the following amendments to the unofficial engrossment:
Page 32, line 22, delete "7" and insert "6"
Page 32, delete line 24 and insert "24 is effective July 1, 1998. Sections 1 to 5, 7 to 23, and 25"
Page 68, line 34, delete "10" and insert "9"
Pages 77 and 78, delete subdivision 3 and insert:
"Subd. 3. [MANDATORY SENTENCE FOR DANGEROUS OFFENDER WHO COMMITS A SECOND VIOLENT FELONY.] (a) Unless a longer mandatory minimum sentence is otherwise required by law or the court imposes a longer aggravated durational departure under subdivision 2, a person who is convicted of a violent crime that is a felony must be committed to the commissioner of corrections if:
(1) the court determines on the record at the time of sentencing that the person has one or more prior felony convictions for violent crimes; and
(2) the person's presumptive
sentence under the sentencing guidelines is commitment to the commissioner of
corrections.
Any person convicted and sentenced
as required by this subdivision is not eligible for probation, parole,
discharge, or work release, until that person has served the full term of
imprisonment imposed by the court, notwithstanding sections 241.26, 242.19,
243.05, 244.04, 609.12, and 609.135.
(b) For purposes of this
subdivision, "violent crime" does not include a violation of section 152.023 or
152.024."
Pages 132 and 133, delete section 18
Page 134, line 35, after "7,"
insert "8, and" and delete ",
and 18"
Page 134, line 36, delete everything after the first
comma, and insert "19, and 22, paragraph"
Page 148, line 15, strike the old language
Page 148, line 16, strike everything before the period
Page 152, line 3, delete "7,
8," and insert "1, 7, 8, 12,"
Page 152, line 4, delete the second comma and insert "to"
Renumber the sections in sequence and correct internal
references
Amend the title accordingly
With the recommendation that when so amended the bill
pass.
The report was adopted.
Dorn from the Committee on Health and Human Services to
which was referred:
S. F. No. 3346, A bill for an act relating to human
services; appropriating money; changing provisions for long-term care, health
care programs and provisions, including MA and GAMC, MinnesotaCare, welfare
reform, and regional treatment centers; providing for the sale of certain
nursing home property; regulating compulsive gambling; imposing penalties;
amending Minnesota Statutes 1996, sections 119B.24; 144.701, subdivisions 1, 2,
and 4; 144.702, subdivisions 1, 2, and 8; 144A.09, subdivision 1; 144A.44,
subdivision 2; 214.03; 245.462, subdivisions 4 and 8; 245.4871, subdivision 4;
245A.03, by adding a subdivision; 245A.14, subdivision 4; 256.014, subdivision
1; 256.969, subdivisions 16 and 17; 256B.03, subdivision 3; 256B.04, by adding a
subdivision; 256B.055, subdivision 7, and by adding a subdivision; 256B.057,
subdivision 3a, and by adding subdivisions; 256B.0625, subdivisions 7, 17, 19a,
20, 34, and by adding subdivisions; 256B.0627, subdivision 4; 256B.0911,
subdivision 4; 256B.0916; 256B.41, subdivision 1; 256B.431, subdivisions 2b, 4,
11, 22, and by adding a subdivision; 256B.501, subdivision 2; 256B.69, by adding
subdivisions; 256D.03, subdivision 4, and by adding subdivisions; 256D.051, by
adding a subdivision; 256D.46, subdivision 2; 256I.04, subdivisions 1, 3, and by
adding a subdivision; 256I.05, subdivision 2; and 609.115, subdivision 9;
Minnesota Statutes 1997 Supplement, sections 60A.15, subdivision 1; 62J.685;
62J.69, subdivisions 1, 2, and by adding a subdivision; 62J.75; 103I.208,
subdivision 2; 144.1494, subdivision 1; 144A.071, subdivision 4a; 171.29,
subdivision 2; 214.32, subdivision 1; 245B.06, subdivision 2; 256.01,
subdivision 2; 256.031, subdivision 6; 256.9657, subdivision 3; 256.9685,
subdivision 1; 256.9864; 256B.04, subdivision 18; 256B.056, subdivisions 1a and
4; 256B.06, subdivision 4; 256B.062; 256B.0625, subdivision 31a; 256B.0627,
subdivision 5; 256B.0645; 256B.0911, subdivisions 2 and 7; 256B.0913,
subdivision 14; 256B.0915, subdivisions 1d and 3; 256B.0951, by adding a
subdivision; 256B.431, subdivisions 3f and 26; 256B.433, subdivision 3a;
256B.434, subdivision 10; 256B.69, subdivisions 2 and 3a; 256B.692, subdivisions
2 and 5; 256B.77, subdivisions 3, 7a, 10, and 12; 256D.05, subdivision 8;
256J.02, subdivision 4; 256J.03; 256J.08, subdivisions 11, 26, 28, 40, 60, 68,
73, 83, and by adding subdivisions; 256J.09, subdivisions 6 and 9; 256J.11,
subdivision 2, as amended; 256J.12; 256J.14; 256J.15, subdivision 2; 256J.20,
subdivisions 2 and 3; 256J.21; 256J.24, subdivisions 1, 2, 3, 4, and by adding
subdivisions; 256J.26, subdivisions 1, 2, 3, and 4;
256J.28, subdivisions 1, 2, and by adding a subdivision; 256J.30, subdivisions
10 and 11; 256J.31, subdivisions 5 and 10; 256J.32, subdivisions 4, 6, and by
adding a subdivision; 256J.33, subdivisions 1 and 4; 256J.35; 256J.36; 256J.37,
subdivisions 1, 2, 9, and by adding subdivisions; 256J.38, subdivision 1;
256J.39, subdivision 2; 256J.395; 256J.42; 256J.43; 256J.45, subdivisions 1, 2,
and by adding a subdivision; 256J.46, subdivisions 1, 2, and 2a; 256J.47,
subdivision 4; 256J.48, subdivisions 2, 3, and by adding a subdivision; 256J.49,
subdivision 4; 256J.50, subdivision 5, and by adding a subdivision; 256J.52,
subdivision 4; 256J.54, subdivisions 2, 3, 4, and 5; 256J.55, subdivision 5;
256J.56; 256J.57, subdivision 1; 256J.645, subdivision 3; 256J.74, subdivision
2, and by adding a subdivision; 256K.03, subdivision 5; 256L.01; 256L.02,
subdivisions 2 and 3; 256L.03, subdivisions 1, 3, 4, 5, and by adding
subdivisions; 256L.04, subdivisions 1, 2, 7, 8, 9, 10, and by adding
subdivisions; 256L.05, subdivisions 2, 3, 4, and by adding subdivisions;
256L.06, subdivision 3; 256L.07; 256L.09, subdivisions 2, 4, and 6; 256L.11,
subdivision 6; 256L.12, subdivision 5; 256L.15; 256L.17, by adding a
subdivision; and 270A.03, subdivision 5; Laws 1994, chapter 633, article 7,
section 3; Laws 1997, chapter 203, article 4, section 64; and article 9, section
21; chapter 207, section 7; chapter 225, article 2, section 64; and chapter 248,
section 46, as amended; proposing coding for new law in Minnesota Statutes,
chapters 144; 145; 245; 256; 256B; 256D; 256J; and 256L; repealing Minnesota
Statutes 1996, sections 144.0721, subdivision 3a; 256.031, subdivisions 1, 2, 3,
and 4; 256.032; 256.033, subdivisions 2, 3, 4, 5, and 6; 256.034; 256.035;
256.036; 256.0361; 256.047; 256.0475; 256.048; 256.049; and 256B.501,
subdivision 3g; Minnesota Statutes 1997 Supplement, sections 62J.685; 144.0721,
subdivision 3; 256.031, subdivisions 5 and 6; 256.033, subdivisions 1 and 1a;
256B.057, subdivision 1a; 256B.062; 256B.0913, subdivision 15; 256J.25; 256J.28,
subdivision 4; 256J.32, subdivision 5; 256J.34, subdivision 5; 256J.76; 256L.04,
subdivisions 3, 4, 5, and 6; 256L.06, subdivisions 1 and 2; 256L.08; 256L.09,
subdivision 3; 256L.13; and 256L.14; Laws 1997, chapter 85, article 1, sections
61 and 71; and article 3, section 55; Minnesota Rules (Exempt), parts 9500.9100;
9500.9110; 9500.9120; 9500.9130; 9500.9140; 9500.9150; 9500.9160; 9500.9170;
9500.9180; 9500.9190; 9500.9200; 9500.9210; and 9500.9220.
Reported the same back with the following amendments:
Delete everything after the enacting clause and insert:
Section 1. [HEALTH AND HUMAN SERVICES APPROPRIATIONS.]
The sums in the columns headed "APPROPRIATIONS" are
appropriated or reductions from appropriations from the general fund, or another
named fund, to the agencies and for the purposes specified to be available for
the fiscal years indicated for each purpose.
1998 1999
General $ (118,953,000)$ (122,813,000)
State Government Special Revenue Fund 113,000 90,000
Special Revenue Fund -0- 400,000
Health Care Access 6,616,000 (1,161,000)
APPROPRIATIONS
Available for the Year
Ending June 30
1998 1999
Sec. 2. COMMISSIONER OF HUMAN SERVICES
Subdivision 1. Total Appropriation (112,337,000)
(142,747,000)
1998 1999
General (118,953,000) (141,721,000)
Special Revenue Fund -0- 400,000
Health Care Access 6,616,000 (1,420,000)
Subd. 2. Children's Grants
General -0- 1,665,000
[TECHNICAL ASSISTANCE FOR CRISIS NURSERIES.] Of this
appropriation, $200,000 in fiscal year 1999 is from the general fund for the
commissioner to contract for technical assistance with counties that are
interested in developing a crisis nursery program. The technical assistance must
be designed to assist interested counties in building capacity to develop and
maintain a crisis nursery program in the county. The grant amount to a county
must range from $10,000 to $20,000. To be eligible to receive a grant under this
program, the county must not have an existing crisis nursery program and must
not be a metropolitan county, as that term is defined in Minnesota Statutes
1996, section 473.121. This appropriation shall not become part of the base for
the 2000-2001 biennial budget.
[PRIMARY SUPPORT TO IMPLEMENT THE INDIAN FAMILY
PRESERVATION ACT.] For fiscal year 1998, $100,000 of federal funds are
transferred from the state's federal TANF block grant and added to the state's
allocation of federal Title XX block grant funds. Notwithstanding the provisions
of Minnesota Statutes 1997 Supplement, section 256E.07, the commissioner shall
use $100,000 of the state's Title XX block grant funds for a grant under
Minnesota Statutes, section 257.3571, subdivision 1, to an Indian organization
licensed as an adoption agency. The grant must be used to provide primary
support for implementation of the Minnesota Indian Family Preservation Act and
compliance with the Indian Child Welfare Act. This appropriation must be used
according to the requirements of the amendments to section 404(d)(3)(B) of Part
A of Title IV of the Social Security Act in Public Law Number 104-193. This
appropriation is available until June 30, 1999.
[ADOPTION ASSISTANCE CARRYFORWARD.] Of the appropriation
in Laws 1997, chapter 203, section 2, subdivision 3, for children's grants for
fiscal year 1998, $600,000 of the amount appropriated for the adoption
assistance program is available for the same purpose in fiscal year 1999. The
amount carried forward shall become part of the base for the adoption assistance
program in the 2000-2001 biennial budget.
[FAMILY PRESERVATION PROGRAM FUNDING.] $10,000,000 is
transferred in fiscal year 1999 from the state's federal TANF block grant to the
state's federal Title XX block grant. Notwithstanding the provisions of
Minnesota Statutes 1997 Supplement, section 256E.07, in fiscal year 1999 the
commissioner shall transfer $10,000,000 of the state's Title XX block grant
funds to the family preservation program under Minnesota Statutes, chapter 256F.
Of the total amount transferred, the commissioner shall allocate $8,800,000 to
counties for the purposes of the child protection assessments or investigations
community collaboration pilot program under Minnesota Statutes, section
626.5560. The commissioner shall allocate $750,000 to counties for the
concurrent permanency planning pilot program under Minnesota Statutes, section
257.0711. The commissioner shall transfer $200,000 to the commissioner of health
for the program under Minnesota Statutes, section 145A.15, that funds home
visiting projects. The commissioner may retain up to $250,000 of the total
amount transferred to conduct evaluations of these pilot programs. The
commissioners shall ensure that money allocated to counties under this provision
must be used in accordance with the requirements of the amendments to section
404(d)(3)(B) of Part A of Title IV of the Social Security Act in Public Law
Number 104-193. This is a one-time appropriation that shall not be added to the
base for the family preservation program for the 2000-2001 biennial budget.
Subd. 3. Children's Services Management
General -0- -0-
Special Revenue Fund -0- 400,000
Subd. 4. Basic Health Care Grants
General (74,679,000) (90,243,000)
Health Care Access 6,808,000 (4,278,000)
The amounts that may be spent from this appropriation for
each purpose are as follows:
(a) MinnesotaCare Grants
Health Care Access 6,808,000 (4,278,000)
(b) MA Basic Health Care Grants; Families and Children
General (23,231,000)(38,644,000)
Of this appropriation, $100,000 in fiscal year 1999 is
from the general fund to the commissioner for the post-kidney transplant drug
program. This appropriation shall not cancel, but is available until expended.
[JANUARY 1, 1999 PROVIDER RATE INCREASE FOR CERTAIN
SERVICES.] (a) Effective for services rendered on or after January 1, 1999, the
commissioner shall increase reimbursement or allocation rates by five percent,
and county boards shall adjust provider contracts as needed, for mental health
services provided by community mental health centers under Minnesota Statutes,
sections 245.62 and 256B.0625, subdivision 5, and for community support services
for deaf and hard-of-hearing adults with mental illness who use or wish to use
sign language as their primary means of communication. The commissioner shall
also increase prepaid medical assistance program capitation rates as appropriate
to reflect the rate increases in this provision. Section 10, sunset of
uncodified language, does not apply to this provision.
(b) It is the intention of the legislature that the
compensation packages of staff within each service be increased by five percent.
(c) MA Basic Health Care Grants; Elderly and Disabled
General (23,819,000)(41,964,000)
[REGION 10 COMMISSION CARRYOVER AUTHORITY.] Any unspent
portion of the appropriation to the commissioner of human services in Laws 1997,
chapter 203, article 1, section 2, subdivision 9, for the region 10 quality
assurance commission for fiscal year 1998 shall not cancel but shall be
available for the commission for fiscal year 1999.
[DD CRISIS INTERVENTION PROJECT.] Of this appropriation,
$150,000 in fiscal year 1999 is from the general fund to the commissioner for
start-up operating and training costs for the action, support, and prevention
project of southeastern Minnesota. This appropriation is to provide crisis
intervention through community-based services in the private sector to persons
with developmental disabilities under Laws 1995, chapter 207, article 3, section
22.
[PRESCRIPTION DRUG BENEFIT.] (a) If, by September 15,
1998, federal approval is obtained to provide a prescription drug benefit for
qualified Medicare beneficiaries at no less than 100 percent of the federal
poverty guidelines and service-limited Medicare beneficiaries under Minnesota
Statutes, section 256B.057, subdivision 3a, at no less than 120 percent of
federal poverty guidelines, the commissioner of human services shall not
implement the senior citizen drug program
under Minnesota Statutes, section 256.955, but shall
implement a drug benefit in accordance with the approved waiver. Upon approval
of this waiver, the total appropriation for the senior citizen drug program
under Laws 1997, chapter 225, article 7, section 2, shall be transferred to the
medical assistance account to fund the federally approved coverage for eligible
persons for fiscal year 1999.
(b) The commissioner may seek approval for a higher
copayment for eligible persons above 100 percent of the federal poverty
guidelines.
(c) The commissioner shall report by October 15, 1998, to
the chairs of the health and human services policy and fiscal committees of the
house and senate whether the waiver referred to in paragraph (a) has been
approved and will be implemented or whether the state senior citizen drug
program will be implemented.
(d) If the commissioner does not receive federal waiver
approval at or above the level of eligibility defined in paragraph (a), the
commissioner shall implement the program under Minnesota Statutes, section
256.955.
(d) General Assistance Medical Care
General (27,629,000) (9,635,000)
Subd. 5. Basic Health Care Management
General -0- 261,000
Health Care Access (192,000) 1,774,000
The amounts that may be spent from this appropriation for
each purpose are as follows:
(a) Health Care Policy Administration
General -0- 173,000
Health Care Access (192,000) 37,000
[DELAY IN TRANSFERRING GAMC CLIENTS.] Due to delaying the
transfer of GAMC clients to MinnesotaCare until January 1, 2000, $192,000 in
fiscal year 1998 health care access fund administrative funds, appropriated in
Laws 1997, chapter 225, article 7, section 2, subdivision 1, are canceled.
[MINNESOTACARE OUTREACH.] Unexpended money in fiscal year
1998 for MinnesotaCare outreach activities appropriated in Laws 1997, chapter
225, article 7, section 2, subdivision 1, does not cancel, but is available for
those purposes in fiscal year 1999.
[HEALTH CARE MANUAL PRODUCTION COSTS.] For the biennium
ending June 30, 1999, the money difference between the cost of producing and
distributing the department of human services health care manual, and the fees
paid by individuals and private entities on January 1, 1998, is appropriated to
the commissioner to defray manual production and distribution costs. The
commissioner must provide the health care manual to government agencies and
nonprofit agencies serving the legal and social service needs of clients at no
cost to those agencies.
(b) Health Care Operations
General -0- 88,000
Health Care Access -0- 1,737,000
Subd. 6. State-Operated Services
General -0- 700,000
The amounts that may be spent from this appropriation for
each purpose are as follows:
RTC Facilities
General -0- 700,000
[LEAVE LIABILITIES.] The accrued leave liabilities of
state employees transferred to state-operated community services programs may be
paid from the appropriation for state-operated services in Laws 1997, chapter
203, article 1, section 2, subdivision 7, paragraph (a). Funds set aside for
this purpose shall not exceed the amount of the actual leave liability
calculated as of June 30, 1999, and shall be available until expended. This
provision is effective the day following final enactment.
Subd. 7. Continuing Care and Community Support Grants
General (35,100,000)(24,527,000)
The amounts that may be spent from this appropriation for
each purpose are as follows:
(a) Community Services Block Grant
General 130,000 -0-
[WILKIN COUNTY.] Of this appropriation, $130,000 for
fiscal year 1998 is to reimburse Wilkin county for flood-related human services
and public health costs which cannot be reimbursed through any other source.
(b) Mental Health Grants
General 300,000 2,144,000
[CHILDREN'S MENTAL HEALTH SERVICES.] (a) Of this
appropriation, $200,000 in fiscal year 1999 is from the general fund for the
commissioner to award grants to counties that have a relatively low net tax
capacity to provide children's mental health services to children and families
residing outside of a metropolitan statistical area, as that term is defined by
the United States Census Bureau. Funds shall be used to provide services
according to an individual family community support plan as described in
Minnesota Statutes, section 245.4881, subdivision 4. The plan must be developed
using a process that enhances consumer empowerment. Counties with an approved
children's mental health collaborative may integrate funds appropriated for
fiscal years 1998 and 1999 with existing funds to meet the needs identified in
the child's individual family community support plan.
(b) In awarding grants to counties under this provision,
the commissioner shall follow the process established in Minnesota Statutes,
section 245.4886, subdivision 2. The commissioner shall give priority for
funding to counties that continued to spend for mental health services specified
in Minnesota Statutes, sections 245.461 to 245.486 and 245.487 to 245.4888,
according to generally accepted accounting principles, in an amount equal to the
total expenditures shown in the county's approved 1987 CSSA plan for services to
persons with mental illness plus the comparable figure for facilities licensed
under Minnesota Rules, chapter 9545, for target populations other than mental
illness in the county's approved 1989 CSSA plan. The commissioner shall ensure
that grant funds are not used to replace existing funds.
[PLANNING GRANT FOR PROSTITUTION RECOVERY CENTER.] Of
this appropriation, $50,000 in fiscal year 1999 is from the general fund to the
commissioner for a planning grant to enable an organization to develop a
long-term treatment program for women escaping systems of prostitution.
[COMPULSIVE GAMBLING CARRYFORWARD.] Unexpended funds
appropriated to the commissioner for compulsive gambling programs for fiscal
year 1998 do not cancel but are available for these purposes for fiscal year
1999.
[FLOOD COSTS.] Of this appropriation, $300,000 in fiscal
year 1998 and $1,000,000 in fiscal year 1999 is from the general fund to the
commissioner for the purpose of continuing initiatives funded by Federal
Emergency Management Agency (FEMA) mental health care grants beyond April 15,
1998. This appropriation is available until June 30, 1999. This provision is
effective April 15, 1998, if FEMA does not extend these mental health care
grants beyond April 15, 1998.
(c) Deaf and Hard-of-hearing Grants
General -0- 81,000
[SERVICES TO DEAF PERSONS WITH MENTAL ILLNESS.] Of this
appropriation, $65,000 in fiscal year 1999 is from the general fund to the
commissioner for a grant to a nonprofit agency that currently serves deaf and
hard-of-hearing adults with mental illness through residential programs and
supported housing outreach activities. The grant must be used to continue or
maintain community support services for deaf and hard-of-hearing adults with
mental illness who use or wish to use sign language as their primary means of
communication. This appropriation is in addition to the appropriation in Laws
1997, chapter 203, article 1, section 2, subdivision 8, paragraph (d), for a
grant to this nonprofit agency.
(d) DD Community Support Grants
General -0- 41,000
(e) Aging and Adult Services
General -0- 100,000
(f) Medical Assistance Long-term Care Waivers and Home
Care
General (8,463,000)(13,096,000)
[JANUARY 1, 1999, PROVIDER RATE INCREASE.] (a) Effective
for services rendered on or after January 1, 1999, the commissioner shall
increase reimbursement or allocation rates by 1.25 percent, and county boards
shall adjust provider contracts as needed, for home and community-based waiver
services for persons with mental retardation or related conditions under
Minnesota Statutes, section 256B.501; home and community-based waiver services
for the elderly under Minnesota Statutes, section 256B.0915; nursing services
and home health services under Minnesota Statutes, section 256B.0625,
subdivision 6a; personal care services and nursing supervision of personal care
services under Minnesota Statutes, section 256B.0625, subdivision 19a; private
duty nursing services under Minnesota Statutes, section 256B.0625, subdivision
7; day training and habilitation services for adults with mental retardation or
related conditions under Minnesota Statutes, sections 252.40 to 252.47; physical
therapy services under Minnesota Statutes, sections 256B.0625, subdivision 8,
and 256D.03, subdivision 4; occupational therapy services under Minnesota
Statutes, sections 256B.0625, subdivision 8a, and 256D.03, subdivision 4;
speech-language therapy services under Minnesota Statutes, section 256D.03,
subdivision 4, and Minnesota Rules, part 9505.0390; respiratory therapy services
under Minnesota Statutes, section 256D.03, subdivision 4, and Minnesota Rules,
part 9505.0295; family community support grants under Minnesota Rules, parts
9535.1700 to 9535.1760; and semi-independent living services under Minnesota
Statutes, section 252.275, including SILS funding under county social services
grants formerly funded under Minnesota Statutes, chapter 256I. The commissioner
shall also increase prepaid medical assistance program capitation rates as
appropriate to reflect the rate increases in this provision. Section 10, sunset
of uncodified language, does not apply to this provision.
(b) It is the intention of the legislature that the
compensation packages of staff within each service be increased by 1.25 percent.
(g) Medical Assistance Long-term Care Facilities
General (18,272,000)(19,117,000)
[ICF/MR DISALLOWANCES.] Of this appropriation, $65,000 in
fiscal year 1999 is from the general fund to the commissioner for the purpose of
reimbursing a 12-bed ICF/MR in Stearns county and a 12-bed ICF/MR in Sherburne
county for disallowances resulting from field audit findings. The commissioner
shall exempt these facilities from the provisions of Minnesota Statutes, section
256B.501, subdivision 5b, paragraph (d), clause (6), for the rate years
beginning October 1, 1997, and October 1, 1998. Section 10, sunset of uncodified
language, does not apply to this provision.
[NURSING HOME MORATORIUM EXCEPTIONS.] Base level funding
for medical assistance long-term care facilities is increased by $255,000 in
fiscal year 2000 and by $278,000 in fiscal year 2001 for the additional medical
assistance costs of the nursing home moratorium exceptions under Minnesota
Statutes 1997 Supplement, section 144A.071, subdivision 4a, paragraphs (w) and
(x). Notwithstanding the provisions of section 10, sunset of uncodified
language, this provision shall not expire.
[ICFs/MR AND NURSING FACILITY FLOOD-RELATED REPORTING.]
For the reporting year ending December 31, 1997, for ICFs/MR that temporarily
admitted victims of the flood of 1997, the resident days related to those
temporary placements (persons not formally admitted which continued to be billed
under the evacuated facility's provider number) shall not be counted in the cost
report submitted to calculate October 1, 1998, rates, and the additional
expenditures shall be considered nonallowable.
For the reporting year ending September 30, 1997, for
nursing facilities that temporarily admitted victims of the flood of 1997, the
resident days related to those temporary placements (persons not formally
admitted which continued to be billed under the evacuated facility's provider
number) shall not be counted in the cost report submitted to calculate July 1,
1998, rates, and the additional expenditures shall be considered nonallowable.
(h) Alternative Care Grants
General -0- 21,666,000
(i) Group Residential Housing
General (8,795,000) (9,447,000)
(j) Chemical Dependency Entitlement Grants
General -0- (7,498,000)
(k) Chemical Dependency Nonentitlement Grants
General -0- 400,000
[MATCHING GRANT FOR YOUTH ALCOHOL TREATMENT.] Of this
appropriation, $400,000 in fiscal year 1999 is from the general fund for the
commissioner to provide a grant to the board of directors of the Minnesota
Indian Primary Residential Treatment Center, Inc., to build a youth alcohol
treatment wing at the Mash-Ka-Wisen Treatment Center. This appropriation is
available only if matched by a $1,500,000 federal grant and a $100,000 grant
from state Indian bands.
[MATCHING GRANT FOR PROJECT TURNABOUT.] If money is
appropriated in fiscal year 1999 to the commissioner from the lottery prize
fund, the money shall be used to provide a grant for capital improvements to
Project Turnabout in Granite Falls. A local match is required before the
commissioner may release this appropriation to the facility. The facility shall
receive state funds equal to the amount of local matching funds provided, up to
the limit of this appropriation.
Subd. 8. Economic Support Grants
General (9,174,000)(29,413,000)
The amounts that may be spent from this appropriation for
each purpose are as follows:
(a) Assistance to Families Grants
General -0-(20,343,000)
[TRANSFER OF STATE MONEY FROM TANF RESERVE.] For fiscal
year 1999, $10,220,000 is appropriated from the state money in the TANF reserve
to the commissioner for the purposes of funding the families-first distribution
of child support arrearages under Minnesota Statutes, section 256.741,
subdivision 2a; the Minnesota food assistance program under Minnesota Statutes,
section 256D.053; and the MFIP-S noncitizen food portion under Minnesota
Statutes, section 256J.11, subdivision 2.
[TRANSFER OF FEDERAL TANF FUNDS TO CHILD CARE DEVELOPMENT
FUND.] $406,000 is transferred in fiscal year 1999 from the state's federal TANF
block grant to the state's child care development fund, and is appropriated to
the commissioner of children, families, and learning for the purposes of
Minnesota Statutes, section 119B.05.
(b) General Assistance
General (6,933,000) (6,321,000)
(c) Minnesota Supplemental Aid
General (2,241,000) (2,749,000)
Subd. 9. Economic Support Management
General -0- 35,000
Health Care Access -0- 1,084,000
[ASSESSMENT OF AFFORDABLE HOUSING SUPPLY.] The
commissioner of human services shall assess the statewide supply of affordable
housing for all MFIP-S and GA recipients, and report to the legislature by
January 15, 1999, on the results of this assessment.
The amounts that may be spent from this appropriation for
each purpose are as follows:
Economic Support Operations
General -0- 35,000
Health Care Access -0- 1,084,000
Sec. 3. COMMISSIONER OF HEALTH
Subdivision 1. Total Appropriation -0- 18,896,000
General -0- 18,896,000
State Government
Special Revenue -0- 7,000
Health Care Access -0- 259,000
Subd. 2. Health Systems and Special Populations -0-
13,759,000
General -0- 13,500,000
Health Care Access -0- 259,000
[FETAL ALCOHOL SYNDROME.] (a) Of this appropriation,
$3,500,000 in fiscal year 1999 is from the general fund to the commissioner for
the fetal alcohol syndrome/fetal alcohol effect (FAS/FAE) initiatives specified
in paragraphs (b) to (k).
(b) Of the amount in paragraph (a), $100,000 is
transferred to the commissioner of children, families, and learning for
school-based pilot programs to identify and implement effective educational
strategies for individuals with FAS/FAE.
(c) Of the amount in paragraph (a), $600,000 is for the
public awareness campaign under Minnesota Statutes, section 145.9266,
subdivision 1.
(d) Of the amount in paragraph (a), $300,000 is to
develop a statewide network of regional FAS diagnostic clinics under Minnesota
Statutes, section 145.9266, subdivision 2.
(e) Of the amount in paragraph (a), $150,000 is for
professional training about FAS under Minnesota Statutes, section 145.9266,
subdivision 3.
(f) Of the amount in paragraph (a), $200,000 is for the
fetal alcohol coordinating board under Minnesota Statutes, section 145.9266,
subdivision 6.
(g) Of the amount in paragraph (a), $500,000 is
transferred to the commissioner of human services to expand the maternal and
child health social service programs under Minnesota Statutes, section 254A.17,
subdivision 1.
(h) Of the amount in paragraph (a), $200,000 is for the
commissioner to study the extent of fetal alcohol syndrome in the state.
(i) Of the amount in paragraph (a), $300,000 is
transferred to the commissioner of human services for the intervention and
advocacy program under Minnesota Statutes, section 254A.17, subdivision 1b.
(j) Of the amount in paragraph (a), $700,000 is for the
FAS community grant program under Minnesota Statutes, section 145.9266,
subdivision 4.
(k) Of the amount in paragraph (a), $450,000 is
transferred to the commissioner of human services to expand treatment services
and halfway houses for pregnant women and women with children who abuse alcohol
during pregnancy.
[RURAL PHYSICIAN LOAN FORGIVENESS BUDGET REQUEST.] The
budget request for the rural physician loan forgiveness program in the 2000-2001
biennial budget shall detail the amount of funds carried forward and obligations
canceled.
[GRANTS FROM HEALTH CARE ACCESS FUND.] Of any grants made
from the health care access fund to the commissioner of health for purposes of
Minnesota Statutes, section 145.925, priority shall be given for grants to
entities providing natural family planning services that did not receive funding
under Minnesota Statutes, section 145.925, in fiscal year 1998.
Subd. 3. Health Protection -0- 5,130,000
General -0- 5,130,000
State Government -0- 7,000
Special Revenue
[OCCUPATIONAL RESPIRATORY DISEASE INFORMATION SYSTEM.] Of
the general fund appropriation, $300,000 in fiscal year 1999 is to design an
occupational respiratory disease information system. This appropriation is
available until expended. This appropriation is added to the base for the
2000-2001 biennial budget.
[INFECTION CONTROL.] Of the general fund appropriation,
$300,000 in fiscal year 1999 is for infection control activities, including
training and technical assistance of health care personnel to prevent and
control disease outbreaks, and for hospital and public health laboratory testing
and other activities to monitor trends in drug-resistant infections. Start-up
costs shall not become part of the base for the 2000-2001 biennial budget.
[CANCER SCREENING.] Of the general fund appropriation,
$989,000 in fiscal year 1999 is for increased cancer screening and diagnostic
services for women, particularly underserved women, and to improve cancer
screening rates for the general population. Of this amount, at least $665,000 is
for grants to support local boards of health in providing outreach and
coordination and to reimburse health care providers for screening and diagnostic
tests, and up to $324,000 is for technical assistance, consultation, and
outreach.
[SEXUALLY TRANSMITTED DISEASE PREVENTION INITIATIVES.]
(a) Of this appropriation, $300,000 in fiscal year 1999 is from the general fund
to the commissioner for the sexually transmitted disease prevention initiatives
specified in paragraphs (b) to (d).
(b) $100,000 is for the commissioner, in consultation
with the HIV/STD prevention task force and the commissioner of children,
families, and learning, to conduct a statewide assessment of need and capacity
to prevent and treat sexually transmitted diseases and to prepare a
comprehensive plan for how to prevent and treat sexually transmitted diseases,
including strategies for reducing infection and for increasing access to
treatment. This appropriation shall not become part of the base level funding
for this activity for the 2000-2001 biennial budget.
(c) $100,000 is for the commissioner to conduct research
on the prevalence of sexually transmitted diseases among populations at highest
risk for infection. The research may be done in collaboration with the
University of Minnesota and nonprofit community health clinics. This
appropriation shall not become part of the base level funding for this activity
for the 2000-2001 biennial budget.
(d) $100,000 is for the commissioner to conduct
laboratory screenings for sexually transmitted diseases and to overcome barriers
to diagnostic screening and treatment services, particularly in populations at
highest risk for acquiring a sexually transmitted disease.
Sec. 4. HEALTH-RELATED BOARDS
Subdivision 1. Total Appropriation 113,000 83,000
The appropriations in this section are from the state
government special revenue fund.
Subd. 2. Board of Medical Practice 80,000 (110,000)
This appropriation is added to the appropriation in Laws
1997, chapter 203, article 1, section 5, subdivision 6, and is for the health
professional services activity.
Subd. 3. Board of Physical Therapy -0- 160,000
Subd. 4. Board of Veterinary Medicine 33,000 33,000
This appropriation is added to the appropriation in Laws
1997, chapter 203, article 1, section 5, subdivision 14, and is for national
examination costs.
Sec. 5. EMERGENCY MEDICAL SERVICES BOARD
General -0- 78,000
[EMERGENCY MEDICAL SERVICES COMMUNICATIONS NEEDS
ASSESSMENT.] (a) Of this appropriation, $78,000 in fiscal year 1999 is from the
general fund to the board to conduct an emergency medical services needs
assessment for areas outside the seven-county metropolitan area. The assessment
shall determine the current status of and need for emergency medical services
communications equipment. All regional emergency medical services programs
designated by the board under Minnesota Statutes 1997 Supplement, section
144E.50, shall cooperate in the preparation of the assessment.
(b) The appropriation for this project shall be
distributed through the emergency medical services system fund under Minnesota
Statutes, section 144E.50, through a request-for-proposal process. The board
must select a regional EMS program that receives at least 20 percent of its
funding from nonstate sources to conduct the assessment. The request for
proposals must be issued by August 1, 1998.
(c) A final report with recommendations shall be
presented to the board and the legislature by July 1, 1999.
(d) This appropriation shall not become part of base
level funding for the 2000-2001 biennium.
Sec. 6. OMBUDSMAN FOR MENTAL HEALTH AND MENTAL
RETARDATION
General -0- 200,000
Sec. 7. Laws 1997, chapter 203, article 1, section 2,
subdivision 5, is amended to read:
Subd. 5. Basic Health Care Grants
General 834,098,000938,504,000
The amounts that may be spent from this appropriation for
each purpose are as follows:
(a) MA Basic Health Care Grants-Families and Children
General 322,970,000367,726,000
(b) MA Basic Health Care Grants-Elderly & Disabled
General 337,659,000 400,408,000
[PUBLIC HEALTH NURSE ASSESSMENT.] The reimbursement for
public health nurse visits relating to the provision of personal care services
under Minnesota Statutes, sections 256B.0625, subdivision 19a, and 256B.0627, is
$204.36 for the initial assessment visit and $102.18 for each reassessment
visit.
[SURCHARGE COMPLIANCE.] In the event that federal
financial participation in the Minnesota medical assistance program is reduced
as a result of a determination that Minnesota is out of compliance with Public
Law Number 102-234 or its implementing regulations or with any other federal law
designed to restrict provider tax programs or intergovernmental transfers, the
commissioner shall appeal the determination to the fullest extent permitted by
law and may ratably reduce all medical assistance and general assistance medical
care payments to providers other than the state of Minnesota in order to
eliminate any shortfall resulting from the reduced federal funding. Any amount
later recovered through the appeals process shall be used to reimburse providers
for any ratable reductions taken.
[BLOOD PRODUCTS LITIGATION.] To the extent permitted by
federal law, Minnesota Statutes, sections 256.015, 256B.042, 256B.056, and
256B.15 are waived as necessary for the limited purpose of resolving the state's
claims in connection with In re Factor VIII or IX Concentrate Blood Products
Litigation, MDL-986, No. 93-C7452 (N.D.III.).
[DISTRIBUTION TO MEDICAL ASSISTANCE PROVIDERS.] (a) Of
the amount appropriated to the medical assistance account in fiscal year 1998,
$5,000,000 plus the federal financial participation amount shall be distributed
to medical assistance providers according to the distribution methodology of the
medical education research trust fund established under Minnesota Statutes,
section 62J.69.
(b) In fiscal year 1999, the prepaid medical assistance
and prepaid general assistance medical care capitation rate reduction amounts
under Minnesota Statutes, section 256B.69, subdivision 5c, and the federal
financial participation amount associated with the medical assistance reduction,
shall be distributed to medical assistance providers according to the
distribution methodology of the trust fund.
(c) General Assistance Medical Care
General 173,469,000 170,370,000
[HEALTH CARE ACCESS TRANSFERS TO GENERAL FUND.] Funds
shall be transferred from the health care access fund to the general fund in an
amount equal to the projected savings to general assistance medical care (GAMC)
that would result from the transition of GAMC parents and adults without
children to MinnesotaCare. Based on this projection, for state fiscal year 1998,
the amount transferred from the health care access fund to the general fund
shall be $13,700,000. The amount of transfer, if any, necessary for state fiscal
year 1999 shall be [TUBERCULOSIS COST OF CARE.] Of the general fund
appropriation, $89,000 for the biennium is for the cost of care that is required
to be paid by the commissioner under Minnesota Statutes, section 144.4872, to
diagnose or treat tuberculosis carriers.
Sec. 8. Laws 1997, chapter 203, article 1, section 2,
subdivision 12, is amended to read:
Subd. 12. Federal TANF Funds
[FEDERAL TANF FUNDS.] (a)
Federal Temporary Assistance for Needy Families block grant funds authorized
under title I of Public Law Number 104-193, the Personal Responsibility and Work
Opportunity Reconciliation Act of 1996, are appropriated to the commissioner in
amounts up to (b) The commissioner may use TANF
reserve funds to offset any future reductions in the amount of the state's
allocation of federal TANF block grant funds.
Sec. 9. [CARRYOVER LIMITATION.]
The appropriations in this article
which are allowed to be carried forward from fiscal year 1998 to fiscal year
1999 shall not become part of the base level funding for the 2000-2001 biennial
budget, unless specifically directed by the legislature.
Sec. 10. [SUNSET OF UNCODIFIED LANGUAGE.]
All uncodified language contained
in this article expires on June 30, 1999, unless a different expiration date is
specified.
Sec. 11. [EFFECTIVE DATE.]
The amendments to Laws 1997,
chapter 203, article 1, section 2, subdivision 12, in section 8 are effective
the day following final enactment.
Section 1. Minnesota Statutes 1997 Supplement, section
62D.11, subdivision 1, is amended to read:
Subdivision 1. [ENROLLEE COMPLAINT SYSTEM.] Every health
maintenance organization shall establish and maintain a complaint system, as
required under section 62Q.105 to provide reasonable procedures for the
resolution of written complaints initiated by or on behalf of enrollees
concerning the provision of health care services. "Provision of health
services" includes, but is not limited to, questions of
the scope of coverage, quality of care, and administrative operations. The
health maintenance organization must inform enrollees that they may choose to
use Sec. 2. Minnesota Statutes 1997 Supplement, section
62J.70, subdivision 3, is amended to read:
Subd. 3. [HEALTH PLAN COMPANY.] "Health plan company"
means a health plan company as defined in section
62Q.01, subdivision 4, the medical assistance program,
the MinnesotaCare program, the general assistance medical care program, the
state employee group insurance program, the public employees insurance program
under section 43A.316, and coverage provided by political subdivisions under
section 471.617.
Sec. 3. Minnesota Statutes 1997 Supplement, section
62J.71, subdivision 1, is amended to read:
Subdivision 1. [PROHIBITED AGREEMENTS AND DIRECTIVES.]
The following types of agreements and directives are contrary to state public
policy, are prohibited under this section, and are null and void:
(1) any agreement or directive
that prohibits a health care provider from communicating with an enrollee with
respect to the enrollee's health status, health care, or treatment options, if
the health care provider is acting in good faith and within the provider's scope
of practice as defined by law;
(2) any agreement or directive that prohibits a health
care provider from making a recommendation regarding the suitability or
desirability of a health plan company, health insurer, or health coverage plan
for an enrollee, unless the provider has a financial conflict of interest in the
enrollee's choice of health plan company, health insurer, or health coverage
plan;
(3) any agreement or directive that prohibits a provider
from providing testimony, supporting or opposing legislation, or making any
other contact with state or federal legislators or legislative staff or with
state and federal executive branch officers or staff;
(4) any agreement or directive that prohibits a health
care provider from disclosing accurate information about whether services or
treatment will be paid for by a patient's health plan company or health insurer
or health coverage plan; and
(5) any agreement or directive that prohibits a health
care provider from informing an enrollee about the nature of the reimbursement
methodology used by an enrollee's health plan company, health insurer, or health
coverage plan to pay the provider.
Sec. 4. Minnesota Statutes 1997 Supplement, section
62J.71, subdivision 3, is amended to read:
Subd. 3. [RETALIATION PROHIBITED.] No person, health plan
company, or other organization may take retaliatory action against a health care
provider solely on the grounds that the provider:
(1) refused to enter into an agreement or provide
services or information in a manner that is prohibited under this section or
took any of the actions listed in subdivision 1;
(2) disclosed accurate information about whether a health
care service or treatment is covered by an enrollee's health plan company,
health insurer, or health coverage plan; (3) discussed diagnostic,
treatment, or referral options that are not covered or are limited by the
enrollee's health plan company, health insurer, or health coverage plan;
(4) criticized coverage of the
enrollee's health plan company, health insurer, or health coverage plan; or
(5) expressed personal
disagreement with a decision made by a person, organization, or health care
provider regarding treatment or coverage provided to a patient of the provider,
or assisted or advocated for the patient in seeking
reconsideration of such a decision, provided the health care provider makes it
clear that the provider is acting in a personal capacity and not as a
representative of or on behalf of the entity that made the decision.
Sec. 5. Minnesota Statutes 1997 Supplement, section
62J.71, subdivision 4, is amended to read:
Subd. 4. [EXCLUSION.] (a) Nothing in this section
prohibits (b) Nothing in this section prohibits a contract
provision or directive that requires any contracting party to keep confidential
or to not use or disclose the specific amounts paid to a provider, provider fee
schedules, provider salaries, and other similar
provider-specific proprietary information of a specific Sec. 6. Minnesota Statutes 1997 Supplement, section
62J.72, subdivision 1, is amended to read:
Subdivision 1. [WRITTEN DISCLOSURE.] (a) A health plan
company, as defined under section 62J.70, subdivision 3, a health care network
cooperative as defined under section 62R.04, subdivision 3, and a health care
provider as defined under section 62J.70, subdivision 2, shall, during open
enrollment, upon enrollment, and annually thereafter, provide enrollees with a
description of the general nature of the reimbursement methodologies used by the
health plan company, health insurer, or health coverage plan to pay providers.
The description must explain clearly any aspect of the
reimbursement methodology that in any way may tend to make it advantageous for
the health care provider to minimize or restrict the health care provided to
enrollees. This description may be incorporated into the member handbook,
subscriber contract, certificate of coverage, or other written enrollee
communication. The general reimbursement methodology shall be made available to
employers at the time of open enrollment.
(b) Health plan companies, health
care network cooperatives, and providers must, upon request, provide an
enrollee with specific information regarding the reimbursement methodology,
including, but not limited to, the following information:
(1) a concise written description of the provider payment
plan, including any incentive plan applicable to the enrollee;
(2) a written description of any incentive to the
provider relating to the provision of health care services to enrollees,
including any compensation arrangement that is dependent on the amount of health
coverage or health care services provided to the enrollee, or the number of
referrals to or utilization of specialists; and
(3) a written description of any incentive plan that
involves the transfer of financial risk to the health care provider.
(c) The disclosure statement describing the general
nature of the reimbursement methodologies must comply with the Readability of
Insurance Policies Act in chapter 72C (d) A disclosure statement that has (e) The disclosure statement describing the general
nature of the reimbursement methodologies must be provided upon request in
English, Spanish, Vietnamese, and Hmong. In addition, reasonable efforts must be
made to provide information contained in the disclosure statement to other
non-English-speaking enrollees.
(f) Health plan companies and providers may enter into
agreements to determine how to respond to enrollee requests received by either
the provider or the health plan company. Health plan
companies may also enter into agreements to determine how to respond to enrollee
requests. This subdivision does not require disclosure of specific amounts
paid to a provider, provider fee schedules, provider salaries, or other
proprietary information of a specific health plan company or health insurer or
health coverage plan or provider.
Sec. 7. [62J.77] [DEFINITIONS.]
Subdivision 1.
[APPLICABILITY.] For purposes of sections 62J.77 to
62J.80, the terms defined in this section have the meanings given them.
Subd. 2. [ENROLLEE.] "Enrollee" means a natural person covered by a health plan
company, health insurance, or health coverage plan and includes an insured,
policyholder, subscriber, contract holder, member, covered person, or
certificate holder.
Subd. 3. [PATIENT.] "Patient" means a former, current, or prospective patient of
a health care provider.
Sec. 8. [62J.78] [ESTABLISHMENT; ORGANIZATION.]
Subdivision 1. [GENERAL.] The office of health care consumer assistance, advocacy, and
information is established to provide assistance, advocacy, and information to
all health care consumers within the state. The office shall have no regulatory
power or authority and shall not provide legal representation in a court of
law.
Subd. 2. [EXECUTIVE DIRECTOR.]
An executive director shall be appointed by the governor,
in consultation with the consumer advisory board, for a three-year term and may
be removed only for just cause. The executive director must be selected without
regard to political affiliation and must be a person who has knowledge and
experience concerning the needs and rights of health care consumers and must be
qualified to analyze questions of law, administrative functions, and public
policy. No person may serve as executive director while holding another public
office. The director shall serve in the unclassified service.
Subd. 3. [STAFF.] The executive director shall appoint at least nine consumer
advocates to discharge the responsibilities and duties of the office. The
executive director and full-time staff shall be included in the Minnesota state
retirement association.
Subd. 4. [DELEGATION.] The executive director may delegate to staff any of the
authority or duties of the director, except the duty of formally making
recommendations to the legislature.
Subd. 5. [TRAINING.] The executive director shall ensure that the consumer
advocates are adequately trained.
Subd. 6. [STATEWIDE ADVOCACY.]
The executive director shall assign a consumer advocate
to represent each regional coordinating board's geographic area.
Subd. 7. [FINANCIAL INTEREST.]
The executive director and staff must not have any direct
personal financial interest in the health care system, except as an individual
consumer of health care services.
Subd. 8. [ADMINISTRATION.] The office of the ombudsman for mental health and mental
retardation shall coordinate and share administrative services with the office
of health care consumer assistance, advocacy, and information. To the extent
practical, all ombudsman offices with health care responsibilities shall have
their telephone systems linked in order to facilitate immediate referrals.
Sec. 9. [62J.79] [DUTIES AND POWERS OF THE OFFICE OF
HEALTH CARE CONSUMER ASSISTANCE, ADVOCACY, AND INFORMATION.]
Subdivision 1. [DUTIES.] (a) The executive director shall provide information and
assistance to all health care consumers by:
(1) assisting patients and
enrollees in understanding and asserting their contractual and legal rights,
including the rights under an alternative dispute resolution process. This
assistance may include advocacy for enrollees in administrative proceedings or
other formal or informal dispute resolution processes;
(2) assisting enrollees in
obtaining health care referrals under their health plan company, health
insurance, or health coverage plan;
(3) assisting patients and
enrollees in accessing the services of governmental agencies, regulatory boards,
and other state consumer assistance programs, ombudsman, or advocacy services
whenever appropriate so that the patient or enrollee can take full advantage of
existing mechanisms for resolving complaints;
(4) referring patients and
enrollees to governmental agencies and regulatory boards for the investigation
of health care complaints and for enforcement action;
(5) educating and training
enrollees about their health plan company, health insurance, or health coverage
plan in order to enable them to assert their rights and to understand their
responsibilities;
(6) assisting enrollees in
receiving a timely resolution of their complaints;
(7) monitoring health care
complaints addressed by the office to identify specific complaint patterns or
areas of potential improvement;
(8) recommending to health plan
companies ways to identify and remove any barriers that might delay or impede
the health plan company's effort to resolve consumer complaints; and
(9) in performing the duties
specified in clauses (1) to (8), taking into consideration the special
situations of patients and enrollees who have unique culturally defined
needs.
(b) The executive director shall
prioritize the duties listed in this subdivision within the appropriations
allocated.
Subd. 2. [COMMUNICATION.] The executive director shall meet at least six times per
year with the consumer advisory board. The executive director shall share all
public information obtained by the office of health care consumer assistance,
advocacy, and information with the consumer advisory board in order to assist
the consumer advisory board in its role of advising the commissioners of health
and commerce and the legislature in accordance with section 62J.75.
Subd. 3. [REPORTS.] Beginning January 15, 1999, the executive director, on at
least a quarterly basis, shall provide data from the health care complaints
addressed by the office to the commissioners of health and commerce, the
consumer advisory board, the Minnesota council of health plans, the Insurance
Federation of Minnesota, and the information clearinghouse. Beginning January
15, 1999, the executive director must make an annual written report to the
legislature regarding activities of the office, including recommendations on
improving health care consumer assistance and complaint resolution
processes.
Sec. 10. [62J.80] [RETALIATION.]
A health plan company or health
care provider shall not retaliate or take adverse action against an enrollee or
patient who, in good faith, makes a complaint against a health plan company or
health care provider. If retaliation is suspected, the executive director may
report it to the appropriate regulatory authority.
Sec. 11. Minnesota Statutes 1997 Supplement, section
62Q.105, subdivision 1, is amended to read:
Subdivision 1. [ESTABLISHMENT.] Each health plan company
shall establish and make available to enrollees, by July 1, Sec. 12. [62Q.107] [PROHIBITED PROVISION; EFFECT OF
DENIAL OF CLAIM.]
No health plan, including the
coverages described in section 62A.011, subdivision 3, clauses (7) and (10), may
specify a standard of review upon which a court may review denial of a claim or
of any other decision made by a health plan company with respect to an enrollee.
This section prohibits limiting court review to a determination of whether the
health plan company's decision is arbitrary and capricious, an abuse of
discretion, or any other standard less favorable to the enrollee than a
preponderance of the evidence.
Sec. 13. Minnesota Statutes 1997 Supplement, section
62Q.30, is amended to read:
62Q.30 [EXPEDITED FACT FINDING AND DISPUTE RESOLUTION
PROCESS.]
The commissioner shall establish an expedited fact
finding and dispute resolution process to assist enrollees of health plan
companies with contested treatment, coverage, and service issues to be in effect
July 1, Sec. 14. Minnesota Statutes 1997 Supplement, section
103I.208, subdivision 2, is amended to read:
Subd. 2. [PERMIT FEE.] The permit fee to be paid by a
property owner is:
(1) for a well that is not in use under a maintenance
permit, $100 annually;
(2) for construction of a monitoring well, $120, which
includes the state core function fee;
(3) for a monitoring well that is unsealed under a
maintenance permit, $100 annually;
(4) for monitoring wells used as a leak detection device
at a single motor fuel retail outlet (5) for a groundwater thermal exchange device, in
addition to the notification fee for wells, $120, which includes the state core
function fee;
(6) for a vertical heat exchanger, $120;
(7) for a dewatering well that is unsealed under a
maintenance permit, $100 annually for each well, except a dewatering project
comprising more than five wells shall be issued a single permit for $500
annually for wells recorded on the permit; and
(8) for excavating holes for the purpose of installing
elevator shafts, $120 for each hole.
Sec. 15. Minnesota Statutes 1997 Supplement, section
144.1494, subdivision 1, is amended to read:
Subdivision 1. [CREATION OF ACCOUNT.] A rural physician
education account is established in the health care access fund. The
commissioner shall use money from the account to establish a loan forgiveness
program for medical residents agreeing to practice in designated rural areas, as
defined by the commissioner. Appropriations made to this
account do not cancel and are available until expended, except that at the end
of each biennium the commissioner shall cancel to the health care access fund
any remaining unobligated balance in this account.
Sec. 16. Minnesota Statutes 1996, section 144.701,
subdivision 1, is amended to read:
Subdivision 1. [CONSUMER INFORMATION.] The commissioner
of health shall ensure that the total costs, total revenues, overall utilization, and total services of each hospital
and each outpatient surgical center are reported to the public in a form
understandable to consumers.
Sec. 17. Minnesota Statutes 1996, section 144.701,
subdivision 2, is amended to read:
Subd. 2. [DATA FOR POLICY MAKING.] The commissioner of
health shall compile relevant financial and accounting,
utilization, and services data concerning hospitals and outpatient surgical
centers in order to have statistical information available for legislative
policy making.
Sec. 18. Minnesota Statutes 1996, section 144.701,
subdivision 4, is amended to read:
Subd. 4. [FILING FEES.] Each report which is required to
be submitted to the commissioner of health under sections 144.695 to 144.703 and
which is not submitted to a voluntary, nonprofit reporting organization in
accordance with section 144.702 shall be accompanied by a filing fee in an
amount prescribed by rule of the commissioner of health. Sec. 19. Minnesota Statutes 1996, section 144.702,
subdivision 1, is amended to read:
Subdivision 1. [REPORTING THROUGH A REPORTING
ORGANIZATION.] A hospital or outpatient surgical center may agree to submit its
financial, utilization, and services reports to a
voluntary, nonprofit reporting organization whose reporting procedures have been
approved by the commissioner of health in accordance with this section. Each report submitted to the voluntary, nonprofit reporting
organization under this section shall be accompanied by a filing fee.
Sec. 20. Minnesota Statutes 1996, section 144.702,
subdivision 2, is amended to read:
Subd. 2. [APPROVAL OF ORGANIZATION'S REPORTING
PROCEDURES.] The commissioner of health may approve voluntary reporting
procedures consistent with written operating requirements for the voluntary,
nonprofit reporting organization which shall be established annually by the
commissioner. These written operating requirements shall specify reports,
analyses, and other deliverables to be produced by the voluntary, nonprofit
reporting organization, and the dates on which those deliverables must be
submitted to the commissioner. These written operating requirements shall
specify deliverable dates sufficient to enable the commissioner of health to
process and report health care cost information system data to the commissioner
of human services by August 15 of each year. The commissioner of health shall,
by rule, prescribe standards for submission of data by hospitals and outpatient
surgical centers to the voluntary, nonprofit reporting organization or to the
commissioner. These standards shall provide for:
(a) The filing of appropriate financial, utilization, and services information with the
reporting organization;
(b) Adequate analysis and verification of that
financial, utilization, and services information; and
(c) Timely publication of the costs, revenues, and rates
of individual hospitals and outpatient surgical centers prior to the effective
date of any proposed rate increase. The commissioner of health shall annually
review the procedures approved pursuant to this subdivision.
Sec. 21. Minnesota Statutes 1996, section 144.702,
subdivision 8, is amended to read:
Subd. 8. [TERMINATION OR NONRENEWAL OF REPORTING
ORGANIZATION.] The commissioner may withdraw approval of any voluntary,
nonprofit reporting organization for failure on the part of the voluntary,
nonprofit reporting organization to comply with the written operating
requirements under subdivision 2. Upon the effective date of the withdrawal, all
funds collected by the voluntary, nonprofit reporting organization under The commissioner may choose not to renew approval of a
voluntary, nonprofit reporting organization if the organization has failed to
perform its obligations satisfactorily under the written operating requirements
under subdivision 2.
Sec. 22. [144.7022] [ADMINISTRATIVE PENALTY ORDERS FOR
REPORTING ORGANIZATIONS.]
Subdivision 1.
[AUTHORIZATION.] The commissioner may issue an order to
the voluntary, nonprofit reporting organization requiring violations to be
corrected and administratively assessing monetary penalties for violations of
sections 144.695 to 144.703 or rules, written operating requirements, orders,
stipulation agreements, settlements, or compliance agreements adopted, enforced,
or issued by the commissioner.
Subd. 2. [CONTENTS OF ORDER.]
An order assessing an administrative penalty under this
section must include:
(1) a concise statement of the
facts alleged to constitute a violation;
(2) a reference to the section of
law, rule, written operating requirement, order, stipulation agreement,
settlement, or compliance agreement that has been violated;
(3) a statement of the amount of
the administrative penalty to be imposed and the factors upon which the penalty
is based;
(4) a statement of the corrective
actions necessary to correct the violation; and
(5) a statement of the right to
request a hearing pursuant to sections 14.57 to 14.62.
Subd. 3. [CONCURRENT
CORRECTIVE ORDER.] The commissioner may issue an order
assessing an administrative penalty and requiring the violations cited in the
order to be corrected within 30 calendar days from the date the order is
received. Before the 31st day after the order was received, the voluntary,
nonprofit reporting organization that is subject to the order shall provide the
commissioner with information demonstrating that the violation has been
corrected or that a corrective plan, acceptable to the commissioner, has been
developed. The commissioner shall determine whether the violation has been
corrected and notify the voluntary, nonprofit reporting organization of the
commissioner's determination.
Subd. 4. [PENALTY.] If the commissioner determines that the violation has been
corrected or an acceptable corrective plan has been developed, the penalty may
be forgiven, except where there are repeated or serious violations, the
commissioner may issue an order with a penalty that will not be forgiven after
corrective action is taken. Unless there is a request for review of the order
under subdivision 6 before the penalty is due, the penalty is due and
payable:
(1) on the 31st calendar day after
the order was received, if the voluntary, nonprofit reporting organization fails
to provide information to the commissioner showing that the violation has been
corrected or that appropriate steps have been taken toward correcting the
violation;
(2) on the 20th day after the
voluntary, nonprofit reporting organization receives the commissioner's
determination that the information provided is not sufficient to show that
either the violation has been corrected or that appropriate steps have been
taken toward correcting the violation; or
(3) on the 31st day after the
order was received where the penalty is for repeated or serious violations and
according to the order issued, the penalty will not be forgiven after corrective
action is taken.
All penalties due under this
section are payable to the treasurer, state of Minnesota, and shall be deposited
in the general fund.
Subd. 5. [AMOUNT OF PENALTY;
CONSIDERATIONS.] (a) The maximum amount for an
administrative penalty is $5,000 for each specific violation identified in an
inspection, investigation, or compliance review, up to an annual maximum total
for all violations of ten percent of the fees collected by the voluntary,
nonprofit reporting organization under section 144.702, subdivision 1. The
annual total is based upon the reporting year.
(b) In determining the amount of
the administrative penalty, the commissioner shall consider the following:
(1) the willfulness of the
violation;
(2) the gravity of the
violation;
(3) the history of past
violations;
(4) the number of violations;
(5) the economic benefit gained by
the person allowing or committing the violation; and
(6) other factors as justice may
require, if the commissioner specifically identifies the additional factors in
the commissioner's order.
(c) In determining the amount of a
penalty for a violation committed after an initial violation, the commissioner
shall also consider:
(1) the similarity of the most
recent previous violation and the current violation;
(2) the time elapsed since the
last violation; and
(3) the response of the voluntary,
nonprofit reporting organization to the most recent previous violation.
Subd. 6. [REQUEST FOR HEARING;
HEARING; AND FINAL ORDER.] A request for hearing must be
in writing, delivered to the commissioner by certified mail within 20 calendar
days after the receipt of the order, and specifically state the reasons for
seeking review of the order. The commissioner must initiate a hearing within 30
calendar days from the date of receipt of the written request for hearing. The
hearing shall be conducted pursuant to the contested case procedures in sections
14.57 to 14.62. No earlier than ten calendar days after and within 30 calendar
days of receipt of the presiding administrative law judge's report, the
commissioner shall, based on all relevant facts, issue a final order modifying,
vacating, or making the original order permanent. If, within 20 calendar days of
receipt of the original order, the voluntary, nonprofit reporting organization
fails to request a hearing in writing, the order becomes the final order of the
commissioner.
Subd. 7. [REVIEW OF FINAL
ORDER AND PAYMENT OF PENALTY.] Once the commissioner
issues a final order, any penalty due under that order shall be paid within 30
calendar days after the date of the final order, unless review of the final
order is requested. The final order of the commissioner may be appealed in the
manner prescribed in sections 14.63 to 14.69. If the final order is reviewed and
upheld, the penalty shall be paid 30 calendar days after the date of the
decision of the reviewing court. Failure to request an administrative hearing
pursuant to subdivision 6 shall constitute a waiver of the right to further
agency or judicial review of the final order.
Subd. 8. [REINSPECTIONS AND
EFFECT OF NONCOMPLIANCE.] If upon reinspection, or in the
determination of the commissioner, it is found that any deficiency specified in
the order has not been corrected or an acceptable corrective plan has not been
developed, the voluntary, nonprofit reporting organization is in noncompliance.
The commissioner shall issue a notice of noncompliance and may impose any
additional remedy available under sections 144.695 to 144.703.
Subd. 9. [ENFORCEMENT.] The attorney general may proceed on behalf of the
commissioner to enforce penalties that are due and payable under this section in
any manner provided by law for the collection of debts.
Subd. 10. [TERMINATION OR
NONRENEWAL OF REPORTING ORGANIZATION.] The commissioner
may withdraw or not renew approval of any voluntary, nonprofit reporting
organization for failure on the part of the voluntary, nonprofit reporting
organization to pay penalties owed under this section.
Subd. 11. [CUMULATIVE REMEDY.]
The authority of the commissioner to issue an
administrative penalty order is in addition to other lawfully available
remedies.
Subd. 12. [MEDIATION.] In addition to review under subdivision 6, the commissioner
is authorized to enter into mediation concerning an order issued under this
section if the commissioner and the voluntary, nonprofit reporting organization
agree to mediation.
Sec. 23. Minnesota Statutes 1996, section 144.9501,
subdivision 1, is amended to read:
Subdivision 1. [CITATION.] Sections 144.9501 to 144.9509
may be cited as the " Sec. 24. Minnesota Statutes 1996, section 144.9501, is
amended by adding a subdivision to read:
Subd. 4a. [ASSESSING AGENCY.]
"Assessing agency" means the commissioner or a board of
health with authority and responsibility to conduct lead risk assessments in
response to reports of children or pregnant women with elevated blood lead
levels.
Sec. 25. Minnesota Statutes 1996, section 144.9501, is
amended by adding a subdivision to read:
Subd. 6b. [CLEARANCE
INSPECTION.] "Clearance inspection" means a visual
identification of deteriorated paint and bare soil and a resampling and analysis
of interior dust lead concentrations in a residence to ensure that the lead
standards established in rules adopted under section 144.9508 are not
exceeded.
Sec. 26. Minnesota Statutes 1996, section 144.9501,
subdivision 17, is amended to read:
Subd. 17. [LEAD HAZARD REDUCTION.] "Lead hazard
reduction" means action undertaken (1) a property owner or (2) a swab team service provided in response to a lead
order issued under section 144.9504; or
(3) a renter residing at a rental
property or one or more volunteers to comply with a lead order issued under
section 144.9504.
Sec. 27. Minnesota Statutes 1996, section 144.9501, is
amended by adding a subdivision to read:
Subd. 17a. [LEAD HAZARD
SCREEN.] "Lead hazard screen" means visual identification
of the existence and location of any deteriorated paint, collection and analysis
of dust samples, and visual identification of the existence and location of bare
soil.
Sec. 28. Minnesota Statutes 1996, section 144.9501,
subdivision 18, is amended to read:
Subd. 18. [LEAD INSPECTION.] "Lead inspection" means a Sec. 29. Minnesota Statutes 1996, section 144.9501,
subdivision 20, is amended to read:
Subd. 20. [LEAD ORDER.] "Lead order" means a legal
instrument to compel a property owner to engage in lead hazard reduction
according to the specifications given by the Sec. 30. Minnesota Statutes 1996, section 144.9501, is
amended by adding a subdivision to read:
Subd. 20a. [LEAD PROJECT
DESIGNER.] "Lead project designer" means an individual
who is responsible for planning the site-specific performance of lead abatement
or lead hazard reduction and who has been licensed by the commissioner under
section 144.9505.
Sec. 31. Minnesota Statutes 1996, section 144.9501, is
amended by adding a subdivision to read:
Subd. 20b. [LEAD RISK
ASSESSMENT.] "Lead risk assessment" means a quantitative
measurement of the lead content of paint, interior dust, and bare soil to
determine compliance with the standards established under section 144.9508.
Sec. 32. Minnesota Statutes 1996, section 144.9501, is
amended by adding a subdivision to read:
Subd. 20c. [LEAD RISK
ASSESSOR.] "Lead risk assessor" means an individual who
performs lead risk assessments or lead inspections and who has been licensed by
the commissioner under section 144.9506.
Sec. 33. Minnesota Statutes 1996, section 144.9501, is
amended by adding a subdivision to read:
Subd. 22a. [LEAD SUPERVISOR.]
"Lead supervisor" means an individual who is responsible
for the on-site performance of lead abatement or lead hazard reduction and who
has been licensed by the commissioner under section 144.9505.
Sec. 34. Minnesota Statutes 1996, section 144.9501,
subdivision 23, is amended to read:
Subd. 23. [LEAD WORKER.] "Lead worker" means Sec. 35. Minnesota Statutes 1996, section 144.9501, is
amended by adding a subdivision to read:
Subd. 25a. [PLAY AREA.] "Play area" means any established area where children play,
or on residential property, any established area where children play or bare
soil is accessible to children.
Sec. 36. Minnesota Statutes 1996, section 144.9501, is
amended by adding a subdivision to read:
Subd. 28a. [STANDARD.] "Standard" means a quantitative assessment of lead in any
environmental media or consumer product or a work practice or method that
reduces the likelihood of lead exposure.
Sec. 37. Minnesota Statutes 1996, section 144.9501,
subdivision 30, is amended to read:
Subd. 30. [SWAB TEAM WORKER.] "Swab team worker" means Sec. 38. Minnesota Statutes 1996, section 144.9501,
subdivision 32, is amended to read:
Subd. 32. [VOLUNTARY LEAD HAZARD REDUCTION.] "Voluntary
lead hazard reduction" means Sec. 39. Minnesota Statutes 1996, section 144.9502,
subdivision 3, is amended to read:
Subd. 3. [REPORTS OF BLOOD LEAD ANALYSIS REQUIRED.] (a) Every hospital, medical clinic, medical laboratory,
(1) within two working days by telephone, fax, or
electronic transmission, with written or electronic confirmation within one
month, for a venous blood lead level equal to or greater than 15 micrograms of
lead per deciliter of whole blood; or
(2) within one month in writing or by electronic
transmission, for (b) If a blood lead analysis is
performed outside of Minnesota and the facility performing the analysis does not
report the blood lead analysis results and epidemiological information required
in this section to the commissioner, the provider who collected the blood
specimen must satisfy the reporting requirements of this section. For purposes
of this section, "provider" has the meaning given in section 62D.02, subdivision
9.
(c) The commissioner shall
coordinate with hospitals, medical clinics, medical laboratories, and other
facilities performing blood lead analysis to develop a universal reporting form
and mechanism.
Sec. 40. Minnesota Statutes 1996, section 144.9502,
subdivision 4, is amended to read:
Subd. 4. [BLOOD LEAD ANALYSES AND EPIDEMIOLOGIC
INFORMATION.] The blood lead analysis reports required in this section must
specify:
(1) whether the specimen was collected as a capillary or
venous sample;
(2) the date the sample was collected;
(3) the results of the blood lead analysis;
(4) the date the sample was analyzed;
(5) the method of analysis used;
(6) the full name, address, and phone number of the
laboratory performing the analysis;
(7) the full name, address, and phone number of the
physician or facility requesting the analysis;
(8) the full name, address, and phone number of the
person with the Sec. 41. Minnesota Statutes 1996, section 144.9502,
subdivision 9, is amended to read:
Subd. 9. [CLASSIFICATION OF DATA.] Notwithstanding any
law to the contrary, including section 13.05, subdivision 9, data collected by
the commissioner of health about persons with Sec. 42. Minnesota Statutes 1996, section 144.9503,
subdivision 4, is amended to read:
Subd. 4. [SWAB TEAM SERVICES.] Primary prevention must
include the use of swab team services in census tracts identified at high risk
for toxic lead exposure as identified by the commissioner under this section.
The swab team services may be provided based on Sec. 43. Minnesota Statutes 1996, section 144.9503,
subdivision 6, is amended to read:
Subd. 6. [VOLUNTARY LEAD ABATEMENT
OR LEAD HAZARD REDUCTION.] The commissioner shall monitor the lead abatement or lead hazard reduction methods adopted under
section 144.9508 in cases of voluntary lead abatement or
lead hazard reduction. All licensed Sec. 44. Minnesota Statutes 1996, section 144.9503,
subdivision 7, is amended to read:
Subd. 7. [LEAD-SAFE INFORMATIONAL DIRECTIVES.] (a) By July 1, 1995, and amended and updated as
necessary, the commissioner shall develop in cooperation with the commissioner
of administration provisions and procedures to define lead-safe informational directives for residential remodeling,
renovation, installation, and rehabilitation activities that are not lead hazard
reduction, but may disrupt lead-based paint surfaces.
(b) The provisions and
procedures shall define lead-safe directives for nonlead hazard reduction
activities including preparation, cleanup, and disposal procedures. The
directives shall be based on the different levels and types of work involved and
the potential for lead hazards. The directives shall address activities
including painting; remodeling; weatherization; installation of cable, wire,
plumbing, and gas; and replacement of doors and windows. The commissioners of
health and administration shall consult with representatives of builders,
weatherization providers, nonprofit rehabilitation organizations, each of the
affected trades, and housing and redevelopment authorities in developing the
directives and procedures. This group shall also make recommendations for
consumer and contractor education and training. The commissioner of health shall
report to the legislature by February 15, 1996, regarding development of the
provisions required under this (c) By January 1, 1999, the
commissioner, in cooperation with interested and informed persons and using the
meeting structure and format developed in paragraph (b), shall develop lead-safe
informational directives on the following topics:
(1) maintaining floors, walls, and
ceilings;
(2) maintaining and repairing
porches;
(3) conducting a risk evaluation
for lead; and
(4) prohibited practices when
working with lead.
The commissioner shall report to
the legislature by January 1, 1999, regarding development of the provisions
required under this paragraph.
Sec. 45. Minnesota Statutes 1996, section 144.9504,
subdivision 1, is amended to read:
Subdivision 1. [JURISDICTION.] (a) A board of health
serving cities of the first class must conduct lead (b) (c) The commissioner may assist boards of health by
providing technical expertise, equipment, and personnel to boards of health. The
commissioner may provide laboratory or field lead-testing equipment to a board
of health or may reimburse a board of health for direct costs associated with
lead (d) The commissioner shall enforce the rules under
section 144.9508 in cases of voluntary lead hazard reduction.
Sec. 46. Minnesota Statutes 1997 Supplement, section
144.9504, subdivision 2, is amended to read:
Subd. 2. [LEAD (1) within 48 hours of a child or pregnant female in the
residence being identified to the agency as having a venous blood lead level
equal to or greater than 70 micrograms of lead per deciliter of whole blood;
(2) within five working days of a child or pregnant
female in the residence being identified to the agency as having a venous blood
lead level equal to or greater than 45 micrograms of lead per deciliter of whole
blood;
(3) within ten working days of a child in the residence
being identified to the agency as having a venous blood lead level equal to or
greater than 20 micrograms of lead per deciliter of whole blood;
(4) within ten working days of a child in the residence
being identified to the agency as having a venous blood lead level that persists
in the range of 15 to 19 micrograms of lead per deciliter of whole blood for 90
days after initial identification; or
(5) within ten working days of a pregnant female in the
residence being identified to the agency as having a venous blood lead level
equal to or greater than ten micrograms of lead per deciliter of whole blood.
(b) Within the limits of available state and federal
appropriations, an (c) In a building with two or more dwelling units, an (d) Within the limits of appropriations, the (e) The to determine the lead content, except that deteriorated
painted surfaces or bare soil need not be tested if the property owner agrees to
engage in lead hazard reduction on those surfaces. The
lead content of drinking water must be measured if a probable source of lead
exposure is not identified by measurement of lead in paint, bare soil, or dust.
Within a standard metropolitan statistical area, an assessing agency may order
lead hazard reduction of bare soil without measuring the lead content of the
bare soil if the property is in a census tract in which soil sampling has been
performed according to rules established by the commissioner and at least 25
percent of the soil samples contain lead concentrations above the standard in
section 144.9508.
(f) A lead (g) Each (h) Sections 144.9501 to 144.9509 neither authorize nor
prohibit an Sec. 47. Minnesota Statutes 1996, section 144.9504,
subdivision 3, is amended to read:
Subd. 3. [LEAD EDUCATION STRATEGY.] At the time of a lead
Sec. 48. Minnesota Statutes 1996, section 144.9504,
subdivision 4, is amended to read:
Subd. 4. [LEAD (1) the requirements of this section and rules adopted
under section 144.9508;
(2) information on the administrative appeal procedures
required under this section;
(3) summary information on lead-safe directives;
(4) be understandable at an eighth grade reading level;
and
(5) be translated for use by non-English-speaking
persons.
(b) An (1) parents and other caregivers of children who are
identified as having blood lead levels of at least ten micrograms of lead per
deciliter of whole blood;
(2) all property owners who are issued housing code or
lead orders requiring lead hazard reduction of lead sources and all occupants of
those properties; and
(3) occupants of residences adjacent to the inspected
property.
(c) An Sec. 49. Minnesota Statutes 1996, section 144.9504,
subdivision 5, is amended to read:
Subd. 5. [LEAD ORDERS.] An Sec. 50. Minnesota Statutes 1996, section 144.9504,
subdivision 6, is amended to read:
Subd. 6. [SWAB TEAM SERVICES.] After a lead Sec. 51. Minnesota Statutes 1996, section 144.9504,
subdivision 7, is amended to read:
Subd. 7. [RELOCATION OF RESIDENTS.] (a) Within the limits
of appropriations, the (b) A resident of rental property who is notified by an
(1) shall not be required to pay rent due the landlord
for the period of time the tenant vacates the premises due to lead hazard
reduction;
(2) may elect to immediately terminate the tenancy
effective on the date the tenant vacates the premises due to lead hazard
reduction; and
(3) shall not, if the tenancy is terminated, be liable
for any further rent or other charges due under the terms of the tenancy.
(c) A landlord of rental property whose tenants vacate
the premises during lead hazard reduction shall:
(1) allow a tenant to return to the dwelling unit after
lead hazard reduction and clearance inspection, required under this section, is
completed, unless the tenant has elected to terminate the tenancy as provided
for in paragraph (b); and
(2) return any security deposit due under section 504.20
within five days of the date the tenant vacates the unit, to any tenant who
terminates tenancy as provided for in paragraph (b).
Sec. 52. Minnesota Statutes 1996, section 144.9504,
subdivision 8, is amended to read:
Subd. 8. [PROPERTY OWNER RESPONSIBILITY.] Property owners
shall comply with lead orders issued under this section within 60 days or be
subject to enforcement actions as provided under section 144.9509. For orders or
portions of orders concerning external lead hazards, property owners shall
comply within 60 days, or as soon thereafter as weather permits. If the property
owner does not Sec. 53. Minnesota Statutes 1996, section 144.9504,
subdivision 9, is amended to read:
Subd. 9. [CLEARANCE INSPECTION.] After completion of swab
team services and compliance with the lead orders by the property owner,
including any repairs ordered by a local housing or building inspector, the Sec. 54. Minnesota Statutes 1996, section 144.9504,
subdivision 10, is amended to read:
Subd. 10. [CASE CLOSURE.] A lead (1) lead orders are written on all known sources of
violations of lead standards under section 144.9508;
(2) compliance with all lead orders has been completed;
and
(3) clearance inspections demonstrate that no
deteriorated lead paint, bare soil, or lead dust levels exist that exceed the
standards adopted under section 144.9508.
Sec. 55. Minnesota Statutes 1996, section 144.9505,
subdivision 1, is amended to read:
Subdivision 1. [LICENSING AND CERTIFICATION.] (a) training provided by the commissioner. (b) Sec. 56. Minnesota Statutes 1996, section 144.9505,
subdivision 4, is amended to read:
Subd. 4. [NOTICE OF LEAD ABATEMENT OR LEAD HAZARD
REDUCTION WORK.] (a) At least five working days before starting work at each
lead abatement or lead hazard reduction worksite, the person performing the lead
abatement or lead hazard reduction work shall give written notice and an
approved work plan as required in this section to the commissioner and the
appropriate board of health. Within the limits of appropriations, the
commissioner shall review plans and shall approve or disapprove them as to
compliance with the requirements in subdivision 5.
(b) This provision does not apply to swab team workers
performing work under an order of an Sec. 57. Minnesota Statutes 1996, section 144.9505,
subdivision 5, is amended to read:
Subd. 5. [ABATEMENT OR LEAD HAZARD REDUCTION WORK PLANS.] (a) A (1) the building area and building components to be
worked on;
(2) the amount of lead-containing material to be removed,
encapsulated, or enclosed;
(3) the schedule to be followed for each work stage;
(4) the workers' personal protection equipment and
clothing;
(5) the dust suppression and debris containment methods;
(6) the lead abatement or lead hazard reduction methods
to be used on each building component;
(7) cleaning methods;
(8) temporary, on-site waste storage, if any; and
(9) the methods for transporting waste material and its
destination.
(b) (c) (d) (e) This provision does not apply to swab team workers
performing work under an order of an Sec. 58. Minnesota Statutes 1997 Supplement, section
144.9506, subdivision 1, is amended to read:
Subdivision 1. [LICENSE REQUIRED.] (a) A (b) Individuals shall not advertise or otherwise present
themselves as lead inspectors or lead risk assessors
unless licensed by the commissioner.
(c) An individual may use sodium rhodizonate to test
paint for the presence of lead without obtaining a lead inspector or lead risk assessor license, but must not represent
the test as a lead inspection or lead risk
assessment.
Sec. 59. Minnesota Statutes 1996, section 144.9506,
subdivision 2, is amended to read:
Subd. 2. [LICENSE APPLICATION.] An application for a
license or license renewal shall be on a form provided by the commissioner and
shall include:
(1) a (2) evidence that the applicant has successfully
completed a lead inspector training course approved under this section or from
another state with which the commissioner has established reciprocity. The fee
required in this section is waived for federal, state, or local government
employees within Minnesota.
Sec. 60. Minnesota Statutes 1996, section 144.9507,
subdivision 2, is amended to read:
Subd. 2. [LEAD Sec. 61. Minnesota Statutes 1996, section 144.9507,
subdivision 3, is amended to read:
Subd. 3. [TEMPORARY LEAD-SAFE HOUSING CONTRACTS.] The
commissioner shall, within the limits of available appropriations, contract with
boards of health for temporary housing, to be used in meeting relocation
requirements in section 144.9504, and award grants to boards of health for the
purposes of paying housing and relocation costs under section 144.9504. The commissioner may use up to 15 percent of the available
appropriations to provide temporary lead-safe housing in areas of the state in
which the commissioner has the duty under section 144.9504 to perform secondary
prevention.
Sec. 62. Minnesota Statutes 1996, section 144.9507,
subdivision 4, is amended to read:
Subd. 4. [ (b) Nonprofit community-based
organizations in areas at high risk for toxic lead exposure may apply for grants
from the commissioner to purchase lead cleanup equipment and materials and to
pay for training for staff and volunteers for lead licensure under sections
144.9505 and 144.9506.
(c) For purposes of this section,
lead cleanup equipment and materials means high efficiency particle accumulator
(HEPA) and wet vacuum cleaners, wash water filters, mops, buckets, hoses,
sponges, protective clothing, drop cloths, wet scraping equipment, secure
containers, dust and particle containment material, and other cleanup and
containment materials to remove loose paint and plaster, patch plaster, control
household dust, wax floors, clean carpets and sidewalks, and cover bare
soil.
(d) The grantee's staff and
volunteers may make lead cleanup equipment and materials available to residents
and property owners and instruct them on the proper use of the equipment. Lead
cleanup equipment and materials must be made available to low-income households,
as defined by federal guidelines, on a priority basis at no fee. Other
households may be charged on a sliding fee scale.
(e) The grantee shall not charge a
fee for services performed using the equipment or materials.
(f) Any funds appropriated for
purposes of this subdivision that are not awarded, due to a lack of acceptable
proposals for the full amount appropriated, may be used for any purpose
authorized in this section.
Sec. 63. Minnesota Statutes 1996, section 144.9508,
subdivision 1, is amended to read:
Subdivision 1. [SAMPLING AND ANALYSIS.] The commissioner
shall adopt, by rule, (1) lead inspections (2) environmental surveys of lead in paint, soil, dust,
and drinking water to determine census tracts that are areas at high risk for
toxic lead exposure;
(3) soil sampling for soil used as replacement soil; (4) drinking water sampling, which shall be done in
accordance with lab certification requirements and analytical techniques
specified by Code of Federal Regulations, title 40, section 141.89; and
(5) sampling to determine whether
at least 25 percent of the soil samples collected from a census tract within a
standard metropolitan statistical area contain lead in concentrations that
exceed 100 parts per million.
Sec. 64. Minnesota Statutes 1996, section 144.9508, is
amended by adding a subdivision to read:
Subd. 2a. [LEAD STANDARDS FOR
EXTERIOR SURFACES AND STREET DUST.] The commissioner may,
by rule, establish lead standards for exterior horizontal surfaces, concrete or
other impervious surfaces, and street dust on residential property to protect
the public health and the environment.
Sec. 65. Minnesota Statutes 1996, section 144.9508,
subdivision 3, is amended to read:
Subd. 3. [ also adopt rules requiring certification of firms that
perform lead abatement, lead hazard reduction, lead hazard screens, or lead risk
assessments. The commissioner shall require periodic renewal of licenses and
certificates and shall establish the renewal periods Sec. 66. Minnesota Statutes 1996, section 144.9508,
subdivision 4, is amended to read:
Subd. 4. [LEAD TRAINING COURSE.] The commissioner shall
establish by rule a permit fee to be paid by a training course provider on
application for a training course permit or renewal period for each lead-related
training course required for certification or licensure. The commissioner shall establish criteria in rules for the
content and presentation of training courses intended to qualify trainees for
licensure under subdivision 3. Training course permit fees shall be
nonrefundable and must be submitted with each application in the amount of $500
for an initial training course, $250 for renewal of a permit for an initial
training course, $250 for a refresher training course, and $125 for renewal of a
permit of a refresher training course.
Sec. 67. Minnesota Statutes 1996, section 144.9509,
subdivision 2, is amended to read:
Subd. 2. [DISCRIMINATION.] A person who discriminates
against or otherwise sanctions an employee who complains to or cooperates with
the Sec. 68. [144.9511] [LEAD-SAFE PROPERTY CERTIFICATION.]
Subdivision 1. [LEAD-SAFE
PROPERTY CERTIFICATION PROGRAM ESTABLISHED.] (a) The
commissioner shall establish, within the limits of available appropriations, a
voluntary lead-safe property certification program for residential properties.
This program shall involve an initial property certification process, a property
condition report, and a lead-safe property certification booklet.
(b) The commissioner shall
establish an initial property certification process composed of the
following:
(1) a lead hazard screen, which
shall include a visual evaluation of a residential property for both
deteriorated paint and bare soil; and
(2) a quantitative measure of lead
in dust within the structure and in common areas as determined by rule adopted
under authority of section 144.9508.
(c) The commissioner shall
establish forms and checklists for conducting a property condition report. A
property condition report is an evaluation of property components, without
regard to aesthetic considerations, to determine whether any of the following
conditions are likely to occur within one year of the report:
(1) paint will become chipped,
flaked, or cracked;
(2) structural defects in the
roof, windows, or plumbing will fail and cause paint to deteriorate;
(3) window wells or window troughs
will not be cleanable and washable;
(4) windows will generate dust due
to friction;
(5) cabinet, room, and threshold
doors will rub against casings or have repeated contact with painted
surfaces;
(6) floors will not be smooth and
cleanable and carpeted floors will not be cleanable;
(7) soil will not remain
covered;
(8) bare soil in vegetable and
flower gardens will not (i) be inaccessible to children or (ii) be tested to
determine if it is below the soil standard under section 144.9508;
(9) parking areas will not remain
covered by an impervious surface or gravel;
(10) covered soil will erode,
particularly in play areas; and
(11) gutters and down spouts will
not function correctly.
(d) The commissioner shall develop
a lead-safe property certification booklet that contains the following:
(1) information on how property
owners and their maintenance personnel can perform essential maintenance
practices to correct any of the property component conditions listed in
paragraph (c) that may occur;
(2) the lead-safe work practices
fact sheets created under section 144.9503, subdivision 7;
(3) forms, checklists, and copies
of recommended lead-safe property certification certificates; and
(4) an educational sheet for
landlords to give to tenants on the importance of having tenants inform property
owners or designated maintenance staff of one or more of the conditions listed
in paragraph (c).
Subd. 2. [CONDITIONS FOR
CERTIFICATION.] A property shall be certified as
lead-safe only if the following conditions are met:
(1) the property passes the
initial certification process in subdivision 1;
(2) the property owner agrees in
writing to perform essential maintenance practices;
(3) the property owner agrees in
writing to use lead-safe work practices, as provided for under section 144.9503,
subdivision 7;
(4) the property owner performs
essential maintenance as the need arises or uses maintenance personnel who have
completed a United States Environmental Protection Agency- or Minnesota
department of health-approved maintenance training program or course to perform
essential maintenance;
(5) the lead-safe property
certification booklet is distributed to the property owner, maintenance
personnel, and tenants at the completion of the initial certification process;
and
(6) a copy of the lead-safe
property certificate is filed with the commissioner along with a $5 filing
fee.
Subd. 3. [LEAD STANDARDS.] Lead standards used in this section shall be those approved
by the commissioner under section 144.9508.
Subd. 4. [LEAD RISK
ASSESSORS.] Lead-safe property certifications shall only
be performed by lead risk assessors licensed by the commissioner under section
144.9506.
Subd. 5. [EXPIRATION.] Lead-safe property certificates are valid for one year.
Subd. 6. [LIST OF CERTIFIED
PROPERTIES.] Within the limits of available
appropriations, the commissioner shall maintain a list of all properties
certified as lead-safe under this section and make it freely available to the
public.
Subd. 7. [REAPPLICATION.] Properties failing the initial property certification may
reapply for a lead-safe property certification by having a new initial
certification process performed and by correcting any condition listed by the
licensed lead risk assessor in the property condition report. Properties that
fail the initial property certification process must have the condition
corrected by the property owner, by trained maintenance staff, or by a
contractor with personnel licensed for lead hazard reduction or lead abatement
work by the commissioner under section 144.9505, in order to have the property
certified.
Sec. 69. Minnesota Statutes 1996, section 144.99,
subdivision 1, is amended to read:
Subdivision 1. [REMEDIES AVAILABLE.] The provisions of
chapters 103I and 157 and sections 115.71 to 115.77; 144.12, subdivision 1,
paragraphs (1), (2), (5), (6), (10), (12), (13), (14), and (15); 144.121;
144.1222; 144.35; 144.381 to 144.385; 144.411 to 144.417; Sec. 70. Minnesota Statutes 1996, section 144A.44,
subdivision 2, is amended to read:
Subd. 2. [INTERPRETATION AND ENFORCEMENT OF RIGHTS.]
These rights are established for the benefit of persons who receive home care
services. "Home care services" means home care services as defined in section
144A.43, subdivision 3. A home care provider may not require a person to
surrender these rights as a condition of receiving services. A guardian or
conservator or, when there is no guardian or conservator, a designated person,
may seek to enforce these rights. This statement of rights does not replace or
diminish other rights and liberties that may exist relative to persons receiving
home care services, persons providing home care services, or providers licensed
under Laws 1987, chapter 378. A copy of these rights must be provided to an
individual at the time home care services are initiated. The copy shall also
contain the address and phone number of the office of health facility complaints
and the office of the ombudsman for older Minnesotans
and a brief statement describing how to file a complaint with Sec. 71. Minnesota Statutes 1997 Supplement, section
144A.46, subdivision 2, is amended to read:
Subd. 2. [EXEMPTIONS.] The following individuals or
organizations are exempt from the requirement to obtain a home care provider
license:
(1) a person who is licensed as a registered nurse under
sections 148.171 to 148.285 and who independently provides nursing services in
the home without any contractual or employment relationship to a home care
provider or other organization;
(2) a personal care assistant who provides services to
only one individual under the medical assistance program as authorized under
sections 256B.0625, subdivision 19, and 256B.04, subdivision 16;
(3) a person or organization that exclusively offers,
provides, or arranges for personal care assistant services to only one
individual under the medical assistance program as authorized under sections
256B.0625, subdivision 19, and 256B.04, subdivision 16;
(4) a person who is (5) a provider that is licensed by the commissioner of
human services to provide semi-independent living services under Minnesota
Rules, parts 9525.0500 to 9525.0660 when providing home care services to a
person with a developmental disability;
(6) a provider that is licensed by the commissioner of
human services to provide home and community-based services under Minnesota
Rules, parts 9525.2000 to 9525.2140 when providing home care services to a
person with a developmental disability;
(7) a person or organization that provides only home
management services, if the person or organization is registered under section
144A.461; or
(8) a person who is licensed as a social worker under
sections 148B.18 to 148B.289 and who provides social work services in the home
independently and not through any contractual or employment relationship with a
home care provider or other organization.
An exemption under this subdivision does not excuse the
individual from complying with applicable provisions of the home care bill of
rights.
Sec. 72. Minnesota Statutes 1997 Supplement, section
144A.4605, subdivision 4, is amended to read:
Subd. 4. [LICENSE REQUIRED.] (a) A housing with services
establishment registered under chapter 144D that is required to obtain a home
care license must obtain an assisted living home care license according to this
section or a class A or class E license according to
rule. A housing with services establishment that obtains
a class E license under this subdivision remains subject to the payment
limitations in sections 256B.0913, subdivision 5, paragraph (h), and 256B.0915,
subdivision 3, paragraph (g).
(b) A board and lodging establishment registered for
special services as of December 31, 1996, and also registered as a housing with
services establishment under chapter 144D, must deliver home care services
according to sections 144A.43 to 144A.49, and may apply for a waiver from
requirements under Minnesota Rules, parts 4668.0002 to 4668.0240, to operate a
licensed agency under the standards of section 157.17. Such waivers as may be
granted by the department will expire upon promulgation of home care rules
implementing section 144A.4605.
(c) An adult foster care provider licensed by the
department of human services and registered under chapter 144D may continue to
provide health-related services under its foster care license until the
promulgation of home care rules implementing this section.
Sec. 73. Minnesota Statutes 1996, section 145.411, is
amended by adding a subdivision to read:
Subd. 6. [COMMISSIONER.] "Commissioner" means the commissioner of health.
Sec. 74. [145.4131] [RECORDING AND REPORTING ABORTION
DATA.]
Subdivision 1. [FORMS.] (a) Within 90 days of the effective date of this section,
the commissioner shall prepare a reporting form for physicians performing
abortions. A copy of this section shall be attached to the form. A physician
performing an abortion shall obtain a form from the commissioner.
(b) The form shall require the
following information:
(1) the number of abortions
performed by the physician in the previous calendar year, reported by month;
(2) the method used for each
abortion;
(3) the approximate gestational
age of each child subject to abortion, expressed in one of the following
increments:
(i) less than nine weeks;
(ii) nine to ten weeks;
(iii) 11 to 12 weeks;
(iv) 13 to 15 weeks;
(v) 16 to 20 weeks;
(vi) 21 to 24 weeks;
(vii) 25 to 30 weeks;
(viii) 31 to 36 weeks; or
(ix) 37 weeks to term;
(4) the age of the mother on whom
the abortion was performed at the time the abortion was performed;
(5) the specific reason for the
abortion, including, but not limited to, the following:
(i) the pregnancy was a result of
rape;
(ii) the pregnancy was a result of
incest;
(iii) the mother cannot afford the
child;
(iv) the mother does not want the
child;
(v) the mother's emotional health
is at stake;
(vi) the mother will suffer
substantial and irreversible impairment of a major bodily function if the
pregnancy continues; or
(vii) other;
(6) the number of prior induced
abortions;
(7) the number of prior
spontaneous abortions;
(8) whether the abortion was paid
for by:
(i) private insurance;
(ii) a public health plan; or
(iii) another form of payment;
(9) whether coverage was
under:
(i) a fee-for-service insurance
company;
(ii) a managed care company;
or
(iii) another type of health
carrier;
(10) complications, if any, for
each abortion and for the aftermath of each abortion. Space for a description of
any complications shall be available on the form;
(11) the fee collected for each
abortion;
(12) the type of anesthetic used,
if any, for each abortion;
(13) the method used to dispose of
fetal tissue and remains;
(14) the medical specialty of the
physician performing the abortion; and
(15) whether the physician
performing the abortion has had a physician's license suspended or revoked or
has had other professional sanctions in this or another state.
Subd. 2. [SUBMISSION.] A physician performing an abortion shall complete and submit
the form to the commissioner no later than April 1 for abortions performed in
the previous calendar year.
Subd. 3. [ADDITIONAL
REPORTING.] Nothing in this section shall be construed to
preclude the voluntary or required submission of other reports or forms
regarding abortions.
Sec. 75. [145.4132] [RECORDING AND REPORTING ABORTION
COMPLICATION DATA.]
Subdivision 1. [FORMS.] (a) Within 90 days of the effective date of this section,
the commissioner shall prepare an abortion complication reporting form for all
physicians licensed and practicing in the state. A copy of this section shall be
attached to the form.
(b) The board of medical practice
shall ensure that the abortion complication reporting form is distributed:
(1) to all physicians licensed to
practice in the state, within 120 days after the effective date of this section
and by December 1 of each subsequent year; and
(2) to a physician who is newly
licensed to practice in the state, at the same time as official notification to
the physician that the physician is so licensed.
Subd. 2. [REQUIRED REPORTING.]
A physician licensed and practicing in the state who
encounters an illness or injury that is related to an induced abortion shall
complete and submit an abortion complication reporting form to the
commissioner.
Subd. 3. [SUBMISSION.] A physician required to submit an abortion complication
reporting form to the commissioner shall do so as soon as practicable after the
encounter with the abortion related illness or injury, but in no case more than
60 days after the encounter.
Subd. 4. [ADDITIONAL
REPORTING.] Nothing in this section shall be construed to
preclude the voluntary or required submission of other reports or forms
regarding abortion complications.
Sec. 76. [145.4133] [REPORTING OUT-OF-STATE ABORTIONS.]
The commissioner of human services
shall report to the commissioner by April 1 each year the following information
regarding abortions paid for with state funds and performed out of state in the
previous calendar year:
(1) the total number of abortions
performed out of state and partially or fully paid for with state funds through
the medical assistance, general assistance medical care, or MinnesotaCare
program, or any other program;
(2) the total amount of state
funds used to pay for the abortions and expenses incidental to the abortions;
and
(3) the gestational age of each
unborn child at the time of abortion.
Sec. 77. [145.4134] [COMMISSIONER'S PUBLIC REPORT.]
(a) By July 1 of each year, the
commissioner shall issue a public report providing statistics for the previous
calendar year compiled from the data submitted under sections 145.4131 to
145.4133. Each report shall provide the statistics for all previous calendar
years, adjusted to reflect any additional information from late or corrected
reports. The commissioner shall ensure that none of the information included in
the public reports can reasonably lead to identification of an individual having
performed or having had an abortion. All data included on the forms under
sections 145.4131 to 145.4133 must be included in the public report. The
commissioner shall submit the report to the senate health care committee and the
house health and human services committee.
(b) The commissioner may, by rules
adopted under chapter 14, alter the submission dates established under sections
145.4131 to 145.4133 for administrative convenience, fiscal savings, or other
valid reason, provided that physicians and the commissioner of health submit the
required information once each year and the commissioner issues a report once
each year.
Sec. 78. [145.4135] [ENFORCEMENT; PENALTIES.]
(a) A physician who fails to
submit the required forms under sections 145.4131 and 145.4132 within 30 days
following the due date is subject to a late fee of $500 for each 30-day period,
or portion thereof, that the forms are overdue. A physician required to report
under this section who does not submit a report, or submits only an incomplete
report, more than one year following the due date, may be fined and, in an
action brought by the commissioner, be directed by a court of competent
jurisdiction to submit a complete report within a period stated by court order
or be subject to sanctions for civil contempt.
(b) If the commissioner fails to
issue the public report required under this section, or fails in any way to
enforce this section, a group of ten or more citizens of the state may seek an
injunction in a court of competent jurisdiction against the commissioner
requiring that a complete report be issued within a period stated by court order
or requiring that enforcement action be taken. Failure to abide by an injunction
shall subject the commissioner to sanctions for civil contempt.
(c) A physician who knowingly or
recklessly submits a false report under this section is guilty of a
misdemeanor.
(d) The commissioner may take
reasonable steps to ensure compliance with sections 145.4131 to 145.4133 and to
verify data provided, including but not limited to, inspection of places where
abortions are performed in accordance with chapter 14.
Sec. 79. [145.4136] [SEVERABILITY.]
If any one or more provision,
section, subdivision, sentence, clause, phrase, or word in sections 145.4131 to
145.4135, or the application thereof to any person or circumstance is found to
be unconstitutional, the same is hereby declared to be severable and the balance
of sections 145.4131 to 145.4135 shall remain effective notwithstanding such
unconstitutionality. The legislature hereby declares that it would have passed
sections 145.4131 to 145.4135, and each provision, section, subdivision,
sentence, clause, phrase, or word thereof, irrespective of the fact that any one
or more provision, section, subdivision, sentence, clause, phrase, or word be
declared unconstitutional.
Sec. 80. [145.4201] [PARTIAL-BIRTH ABORTION;
DEFINITIONS.]
Subdivision 1. [TERMS.] As used in sections 145.4201 to 145.4206, the terms defined
in this section have the meanings given them.
Subd. 2. [ABORTION.] "Abortion" means the use of any means to intentionally
terminate the pregnancy of a female known to be pregnant with knowledge that the
termination with those means will, with reasonable likelihood, cause the death
of the fetus.
Subd. 3. [FETUS AND INFANT.]
"Fetus" and "infant" are used interchangeably to refer to
the biological offspring of human parents.
Subd. 4. [PARTIAL-BIRTH
ABORTION.] "Partial-birth abortion" means an abortion in
which the person performing the abortion partially vaginally delivers a living
fetus before killing the fetus and completing the delivery.
Sec. 81. [145.4202] [PARTIAL-BIRTH ABORTIONS PROHIBITED.]
No person shall knowingly perform
a partial-birth abortion.
Sec. 82. [145.4203] [LIFE OF THE MOTHER EXCEPTION.]
The prohibition under section
145.4202 shall not apply to a partial-birth abortion that is necessary to save
the life of the mother because her life is endangered by a physical disorder,
physical illness, or physical injury, including a life-endangering condition
caused by or arising from the pregnancy itself, provided that no other medical
procedure would suffice for that purpose.
Sec. 83. [145.4204] [CIVIL REMEDIES.]
Subdivision 1. [STANDING.] The woman upon whom a partial-birth abortion has been
performed in violation of section 145.4202, the father of the fetus or infant,
and the maternal grandparents of the fetus or infant if the mother has not
attained the age of 18 years at the time of the abortion, may obtain appropriate
relief in a civil action, unless the pregnancy resulted from the plaintiff's
criminal conduct or the plaintiff consented to the abortion.
Subd. 2. [TYPE OF RELIEF.] Relief shall include:
(1) money damages for all
injuries, psychological and physical, occasioned by the violation of sections
145.4201 to 145.4206; and
(2) statutory damages equal to
three times the cost of the partial-birth abortion.
Subd. 3. [ATTORNEY'S FEE.] If judgment is rendered in favor of the plaintiff in an
action described in this section, the court shall also render judgment for a
reasonable attorney's fee in favor of the plaintiff against the defendant. If
the judgment is rendered in favor of the defendant and the court finds that the
plaintiff's suit was frivolous and brought in bad faith, the court shall also
render judgment for a reasonable attorney's fee in favor of the defendant
against the plaintiff.
Sec. 84. [145.4205] [CRIMINAL PENALTY.]
Subdivision 1. [FELONY.] A person who performs a partial-birth abortion in knowing or
reckless violation of sections 145.4201 to 145.4206 is guilty of a felony and
may be sentenced to imprisonment for not more than 15 years or to payment of a
fine of not more than $50,000.
Subd. 2. [PROSECUTION OF
MOTHER PROHIBITED.] A woman upon whom a partial-birth
abortion is performed may not be prosecuted under this section for violating
sections 145.4201 to 145.4206, or any provision thereof, or for conspiracy to
violate sections 145.4201 to 145.4206, or any provision thereof.
Sec. 85. [145.4206] [SEVERABILITY.]
(a) If any provision, word,
phrase, or clause of section 145.4203, or the application thereof to any person
or circumstance is found to be unconstitutional, the same is hereby declared to
be inseverable.
(b) If any provision, section,
subdivision, sentence, clause, phrase, or word in section 145.4201, 145.4202,
145.4204, 145.4205, or 145.4206 or the application thereof to any person or
circumstance is found to be unconstitutional, the same is hereby declared to be
severable and the balance of sections 145.4201 to 145.4206 shall remain
effective notwithstanding such unconstitutionality. The legislature hereby
declares that it would have passed sections 145.4201 to 145.4206, and each
provision, section, subdivision, sentence, clause, phrase, or word thereto, with
the exception of section 145.4203, irrespective of the fact that a provision,
section, subdivision, sentence, clause, phrase, or word be declared
unconstitutional.
Sec. 86. [145.9266] [FETAL ALCOHOL SYNDROME.]
Subdivision 1. [PUBLIC
AWARENESS.] The commissioner of health shall design and
implement an ongoing statewide campaign to raise public awareness about fetal
alcohol syndrome and other effects of prenatal alcohol exposure. The campaign
shall include messages directed to the general population as well as culturally
specific and community-based messages. A toll-free resource and referral
telephone line shall be included in the messages. The commissioner of health
shall conduct an evaluation to determine the effectiveness of the campaign.
Subd. 2. [STATEWIDE NETWORK OF
FAS DIAGNOSTIC CLINICS.] A statewide network of regional
fetal alcohol syndrome diagnostic clinics shall be developed between the
department of health and the University of Minnesota. This collaboration shall
be based on a statewide needs assessment and shall include involvement from
consumers, providers, and payors. By the end of calendar year 1998, a plan shall
be developed for the clinic network, and shall include a comprehensive
evaluation component. Sites shall be established in calendar year 1999. The
commissioner shall not access or collect individually identifiable data for the
statewide network of regional fetal alcohol syndrome diagnostic clinics. Data
collected at the clinics shall be maintained according to applicable data
privacy laws, including section 144.335.
Subd. 3. [PROFESSIONAL
TRAINING ABOUT FAS.] (a) The commissioner of health, in
collaboration with the board of medical practice, the board of nursing, and
other professional boards and state agencies, shall develop curricula and
materials about fetal alcohol syndrome for professional training of health care
providers, social service providers, educators, and judicial and corrections
systems professionals. The training and curricula shall increase knowledge and
develop practical skills of professionals to help them address the needs of
at-risk pregnant women and the needs of individuals affected by fetal alcohol
syndrome or fetal alcohol effects and their families.
(b) Training for health care
providers shall focus on skill building for screening, counseling, referral, and
follow-up for women using or at risk of using alcohol while pregnant. Training
for health care professionals shall include methods for diagnosis and evaluation
of fetal alcohol syndrome and fetal alcohol effects. Training for education,
judicial, and corrections professionals shall involve effective education
strategies, methods to identify the behaviors and learning styles of children
with alcohol-related birth defects, and methods to identify available referral
and community resources.
(c) Training for social service
providers shall focus on resources for assessing, referring, and treating
at-risk pregnant women, changes in the mandatory reporting and commitment laws,
and resources for affected children and their families.
Subd. 4. [FAS COMMUNITY GRANT
PROGRAM.] The commissioner of health shall administer a
grant program to provide money to community organizations and coalitions to
collaborate on fetal alcohol syndrome prevention and intervention strategies and
activities. The commissioner shall disburse grant money through a request for
proposal process or sole-source distribution where appropriate, and shall
include at least one grant award for transitional skills and services for
individuals with fetal alcohol syndrome or fetal alcohol effects.
Subd. 5. [SCHOOL PILOT
PROGRAMS.] (a) The commissioner of children, families,
and learning shall award up to four grants to schools for pilot programs to
identify and implement effective educational strategies for individuals with
fetal alcohol syndrome and other alcohol-related birth defects.
(b) One grant shall be awarded in
each of the following age categories:
(1) birth to three years;
(2) three to five years;
(3) six to 12 years; and
(4) 13 to 18 years.
(c) Grant proposals must include
an evaluation plan, demonstrate evidence of a collaborative or multisystem
approach, provide parent education and support, and show evidence of a child-
and family-focused approach consistent with research-based educational practices
and other guidelines developed by the department of children, families, and
learning.
(d) Children participating in the
pilot program sites may be identified through child find activities or a
diagnostic clinic. No identification activity may be undertaken without the
consent of a child's parent or guardian.
Subd. 6. [FETAL ALCOHOL
COORDINATING BOARD; DUTIES.] (a) The fetal alcohol
coordinating board consists of:
(1) the commissioners of health,
human services, corrections, public safety, economic security, and children,
families, and learning;
(2) the director of the office of
strategic and long-range planning;
(3) the chair of the maternal and
child health advisory task force established by section 145.881, or the chair's
designee;
(4) a representative of the
University of Minnesota academic health center, appointed by the provost;
(5) five members from the general
public appointed by the governor, one of whom must be a family member of an
individual with fetal alcohol syndrome or fetal alcohol effect; and
(6) one member from the judiciary
appointed by the chief justice of the supreme court.
Terms, compensation, removal, and
filling of vacancies of appointed members are governed by section 15.0575. The
board shall elect a chair from its membership to serve a one-year term. The
commissioner of health shall provide staff and consultant support for the board.
Support must be provided based on an annual budget and work plan developed by
the board. The board shall contract with the department of health for necessary
administrative services. Administrative services include personnel, budget,
payroll, and contract administration. The board shall adopt an annual budget and
work program.
(b) Board duties include:
(1) reviewing programs of state
agencies that involve fetal alcohol syndrome and coordinating those that are
interdepartmental in nature;
(2) providing an integrated and
comprehensive approach to fetal alcohol syndrome prevention and intervention
strategies both at a local and statewide level;
(3) approving on an annual basis
the statewide public awareness campaign as designed and implemented by the
commissioner of health under subdivision 1;
(4) reviewing fetal alcohol
syndrome community grants administered by the commissioner of health under
subdivision 4; and
(5) submitting a report to the
governor on January 15 of each odd-numbered year summarizing board operations,
activities, findings, and recommendations, and fetal alcohol syndrome activities
throughout the state.
(c) The board expires on January
1, 2001.
Subd. 7. [FEDERAL FUNDS;
CONTRACTS; DONATIONS.] The fetal alcohol coordinating
board may apply for, receive, and disburse federal funds made available to the
state by federal law or rules adopted for any purpose related to the powers and
duties of the board. The board shall comply with any requirements of federal
law, rules, and regulations in order to apply for, receive, and disburse funds.
The board may contract with or provide grants to public and private nonprofit
entities. The board may accept donations or grants from any public or private
entity. Money received by the board must be deposited in a separate account in
the state treasury and invested by the state board of investment. The amount
deposited, including investment earnings, is appropriated to the board to carry
out its duties. Money deposited in the state treasury shall not cancel.
Sec. 87. Minnesota Statutes 1996, section 145A.15,
subdivision 2, is amended to read:
Subd. 2. [GRANT RECIPIENTS.] (a) The commissioner is authorized to award grants to
programs that meet the requirements of subdivision 3 and include a strong child
abuse and neglect prevention focus for families in need of services. Priority
will be given to families considered to be in need of additional services. These
families include, but are not limited to, families with:
(1) adolescent parents;
(2) a history of alcohol and other drug abuse;
(3) a history of child abuse, domestic abuse, or other
types of violence in the family of origin;
(4) a history of domestic abuse, rape, or other forms of
victimization;
(5) reduced cognitive functioning;
(6) a lack of knowledge of child growth and development
stages;
(7) low resiliency to adversities and environmental
stresses; or
(8) lack of sufficient financial resources to meet their
needs.
(b) Grants made under this section
shall be used to fund existing home visiting programs and to establish new
programs. The commissioner shall award grants to home visiting programs that
meet the program requirements in subdivision 3, regardless of the number of
years an existing program has received grant funds in the past.
Sec. 88. Minnesota Statutes 1996, section 148.66, is
amended to read:
148.66 [STATE BOARD OF The state board of The board shall:
(1) adopt rules necessary to
administer and enforce sections 148.65 to 148.78;
(2) administer, coordinate, and
enforce sections 148.65 to 148.78;
(3) evaluate the qualifications of
applicants;
(4) issue subpoenas, examine
witnesses, and administer oaths;
(5) conduct hearings and keep
records and minutes necessary to the orderly administration of sections 148.65
to 148.78;
(6) investigate persons engaging
in practices that violate sections 148.65 to 148.78; and
(7) adopt rules under chapter 14
prescribing a code of ethics for licensees.
Sec. 89. Minnesota Statutes 1996, section 148.67, is
amended to read:
148.67 [STATE BOARD OF
PHYSICAL THERAPY Subdivision 1. [BOARD OF
PHYSICAL THERAPY APPOINTED.] The immediately precede appointment. Membership terms,
compensation of members, removal of members, filling of membership vacancies,
and fiscal year and reporting requirements shall be as provided in sections
214.07 to 214.09. The provision of staff, administrative services, and office
space; the review and processing of complaints; the setting of board fees; and
other provisions relating to board operations shall be as provided in chapter
214. Each member of the board shall file with the secretary of state the
constitutional oath of office before beginning the term of office. Subd. 2. [REPLACEMENT OF
PHYSICAL THERAPISTS AND PHYSICIAN MEMBERS.] When a
member's term expires and the member is a licensed physical therapist, the
governor may appoint a licensed physical therapist from a list submitted by the
Minnesota chapter of the American Physical Therapy Association. When a member
who is a licensed physical therapist leaves the board before the member's term
expires, the governor may appoint a member for the remainder of the term from a
list submitted by the Minnesota chapter of the American Physical Therapy
Association. When a member who is a physician leaves the board before the
member's term expires, the governor may appoint a member for the remainder of
the term from lists submitted by the state board of medical practice or the
Minnesota Medical Association.
Sec. 90. [148.691] [OFFICERS; EXECUTIVE DIRECTOR.]
Subdivision 1. [OFFICERS OF
THE BOARD.] The board shall elect from its members a
president, a vice-president, and a secretary-treasurer. Each shall serve for one
year or until a successor is elected and qualifies. The board shall appoint and
employ an executive secretary. A majority of the board, including one officer,
constitutes a quorum at a meeting.
Subd. 2. [BOARD AUTHORITY TO
HIRE.] The board may employ persons needed to carry out
its work.
Sec. 91. Minnesota Statutes 1996, section 148.70, is
amended to read:
148.70 [APPLICANTS, QUALIFICATIONS.]
(1) establish the
qualifications of applicants for (2) provide for and conduct
all examinations following satisfactory completion of all didactic
requirements (3) determine the applicants
who successfully pass the examination (4) duly The passing score for examinations taken after July 1,
1995, shall be based on objective, numerical standards, as established by a
nationally recognized board approved testing service.
Sec. 92. Minnesota Statutes 1996, section 148.705, is
amended to read:
148.705 [APPLICATION.]
An applicant for An approved program for physical therapists shall include
the following:
Sec. 93. Minnesota Statutes 1996, section 148.71, is
amended to read:
148.71 [ Subdivision 1. [QUALIFIED APPLICANT.] The state board of
Subd. 2. [TEMPORARY PERMIT.] (a) The board may, upon
payment of a fee set by the board, issue a temporary permit to practice physical
therapy under supervision to a physical therapist who is a graduate of an
approved school of physical therapy and qualified for admission to examination
for (b) A physical therapist from another state who is
licensed or otherwise registered in good standing as a physical therapist by
that state and meets the requirements for Subd. 3. [FOREIGN-TRAINED PHYSICAL THERAPISTS; TEMPORARY
PERMITS.] (a) The board of medical practice may issue a temporary permit to a
foreign-trained physical therapist who:
(1) is enrolled in a supervised physical therapy
traineeship that meets the requirements under paragraph (b);
(2) has completed a physical therapy education program
equivalent to that under section 148.705 and Minnesota Rules, part 5601.0800,
subpart 2;
(3) has achieved a score of at least 550 on the test of
English as a foreign language or a score of at least 85 on the Minnesota battery
test; and
(4) has paid a nonrefundable fee set by the board.
A foreign-trained physical therapist must have the
temporary permit before beginning a traineeship.
(b) A supervised physical therapy traineeship must:
(1) be at least six months;
(2) be at a board-approved facility;
(3) provide a broad base of clinical experience to the
foreign-trained physical therapist including a variety of physical agents,
therapeutic exercises, evaluation procedures, and patient diagnoses;
(4) be supervised by a physical therapist who has at
least three years of clinical experience and is (5) be approved by the board before the foreign-trained
physical therapist begins the traineeship.
(c) A temporary permit is effective on the first day of a
traineeship and expires 90 days after the next examination for (d) A foreign-trained physical therapist must
successfully complete a traineeship to be (e) A temporary permit will not be issued to a
foreign-trained applicant who has been issued a temporary permit for longer than
six months in any other state.
Sec. 94. Minnesota Statutes 1996, section 148.72,
subdivision 1, is amended to read:
Subdivision 1. [ISSUANCE OF Sec. 95. Minnesota Statutes 1996, section 148.72,
subdivision 2, is amended to read:
Subd. 2. [ Sec. 96. Minnesota Statutes 1996, section 148.72,
subdivision 4, is amended to read:
Subd. 4. [ISSUANCE OF Sec. 97. Minnesota Statutes 1996, section 148.73, is
amended to read:
148.73 [RENEWALS.]
Every Sec. 98. Minnesota Statutes 1996, section 148.74, is
amended to read:
148.74 [RULES.]
The board the license Sec. 99. Minnesota Statutes 1996, section 148.75, is
amended to read:
148.75 [ (a) The state board of (b) A Sec. 100. Minnesota Statutes 1996, section 148.76, is
amended to read:
148.76 [PROHIBITED CONDUCT.]
Subdivision 1. No person shall:
Nothing Subd. 2. No physical therapist shall:
Sec. 101. Minnesota Statutes 1996, section 148.78, is
amended to read:
148.78 [PROSECUTION, ALLEGATIONS.]
In the prosecution of any person for violation of
sections 148.65 to 148.78 as specified in section 148.76, it shall not be
necessary to allege or prove want of a valid Sec. 102. Minnesota Statutes 1996, section 214.01,
subdivision 2, is amended to read:
Subd. 2. [HEALTH-RELATED LICENSING BOARD.]
"Health-related licensing board" means the board of examiners of nursing home
administrators established pursuant to section 144A.19, the board of medical
practice created pursuant to section 147.01, the board of nursing created
pursuant to section 148.181, the board of chiropractic examiners established
pursuant to section 148.02, the board of optometry established pursuant to
section 148.52, the board of physical therapy established
pursuant to section 148.67, the board of psychology established pursuant to
section 148.90, the board of social work pursuant to section 148B.19, the board
of marriage and family therapy pursuant to section 148B.30, the office of mental
health practice established pursuant to section 148B.61, the alcohol and drug
counselors licensing advisory council established pursuant to section 148C.02,
the board of dietetics and nutrition practice established under section 148.622,
the board of dentistry established pursuant to section 150A.02, the board of
pharmacy established pursuant to section 151.02, the board of podiatric medicine
established pursuant to section 153.02, and the board of veterinary medicine,
established pursuant to section 156.01.
Sec. 103. Minnesota Statutes 1996, section 214.03, is
amended to read:
214.03 [STANDARDIZED TESTS.]
Subdivision 1. [STANDARDIZED
TESTS USED.] All state examining and licensing boards, other than the state
board of law examiners, the state board of professional responsibility or any
other board established by the supreme court to regulate the practice of law and
judicial functions, shall use national standardized tests for the objective,
nonpractical portion of any examination given to prospective licensees to the
extent that such national standardized tests are appropriate, except when the
subject matter of the examination relates to the application of Minnesota law to
the profession or calling being licensed.
Subd. 2. [HEALTH-RELATED
BOARDS; SPECIAL ACCOUNT.] There is established an account
in the special revenue fund where a health-related licensing board may deposit
applicants' payments for national or regional standardized tests. Money in the
account is appropriated to each board that has deposited monies into the
account, in an amount equal to the amount deposited by the board, to pay for the
use of national or regional standardized tests.
Sec. 104. Minnesota Statutes 1997 Supplement, section
214.32, subdivision 1, is amended to read:
Subdivision 1. [MANAGEMENT.] (a) A health professionals
services program committee is established, consisting of one person appointed by
each participating board, with each participating board having one vote. The
committee shall designate one board to provide administrative management of the
program, set the program budget and the pro rata share of program expenses to be
borne by each participating board, provide guidance on the general operation of
the program, including hiring of program personnel, and ensure that the
program's direction is in accord with its authority. No more than half plus one
of the members of the committee may be of one gender. If
the participating boards change which board is designated to provide
administrative management of the program, any appropriation remaining for the
program shall transfer to the newly designated board on the effective date of
the change. The participating boards must inform the appropriate legislative
committees and the commissioner of finance of any change in the administrative
management of the program, and the amount of any appropriation transferred under
this provision.
(b) The designated board, upon recommendation of the
health professional services program committee, shall hire the program manager
and employees and pay expenses of the program from funds appropriated for that
purpose. The designated board may apply for grants to pay program expenses and
may enter into contracts on behalf of the program to carry out the purposes of
the program. The participating boards shall enter into written agreements with
the designated board.
(c) An advisory committee is established to advise the
program committee consisting of:
(1) one member appointed by each of the following: the
Minnesota Academy of Physician Assistants, the Minnesota Dental Association, the
Minnesota Chiropractic Association, the Minnesota Licensed Practical Nurse
Association, the Minnesota Medical Association, the Minnesota Nurses
Association, and the Minnesota Podiatric Medicine Association;
(2) one member appointed by each of the professional
associations of the other professions regulated by a participating board not
specified in clause (1); and
(3) two public members, as defined by section 214.02.
Members of the advisory committee shall be appointed for
two years and members may be reappointed.
No more than half plus one of the members of the
committee may be of one gender.
The advisory committee expires June 30, 2001.
Sec. 105. Minnesota Statutes 1996, section 254A.17,
subdivision 1, is amended to read:
Subdivision 1. [MATERNAL AND CHILD SERVICE PROGRAMS.] (a)
The commissioner shall fund maternal and child health and social service
programs designed to improve the health and functioning of children born to
mothers using alcohol and controlled substances. Comprehensive programs shall
include immediate and ongoing intervention, treatment, and coordination of
medical, educational, and social services through a child's preschool years.
Programs shall also include research and evaluation to identify methods most
effective in improving outcomes among this high-risk population. The commissioner shall ensure that the programs are
available on a statewide basis to the extent possible with available funds.
(b) The commissioner of human services shall develop
models for the treatment of children ages 6 to 12 who are in need of chemical
dependency treatment. The commissioner shall fund at least two pilot projects
with qualified providers to provide nonresidential treatment for children in
this age group. Model programs must include a component to monitor and evaluate
treatment outcomes.
Sec. 106. Minnesota Statutes 1996, section 254A.17, is
amended by adding a subdivision to read:
Subd. 1b. [INTERVENTION AND
ADVOCACY PROGRAM.] Within the limits of money available,
the commissioner of human services shall fund voluntary hospital-based outreach
programs targeted at women who deliver children affected by prenatal alcohol or
drug use. The program shall help women obtain treatment, stay in recovery, and
plan any future pregnancies. An advocate shall be assigned to each woman in the
program to provide guidance and advice with respect to treatment programs, child
safety and parenting, housing, family planning, and any other personal issues
that are barriers to remaining free of chemical dependence. The commissioner
shall develop an evaluation component and provide centralized coordination of
the evaluation process.
Sec. 107. Minnesota Statutes 1997 Supplement, section
256B.692, subdivision 2, is amended to read:
Subd. 2. [DUTIES OF THE COMMISSIONER OF HEALTH.]
Notwithstanding chapters 62D and 62N, a county that elects to purchase medical
assistance and general assistance medical care in return for a fixed sum without
regard to the frequency or extent of services furnished to any particular
enrollee is not required to obtain a certificate of authority under chapter 62D
or 62N. A county that elects to purchase medical assistance and general
assistance medical care services under this section must satisfy the
commissioner of health that the requirements of chapter 62D, applicable to
health maintenance organizations, or chapter 62N, applicable to community
integrated service networks, will be met. A county must also assure the
commissioner of health that the requirements of provisions of chapter 62Q, including sections 62Q.07;
62Q.075; 62Q.105; 62Q.1055; 62Q.106; 62Q.11; 62Q.12; 62Q.135; 62Q.14; 62Q.145;
62Q.19; 62Q.23, paragraph (c); 62Q.30; 62Q.43; 62Q.47; 62Q.50; 62Q.52 to 62Q.56;
62Q.58; 62Q.64; and Sec. 108. Minnesota Statutes 1996, section 268.92,
subdivision 4, is amended to read:
Subd. 4. [LEAD (1) providing on-the-job training for swab team workers;
(2) providing swab team services to meet the requirements
of sections 144.9503, subdivision 4, and 144.9504, subdivision 6;
(3) providing a removal and replacement component using
skilled craft workers under subdivision 7;
(4) providing lead testing according to subdivision 7a;
(5) providing lead dust cleaning supplies, as described
in section (6) having a swab team worker instruct residents and
property owners on appropriate lead control techniques, including the lead-safe
directives developed by the commissioner of health.
(b) Participating lead (1) demonstrate proof of workers' compensation and
general liability insurance coverage;
(2) be knowledgeable about lead abatement requirements
established by the Department of Housing and Urban Development and the
Occupational Safety and Health Administration and lead hazard reduction
requirements and lead-safe directives of the commissioner of health;
(3) demonstrate experience with on-the-job training
programs;
(4) demonstrate an ability to recruit employees from
areas at high risk for toxic lead exposure; and
(5) demonstrate experience in working with low-income
clients.
Sec. 109. [COMPLAINT PROCESS STUDY.]
The complaint process work group
established by the commissioners of health and commerce as required under Laws
1997, chapter 237, section 20, shall continue to meet to develop a complaint
resolution process for health plan companies to make available to enrollees as
required under Minnesota Statutes, sections 62Q.105, 62Q.11, and 62Q.30. The
commissioners of health and commerce shall submit a progress report to the
legislative commission on health care access by September 15, 1998, and shall
submit final recommendations to the legislature, including draft legislation on
developing such a process by November 15, 1998. The recommendations must also
include, in consultation with the work group, a permanent method of financing
the office of health care consumer assistance, advocacy, and information.
Sec. 110. [RESIDENTIAL HOSPICE ADVISORY TASK FORCE.]
The commissioner of health shall
convene an advisory task force to study issues related to the building codes and
safety standards that residential hospice facilities must meet for licensure and
to make recommendations on changes to these standards. Task force membership
shall include representatives of residential hospices, pediatric residential
hospices, the Minnesota hospice organization, the Minnesota department of
health, and other interested parties. The task force is governed by Minnesota
Statutes, section 15.059, subdivision 6. The task force shall submit
recommendations and any draft legislation to the legislature by January 15,
1999.
Sec. 111. [TEMPORARY LICENSURE WAIVER FOR DIETITIANS.]
Until October 31, 1998, the board
of dietetics and nutrition practice may waive the requirements for licensure as
a dietitian established in Minnesota Statutes, section 148.624, subdivision 1,
clause (1), and may issue a license to an applicant who meets the qualifications
for licensure specified in Minnesota Statutes, section 148.627, subdivision 1. A
waiver may be granted in cases in which unusual or extraordinary job-related
circumstances prevented an applicant from applying for licensure during the
transition period specified in Minnesota Statutes, section 148.627, subdivision
1. An applicant must request a waiver in writing and must explain the
circumstances that prevented the applicant from applying for licensure during
the transition period.
Sec. 112. [ADVICE AND RECOMMENDATIONS.]
The commissioners of health and
commerce shall convene an ad hoc advisory panel of selected representatives of
health plan companies, purchasers, and provider groups engaged in the practice
of health care in Minnesota, and interested legislators. This advisory panel
shall meet and assist the commissioners in developing measures to prevent
discrimination against providers and provider groups in managed care in
Minnesota and clarify the requirements of Minnesota Statutes, section 62Q.23,
paragraph (c). Any such measures shall be reported to the legislature prior to
November 15, 1998.
Sec. 113. [AGREEMENT AUTHORIZED.]
In order to have a comprehensive
program to protect the public from radiation hazards, the governor may enter
into an agreement with the United States Nuclear Regulatory Commission, under
the Atomic Energy Act of 1954, United States Code, title 42, section 2021,
paragraph (b). The agreement may allow the state to assume regulation over
nonpower plant radiation hazards including certain by-product, source, and
special nuclear materials not sufficient to form a critical mass.
Sec. 114. [HEALTH DEPARTMENT DESIGNATED LEAD.]
The department of health is
designated as the lead agency to pursue an agreement on behalf of the governor,
and for any assumption of specified licensing and regulatory authority from the
Nuclear Regulatory Commission under an agreement. The department may enter into
negotiations with the Nuclear Regulatory Commission for that purpose. The
commissioner of health shall establish an advisory group to assist the
department in preparing the state to meet the requirements for achieving an
agreement.
Sec. 115. [RULES.]
The department of health may adopt
rules for the state assumption of regulation under an agreement under this act,
including the licensing and regulation of by-product, source, and special
nuclear material not sufficient to form a critical mass.
Sec. 116. [TRANSITION.]
A person who, on the effective
date of an agreement under this act, possesses a Nuclear Regulatory Commission
license that is subject to the agreement shall be deemed to possess a similar
license issued by the department of health. Licenses shall expire on the
expiration date specified in the federal license.
Sec. 117. [STUDY OF EXTENT OF FETAL ALCOHOL SYNDROME.]
The commissioner of health shall
conduct a study of the incidence and prevalence of fetal alcohol syndrome in
Minnesota. The commissioner shall not collect individually identifiable data for
this study.
Sec. 118. [INITIAL APPOINTMENTS TO BOARD.]
Notwithstanding Minnesota
Statutes, section 148.67, the first physical therapist members appointed to the
board may be registered physical therapists.
Sec. 119. [SUNSET.]
An agreement entered into before
August 2, 2002, shall remain in effect until terminated or suspended under the
Atomic Energy Act of 1954, United States Code, title 42, section 2021, paragraph
(j). The governor may not enter into an initial agreement with the Nuclear
Regulatory Commission after August 1, 2002. If an agreement is not entered into,
any rules adopted under this act are repealed on that date.
Sec. 120. [REPEALER.]
Minnesota Statutes 1996, sections
144.491; 144.9501, subdivisions 12, 14, and 16; and 144.9503, subdivisions 5, 8,
and 9, are repealed.
Sec. 121. [EFFECTIVE DATES.]
Sections 23 to 37, 39 to 58, 60 to
69, 103 (214.03), 104 (214.32, subdivision 1), 111 (temporary licensure), 112
(advice and recommendations), and 120 (Repealer) are effective the day following
final enactment.
Sections 1 and 7 to 10 are
effective January 1, 1999, and apply to coverage issued, renewed, or continued
as defined in section 60A.02, subdivision 2a, on or after that date.
Section 1. Minnesota Statutes 1996, section 144A.04,
subdivision 5, is amended to read:
Subd. 5. [ADMINISTRATORS.] Except as otherwise provided
by this subdivision, a nursing home must have a full time licensed nursing home
administrator serving the facility. In any nursing home of less than Sec. 2. Minnesota Statutes 1997 Supplement, section
144A.071, subdivision 4a, is amended to read:
Subd. 4a. [EXCEPTIONS FOR REPLACEMENT BEDS.] It is in the
best interest of the state to ensure that nursing homes and boarding care homes
continue to meet the physical plant licensing and certification requirements by
permitting certain construction projects. Facilities should be maintained in
condition to satisfy the physical and emotional needs of residents while
allowing the state to maintain control over nursing home expenditure growth.
The commissioner of health in coordination with the
commissioner of human services, may approve the renovation, replacement,
upgrading, or relocation of a nursing home or boarding care home, under the
following conditions:
(a) to license or certify beds in a new facility
constructed to replace a facility or to make repairs in an existing facility
that was destroyed or damaged after June 30, 1987, by fire, lightning, or other
hazard provided:
(i) destruction was not caused by the intentional act of
or at the direction of a controlling person of the facility;
(ii) at the time the facility was destroyed or damaged
the controlling persons of the facility maintained insurance coverage for the
type of hazard that occurred in an amount that a reasonable person would
conclude was adequate;
(iii) the net proceeds from an insurance settlement for
the damages caused by the hazard are applied to the cost of the new facility or
repairs;
(iv) the new facility is constructed on the same site as
the destroyed facility or on another site subject to the restrictions in section
144A.073, subdivision 5;
(v) the number of licensed and certified beds in the new
facility does not exceed the number of licensed and certified beds in the
destroyed facility; and
(vi) the commissioner determines that the replacement
beds are needed to prevent an inadequate supply of beds.
Project construction costs incurred for repairs
authorized under this clause shall not be considered in the dollar threshold
amount defined in subdivision 2;
(b) to license or certify beds that are moved from one
location to another within a nursing home facility, provided the total costs of
remodeling performed in conjunction with the relocation of beds does not exceed
$750,000;
(c) to license or certify beds in a project recommended
for approval under section 144A.073;
(d) to license or certify beds that are moved from an
existing state nursing home to a different state facility, provided there is no
net increase in the number of state nursing home beds;
(e) to certify and license as nursing home beds boarding
care beds in a certified boarding care facility if the beds meet the standards
for nursing home licensure, or in a facility that was granted an exception to
the moratorium under section 144A.073, and if the cost of any remodeling of the
facility does not exceed $750,000. If boarding care beds are licensed as nursing
home beds, the number of boarding care beds in the facility must not increase
beyond the number remaining at the time of the upgrade in licensure. The
provisions contained in section 144A.073 regarding the upgrading of the
facilities do not apply to facilities that satisfy these requirements;
(f) to license and certify up to 40 beds transferred from
an existing facility owned and operated by the Amherst H. Wilder Foundation in
the city of St. Paul to a new unit at the same location as the existing facility
that will serve persons with Alzheimer's disease and other related disorders.
The transfer of beds may occur gradually or in stages, provided the total number
of beds transferred does not exceed 40. At the time of licensure and
certification of a bed or beds in the new unit, the commissioner of health shall
delicense and decertify the same number of beds in the existing facility. As a
condition of receiving a license or certification under this clause, the
facility must make a written commitment to the commissioner of human services
that it will not seek to receive an increase in its property-related payment
rate as a result of the transfers allowed under this paragraph;
(g) to license and certify nursing home beds to replace
currently licensed and certified boarding care beds which may be located either
in a remodeled or renovated boarding care or nursing home facility or in a
remodeled, renovated, newly constructed, or replacement nursing home facility
within the identifiable complex of health care facilities in which the currently
licensed boarding care beds are presently located, provided that the number of
boarding care beds in the facility or complex are decreased by the number to be
licensed as nursing home beds and further provided that, if the total costs of
new construction, replacement, remodeling, or renovation exceed ten percent of
the appraised value of the facility or $200,000, whichever is less, the facility
makes a written commitment to the commissioner of human services that it will
not seek to receive an increase in its property-related payment rate by reason
of the new construction, replacement, remodeling, or renovation. The provisions
contained in section 144A.073 regarding the upgrading of facilities do not apply
to facilities that satisfy these requirements;
(h) to license as a nursing home and certify as a nursing
facility a facility that is licensed as a boarding care facility but not
certified under the medical assistance program, but only if the commissioner of
human services certifies to the commissioner of health that licensing the
facility as a nursing home and certifying the facility as a nursing facility
will result in a net annual savings to the state general fund of $200,000 or
more;
(i) to certify, after September 30, 1992, and prior to
July 1, 1993, existing nursing home beds in a facility that was licensed and in
operation prior to January 1, 1992;
(j) to license and certify new nursing home beds to
replace beds in a facility (k) to license and certify up to 20 new nursing home beds
in a community-operated hospital and attached convalescent and nursing care
facility with 40 beds on April 21, 1991, that suspended operation of the
hospital in April 1986. The commissioner of human services shall provide the
facility with the same per diem property-related payment rate for each
additional licensed and certified bed as it will receive for its existing 40
beds;
(l) to license or certify beds in renovation,
replacement, or upgrading projects as defined in section 144A.073, subdivision
1, so long as the cumulative total costs of the facility's remodeling projects
do not exceed $750,000;
(m) to license and certify beds that are moved from one
location to another for the purposes of converting up to five four-bed wards to
single or double occupancy rooms in a nursing home that, as of January 1, 1993,
was county-owned and had a licensed capacity of 115 beds;
(n) to allow a facility that on April 16, 1993, was a
106-bed licensed and certified nursing facility located in Minneapolis to
layaway all of its licensed and certified nursing home beds. These beds may be
relicensed and recertified in a newly-constructed teaching nursing home facility
affiliated with a teaching hospital upon approval by the legislature. The
proposal must be developed in consultation with the interagency committee on
long-term care planning. The beds on layaway status shall have the same status
as voluntarily delicensed and decertified beds, except that beds on layaway
status remain subject to the surcharge in section 256.9657. This layaway
provision expires July 1, 1998;
(o) to allow a project which will be completed in
conjunction with an approved moratorium exception project for a nursing home in
southern Cass county and which is directly related to that portion of the
facility that must be repaired, renovated, or replaced, to correct an emergency
plumbing problem for which a state correction order has been issued and which
must be corrected by August 31, 1993;
(p) to allow a facility that on April 16, 1993, was a
368-bed licensed and certified nursing facility located in Minneapolis to
layaway, upon 30 days prior written notice to the commissioner, up to 30 of the
facility's licensed and certified beds by converting three-bed wards to single
or double occupancy. Beds on layaway status shall have the same status as
voluntarily delicensed and decertified beds except that beds on layaway status
remain subject to the surcharge in section 256.9657,
remain subject to the license application and renewal
fees under section 144A.07 and shall be subject to a $100 per bed reactivation
fee. In addition, at any time within three years of the effective date of the
layaway, the beds on layaway status may be:
(1) relicensed and recertified upon relocation and
reactivation of some or all of the beds to an existing licensed and certified
facility or facilities located in Pine River, Brainerd, or International Falls;
provided that the total project construction costs related to the relocation of
beds from layaway status for any facility receiving relocated beds may not
exceed the dollar threshold provided in subdivision 2 unless the construction
project has been approved through the moratorium exception process under section
144A.073;
(2) relicensed and recertified, upon reactivation of some
or all of the beds within the facility which placed the beds in layaway status,
if the commissioner has determined a need for the reactivation of the beds on
layaway status.
The property-related payment rate of a facility placing
beds on layaway status must be adjusted by the incremental change in its rental
per diem after recalculating the rental per diem as provided in section
256B.431, subdivision 3a, paragraph (d). The property-related payment rate for a
facility relicensing and recertifying beds from layaway status must be adjusted
by the incremental change in its rental per diem after recalculating its rental
per diem using the number of beds after the relicensing to establish the
facility's capacity day divisor, which shall be effective the first day of the
month following the month in which the relicensing and recertification became
effective. Any beds remaining on layaway status more than three years after the
date the layaway status became effective must be removed from layaway status and
immediately delicensed and decertified;
(q) to license and certify beds in a renovation and
remodeling project to convert 12 four-bed wards into 24 two-bed rooms, expand
space, and add improvements in a nursing home that, as of January 1, 1994, met
the following conditions: the nursing home was located in Ramsey county; had a
licensed capacity of 154 beds; and had been ranked among the top 15 applicants
by the 1993 moratorium exceptions advisory review panel. The total project
construction cost estimate for this project must not exceed the cost estimate
submitted in connection with the 1993 moratorium exception process;
(r) to license and certify up to 117 beds that are
relocated from a licensed and certified 138-bed nursing facility located in St.
Paul to a hospital with 130 licensed hospital beds located in South St. Paul,
provided that the nursing facility and hospital are owned by the same or a
related organization and that prior to the date the relocation is completed the
hospital ceases operation of its inpatient hospital services at that hospital.
After relocation, the nursing facility's status under section 256B.431,
subdivision 2j, shall be the same as it was prior to relocation. The nursing
facility's property-related payment rate resulting from the project authorized
in this paragraph shall become effective no earlier than April 1, 1996. For
purposes of calculating the incremental change in the facility's rental per diem
resulting from this project, the allowable appraised value of the nursing
facility portion of the existing health care facility physical plant prior to
the renovation and relocation may not exceed $2,490,000;
(s) to license and certify two beds in a facility to
replace beds that were voluntarily delicensed and decertified on June 28, 1991;
(t) to allow 16 licensed and certified beds located on
July 1, 1994, in a 142-bed nursing home and 21-bed boarding care home facility
in Minneapolis, notwithstanding the licensure and certification after July 1,
1995, of the Minneapolis facility as a 147-bed nursing home facility after
completion of a construction project approved in 1993 under section 144A.073, to
be laid away upon 30 days' prior written notice to the commissioner. Beds on
layaway status shall have the same status as voluntarily delicensed or
decertified beds except that they shall remain subject to the surcharge in
section 256.9657. The 16 beds on layaway status may be relicensed as nursing
home beds and recertified at any time within five years of the effective date of
the layaway upon relocation of some or all of the beds to a licensed and
certified facility located in Watertown, provided that the total project
construction costs related to the relocation of beds from layaway status for the
Watertown facility may not exceed the dollar threshold provided in subdivision 2
unless the construction project has been approved through the moratorium
exception process under section 144A.073.
The property-related payment rate of the facility placing
beds on layaway status must be adjusted by the incremental change in its rental
per diem after recalculating the rental per diem as provided in section
256B.431, subdivision 3a, paragraph (d). The property-related payment rate for
the facility relicensing and recertifying beds from layaway status must
be adjusted by the incremental change in its rental per
diem after recalculating its rental per diem using the number of beds after the
relicensing to establish the facility's capacity day divisor, which shall be
effective the first day of the month following the month in which the
relicensing and recertification became effective. Any beds remaining on layaway
status more than five years after the date the layaway status became effective
must be removed from layaway status and immediately delicensed and decertified;
(u) to license and certify beds that are moved within an
existing area of a facility or to a newly constructed addition which is built
for the purpose of eliminating three- and four-bed rooms and adding space for
dining, lounge areas, bathing rooms, and ancillary service areas in a nursing
home that, as of January 1, 1995, was located in Fridley and had a licensed
capacity of 129 beds;
(v) to relocate 36 beds in Crow Wing county and four beds
from Hennepin county to a 160-bed facility in Crow Wing county, provided all the
affected beds are under common ownership;
(w) to license and certify a total replacement project of
up to 49 beds located in Norman county that are relocated from a nursing home
destroyed by flood and whose residents were relocated to other nursing homes.
The operating cost payment rates for the new nursing facility shall be
determined based on the interim and settle-up payment provisions of Minnesota
Rules, part 9549.0057, and the reimbursement provisions of section 256B.431,
except that subdivision 26, paragraphs (a) and (b), shall not apply until the
second rate year after the settle-up cost report is filed. Property-related
reimbursement rates shall be determined under section 256B.431, taking into
account any federal or state flood-related loans or grants provided to the
facility;
(x) to license and certify a total replacement project of
up to 129 beds located in Polk county that are relocated from a nursing home
destroyed by flood and whose residents were relocated to other nursing homes.
The operating cost payment rates for the new nursing facility shall be
determined based on the interim and settle-up payment provisions of Minnesota
Rules, part 9549.0057, and the reimbursement provisions of section 256B.431,
except that subdivision 26, paragraphs (a) and (b), shall not apply until the
second rate year after the settle-up cost report is filed. Property-related
reimbursement rates shall be determined under section 256B.431, taking into
account any federal or state flood-related loans or grants provided to the
facility; (y) to license and certify beds in a renovation and
remodeling project to convert 13 three-bed wards into 13 two-bed rooms and 13
single-bed rooms, expand space, and add improvements in a nursing home that, as
of January 1, 1994, met the following conditions: the nursing home was located
in Ramsey county, was not owned by a hospital corporation, had a licensed
capacity of 64 beds, and had been ranked among the top 15 applicants by the 1993
moratorium exceptions advisory review panel. The total project construction cost
estimate for this project must not exceed the cost estimate submitted in
connection with the 1993 moratorium exception process (z) to allow a 285-bed nursing
facility in St. Paul that provides for the special dietary needs of its
residents under the requirements in section 31.651 to undertake a construction
project that will improve some of the existing structures, create new buildings,
and reduce the licensed and certified beds to 150; or
(aa) to allow the commissioner of
human services to license an additional 36 beds to provide residential services
for the physically handicapped under Minnesota Rules, parts 9570.2000 to
9570.3400, in a 198-bed nursing home located in Red Wing, provided that the
total number of licensed and certified beds at the facility does not
increase.
Sec. 3. Minnesota Statutes 1996, section 144A.09,
subdivision 1, is amended to read:
Subdivision 1. [SPIRITUAL MEANS FOR HEALING.] Sec. 4. Minnesota Statutes 1997 Supplement, section
256B.0951, is amended by adding a subdivision to read:
Subd. 7. [WAIVER OF RULES.] The commissioner of health may exempt residents of
intermediate care facilities for persons with mental retardation (ICFs/MR) who
participate in the three-year quality assurance pilot project established in
section 256B.095 from the requirements of Minnesota Rules, chapter 4665, upon
approval by the federal government of a waiver of federal certification
requirements for ICFs/MR. The commissioners of health and human services shall
apply for any necessary waivers as soon as practicable and shall submit the
concept paper to the federal government by June 1, 1998.
Sec. 5. Minnesota Statutes 1996, section 256B.431,
subdivision 2i, is amended to read:
Subd. 2i. [OPERATING COSTS AFTER JULY 1, 1988.] (a)
[OTHER OPERATING COST LIMITS.] For the rate year beginning July 1, 1988, the
commissioner shall increase the other operating cost limits established in
Minnesota Rules, part 9549.0055, subpart 2, item E, to 110 percent of the median
of the array of allowable historical other operating cost per diems and index
these limits as in Minnesota Rules, part 9549.0056, subparts 3 and 4. The limits
must be established in accordance with subdivision 2b, paragraph (d). For rate
years beginning on or after July 1, 1989, the adjusted other operating cost
limits must be indexed as in Minnesota Rules, part 9549.0056, subparts 3 and 4.
For the rate period beginning October 1, 1992, and for rate years beginning
after June 30, 1993, the amount of the surcharge under section 256.9657,
subdivision 1, shall be included in the plant operations and maintenance
operating cost category. The surcharge shall be an allowable cost for the
purpose of establishing the payment rate.
(b) [CARE-RELATED OPERATING COST LIMITS.] For the rate
year beginning July 1, 1988, the commissioner shall increase the care-related
operating cost limits established in Minnesota Rules, part 9549.0055, subpart 2,
items A and B, to 125 percent of the median of the array of the allowable
historical case mix operating cost standardized per diems and the allowable
historical other care-related operating cost per diems and index those limits as
in Minnesota Rules, part 9549.0056, subparts 1 and 2. The limits must be
established in accordance with subdivision 2b, paragraph (d). For rate years
beginning on or after July 1, 1989, the adjusted care-related limits must be
indexed as in Minnesota Rules, part 9549.0056, subparts 1 and 2.
(c) [SALARY ADJUSTMENT PER DIEM.] (1) for each nursing facility that reports salaries for
registered nurses, licensed practical nurses, and aides, orderlies and
attendants separately, the commissioner shall determine the salary adjustment
per diem by multiplying the total salaries, payroll taxes, and fringe benefits
allowed in each operating cost category, except management fees and
administrator and central office salaries and the related payroll taxes and
fringe benefits, by (2) for each nursing facility that does not report
salaries for registered nurses, licensed practical nurses, aides, orderlies, and
attendants separately, the salary adjustment per diem is the weighted average
salary adjustment per diem increase determined under clause (1).
(3) A nursing facility may apply
for the salary adjustment per diem calculated under clauses (1) and (2). The
application must be made to the commissioner and contain a plan by which the
nursing facility will distribute the salary adjustment to employees of the
nursing facility. For nursing facilities in which the employees are represented
by an exclusive bargaining representative, an agreement negotiated and agreed to
by the employer and the exclusive bargaining representative, after July 1, 1998,
may constitute the plan for the salary distribution. The commissioner shall
review the plan to ensure that the salary adjustment per diem is used solely to
increase the compensation of nursing home facility employees.
(d) [NEW BASE YEAR.] The commissioner shall establish new
base years for both the reporting year ending September 30, 1989, and the
reporting year ending September 30, 1990. In establishing new base years, the
commissioner must take into account:
(1) statutory changes made in geographic groups;
(2) redefinitions of cost categories; and
(3) reclassification, pass-through, or exemption of
certain costs such as public employee retirement act contributions.
(e) [NEW BASE YEAR.] The commissioner shall establish a
new base year for the reporting years ending September 30, 1991, and September
30, 1992. In establishing a new base year, the commissioner must take into
account:
(1) statutory changes made in geographic groups;
(2) redefinitions of cost categories; and
(3) reclassification, pass-through, or exemption of
certain costs.
Sec. 6. Minnesota Statutes 1996, section 256B.431, is
amended by adding a subdivision to read:
Subd. 2s. [NONALLOWABLE COST.]
Costs incurred for any activities which are directed at
or are intended to influence or dissuade employees in the exercise of their
legal rights to freely engage in the process of selecting an exclusive
representative for the purpose of collective bargaining with their employer
shall not be allowable for purposes of setting payment rates.
Sec. 7. Minnesota Statutes 1997 Supplement, section
256B.431, subdivision 3f, is amended to read:
Subd. 3f. [PROPERTY COSTS AFTER JULY 1, 1988.] (a) [
INVESTMENT PER BED LIMIT.] For the rate year beginning July 1, 1988, the
replacement-cost-new per bed limit must be $32,571 per licensed bed in multiple
bedrooms and $48,857 per licensed bed in a single bedroom. For the rate year
beginning July 1, 1989, the replacement-cost-new per bed limit for a single
bedroom must be $49,907 adjusted according to Minnesota Rules, part 9549.0060,
subpart 4, item A, subitem (1). Beginning January 1, 1990, the
replacement-cost-new per bed limits must be adjusted annually as specified in
Minnesota Rules, part 9549.0060, subpart 4, item A, subitem (1). Beginning
January 1, 1991, the replacement-cost-new per bed limits will be adjusted
annually as specified in Minnesota Rules, part 9549.0060, subpart 4, item A,
subitem (1), except that the index utilized will be the Bureau of the Census:
Composite fixed-weighted price index as published in the C30 Report, Value of
New Construction Put in Place.
(b) [RENTAL FACTOR.] For the rate year beginning July 1,
1988, the commissioner shall increase the rental factor as established in
Minnesota Rules, part 9549.0060, subpart 8, item A, by 6.2 percent rounded to
the nearest 100th percent for the purpose of reimbursing nursing facilities for
soft costs and entrepreneurial profits not included in the cost valuation
services used by the state's contracted appraisers. For rate years beginning on
or after July 1, 1989, the rental factor is the amount determined under this
paragraph for the rate year beginning July 1, 1988.
(c) [OCCUPANCY FACTOR.] For rate years beginning on or
after July 1, 1988, in order to determine property-related payment rates under
Minnesota Rules, part 9549.0060, for all nursing facilities except those whose
average length of stay in a skilled level of care within a nursing facility is
180 days or less, the commissioner shall use 95 percent of capacity days. For a
nursing facility whose average length of stay in a skilled level of care within
a nursing facility is 180 days or less, the commissioner shall use the greater
of resident days or 80 percent of capacity days but in no event shall the
divisor exceed 95 percent of capacity days.
(d) [EQUIPMENT ALLOWANCE.] For rate years beginning on
July 1, 1988, and July 1, 1989, the commissioner shall add ten cents per
resident per day to each nursing facility's property-related payment rate. The
ten-cent property-related payment rate increase is not cumulative from rate year
to rate year. For the rate year beginning July 1, 1990, the commissioner shall
increase each nursing facility's equipment allowance as established in Minnesota
Rules, part 9549.0060,
subpart 10, by ten cents per resident per day. For rate
years beginning on or after July 1, 1991, the adjusted equipment allowance must
be adjusted annually for inflation as in Minnesota Rules, part 9549.0060,
subpart 10, item E. For the rate period beginning October 1, 1992, the equipment
allowance for each nursing facility shall be increased by 28 percent. For rate
years beginning after June 30, 1993, the allowance must be adjusted annually for
inflation.
(e) [POST CHAPTER 199 RELATED-ORGANIZATION DEBTS AND
INTEREST EXPENSE.] For rate years beginning on or after July 1, 1990, Minnesota
Rules, part 9549.0060, subpart 5, item E, shall not apply to outstanding related
organization debt incurred prior to May 23, 1983, provided that the debt was an
allowable debt under Minnesota Rules, parts 9510.0010 to 9510.0480, the debt is
subject to repayment through annual principal payments, and the nursing facility
demonstrates to the commissioner's satisfaction that the interest rate on the
debt was less than market interest rates for similar arms-length transactions at
the time the debt was incurred. If the debt was incurred due to a sale between
family members, the nursing facility must also demonstrate that the seller no
longer participates in the management or operation of the nursing facility.
Debts meeting the conditions of this paragraph are subject to all other
provisions of Minnesota Rules, parts 9549.0010 to 9549.0080.
(f) [BUILDING CAPITAL ALLOWANCE FOR NURSING FACILITIES
WITH OPERATING LEASES.] For rate years beginning on or after July 1, 1990, a
nursing facility with operating lease costs incurred for the nursing facility's
buildings shall receive its building capital allowance computed in accordance
with Minnesota Rules, part 9549.0060, subpart 8. If an
operating lease provides that the lessee's rent is adjusted to recognize
improvements made by the lessor and related debt, the costs for capital
improvements and related debt shall be allowed in the computation of the
lessee's building capital allowance, provided that reimbursement for these costs
under an operating lease shall not exceed the rate otherwise paid.
Sec. 8. Minnesota Statutes 1996, section 256B.431,
subdivision 11, is amended to read:
Subd. 11. [SPECIAL PROPERTY RATE SETTING PROCEDURES FOR
CERTAIN NURSING FACILITIES.] (a) Notwithstanding
Minnesota Rules, part 9549.0060, subpart 13, item H, to the contrary, for the
rate year beginning July 1, 1990, a nursing facility leased prior to January 1,
1986, and currently subject to adverse licensure action under section 144A.04,
subdivision 4, paragraph (a), or section 144A.11, subdivision 2, and whose
ownership changes prior to July 1, 1990, shall be allowed a property-related
payment equal to the lesser of its current lease obligation divided by its
capacity days as determined in Minnesota Rules, part 9549.0060, subpart 11, as
modified by subdivision 3f, paragraph (c), or the frozen property-related
payment rate in effect for the rate year beginning July 1, 1989. For rate years
beginning on or after July 1, 1991, the property-related payment rate shall be
its rental rate computed using the previous owner's allowable principal and
interest expense as allowed by the department prior to that prior owner's sale
and lease-back transaction of December 1985.
(b) Notwithstanding other
provisions of applicable law, a nursing facility licensed for 122 beds on
January 1, 1998, and located in Columbia Heights shall have its property-related
payment rate set under this subdivision. The commissioner shall make a rate
adjustment by adding $2.41 to the facility's July 1, 1997, property-related
payment rate. The adjusted property-related payment rate shall be effective for
rate years beginning on or after July 1, 1998. The adjustment in this paragraph
shall remain in effect so long as the facility's rates are set under this
section. If the facility participates in the alternative payment system under
section 256B.434, the adjustment in this paragraph shall be included in the
facility's contract payment rate. If historical rates or property costs
recognized under this section become the basis for future medical assistance
payments to the facility under a managed care, capitation, or other alternative
payment system, the adjustment in this paragraph shall be included in the
computation of the facility's payments.
Sec. 9. Minnesota Statutes 1997 Supplement, section
256B.431, subdivision 26, is amended to read:
Subd. 26. [CHANGES TO NURSING FACILITY REIMBURSEMENT
BEGINNING JULY 1, 1997.] The nursing facility reimbursement changes in
paragraphs (a) to (f) shall apply in the sequence specified in Minnesota Rules,
parts 9549.0010 to 9549.0080, and this section, beginning July 1, 1997.
(a) For rate years beginning on or after July 1, 1997,
the commissioner shall limit a nursing facility's allowable operating per diem
for each case mix category for each rate year. The commissioner shall group
nursing facilities into two groups, freestanding and nonfreestanding, within
each geographic group, using their operating cost per diem for the case mix A
classification. A nonfreestanding nursing facility is a
nursing facility whose other operating cost per diem is subject to the hospital
attached, short length of stay, or the rule 80 limits. All other nursing
facilities shall be considered freestanding nursing facilities. The commissioner
shall then array all nursing facilities in each grouping by their allowable case
mix A operating cost per diem. In calculating a nursing facility's operating
cost per diem for this purpose, the commissioner shall exclude the raw food cost
per diem related to providing special diets that are based on religious beliefs,
as determined in subdivision 2b, paragraph (h). For those nursing facilities in
each grouping whose case mix A operating cost per diem:
(1) is at or below the median of the array, the
commissioner shall limit the nursing facility's allowable operating cost per
diem for each case mix category to the lesser of the prior reporting year's
allowable operating cost per diem as specified in Laws 1996, chapter 451,
article 3, section 11, paragraph (h), plus the inflation factor as established
in paragraph (d), clause (2), increased by two percentage points, or the current
reporting year's corresponding allowable operating cost per diem; or
(2) is above the median of the array, the commissioner
shall limit the nursing facility's allowable operating cost per diem for each
case mix category to the lesser of the prior reporting year's allowable
operating cost per diem as specified in Laws 1996, chapter 451, article 3,
section 11, paragraph (h), plus the inflation factor as established in paragraph
(d), clause (2), increased by one percentage point, or the current reporting
year's corresponding allowable operating cost per diem.
For purposes of paragraph (a), for
rate years beginning on or after July 1, 1998, if a nursing facility reports on
its cost report a reduction in cost due to a refund or credit, the commissioner
shall increase that facility's spend-up limit for the rate year following the
current rate year by the amount of the cost reduction divided by its resident
days for the reporting year preceding the rate year in which the adjustment is
to be made.
(b) For rate years beginning on or after July 1, 1997,
the commissioner shall limit the allowable operating cost per diem for high cost
nursing facilities. After application of the limits in paragraph (a) to each
nursing facility's operating cost per diem, the commissioner shall group nursing
facilities into two groups, freestanding or nonfreestanding, within each
geographic group. A nonfreestanding nursing facility is a nursing facility whose
other operating cost per diem are subject to hospital attached, short length of
stay, or rule 80 limits. All other nursing facilities shall be considered
freestanding nursing facilities. The commissioner shall then array all nursing
facilities within each grouping by their allowable case mix A operating cost per
diem. In calculating a nursing facility's operating cost per diem for this
purpose, the commissioner shall exclude the raw food cost per diem related to
providing special diets that are based on religious beliefs, as determined in
subdivision 2b, paragraph (h). For those nursing facilities in each grouping
whose case mix A operating cost per diem exceeds 1.0 standard deviation above
the median, the commissioner shall reduce their allowable operating cost per
diem by three percent. For those nursing facilities in each grouping whose case
mix A operating cost per diem exceeds 0.5 standard deviation above the median
but is less than or equal to 1.0 standard deviation above the median, the
commissioner shall reduce their allowable operating cost per diem by two
percent. However, in no case shall a nursing facility's operating cost per diem
be reduced below its grouping's limit established at 0.5 standard deviations
above the median.
(c) For rate years beginning on or after July 1, 1997,
the commissioner shall determine a nursing facility's efficiency incentive by
first computing the allowable difference, which is the lesser of $4.50 or the
amount by which the facility's other operating cost limit exceeds its
nonadjusted other operating cost per diem for that rate year. The commissioner
shall compute the efficiency incentive by:
(1) subtracting the allowable difference from $4.50 and
dividing the result by $4.50;
(2) multiplying 0.20 by the ratio resulting from clause
(1), and then;
(3) adding 0.50 to the result from clause (2); and
(4) multiplying the result from clause (3) times the
allowable difference.
The nursing facility's efficiency incentive payment shall
be the lesser of $2.25 or the product obtained in clause (4).
(d) For rate years beginning on or after July 1, 1997,
the forecasted price index for a nursing facility's allowable operating cost per
diem shall be determined under clauses (1) and (2) using the change in the
Consumer Price Index-All Items (United States city average) (CPI-U) as
forecasted by Data Resources, Inc. The commissioner shall use the indices as
forecasted in the fourth quarter of the calendar year preceding the rate year,
subject to subdivision 2l, paragraph (c).
(1) The CPI-U forecasted index for allowable operating
cost per diem shall be based on the 21-month period from the midpoint of the
nursing facility's reporting year to the midpoint of the rate year following the
reporting year.
(2) For rate years beginning on or after July 1, 1997,
the forecasted index for operating cost limits referred to in subdivision 21,
paragraph (b), shall be based on the CPI-U for the 12-month period between the
midpoints of the two reporting years preceding the rate year.
(e) After applying these provisions for the respective
rate years, the commissioner shall index these allowable operating cost per diem
by the inflation factor provided for in paragraph (d), clause (1), and add the
nursing facility's efficiency incentive as computed in paragraph (c).
(f) For rate years beginning on or after July 1, 1997,
the total operating cost payment rates for a nursing facility shall be the
greater of the total operating cost payment rates determined under this section
or the total operating cost payment rates in effect on June 30, 1997, subject to
rate adjustments due to field audit or rate appeal resolution. This provision
shall not apply to subsequent field audit adjustments of the nursing facility's
operating cost rates for rate years beginning on or after July 1, 1997.
(g) For the rate years beginning on July 1, 1997, (h) For a nursing facility whose construction project was
authorized according to section 144A.073, subdivision 5, paragraph (g), the
operating cost payment rates for the third location shall be determined based on
Minnesota Rules, part 9549.0057. Paragraphs (a) and (b) shall not apply until
the second rate year after the settle-up cost report is filed. Notwithstanding
subdivision 2b, paragraph (g), real estate taxes and special assessments payable
by the third location, a 501(c)(3) nonprofit corporation, shall be included in
the payment rates determined under this subdivision for all subsequent rate
years.
(i) For the rate year beginning July 1, 1997, the
commissioner shall compute the payment rate for a nursing facility licensed for
94 beds on September 30, 1996, that applied in October 1993 for approval of a
total replacement under the moratorium exception process in section 144A.073,
and completed the approved replacement in June 1995, with other operating cost
spend-up limit under paragraph (a), increased by $3.98, and after computing the
facility's payment rate according to this section, the commissioner shall make a
one-year positive rate adjustment of $3.19 for operating costs related to the
newly constructed total replacement, without application of paragraphs (a) and
(b). The facility's per diem, before the $3.19 adjustment, shall be used as the
prior reporting year's allowable operating cost per diem for payment rate
calculation for the rate year beginning July 1, 1998. A facility described in
this paragraph is exempt from paragraph (b) for the rate years beginning July 1,
1997, and July 1, 1998.
(j) For the purpose of applying the limit stated in
paragraph (a), a nursing facility in Kandiyohi county licensed for 86 beds that
was granted hospital-attached status on December 1, 1994, shall have the prior
year's allowable care-related per diem increased by $3.207 and the prior year's
other operating cost per diem increased by $4.777 before adding the inflation in
paragraph (d), clause (2), for the rate year beginning on July 1, 1997.
(k) For the purpose of applying the limit stated in
paragraph (a), a 117 bed nursing facility located in Pine county shall have the
prior year's allowable other operating cost per diem increased by $1.50 before
adding the inflation in paragraph (d), clause (2), for the rate year beginning
on July 1, 1997.
(l) For the purpose of applying the limit under paragraph
(a), a nursing facility in Hibbing licensed for 192 beds shall have the prior
year's allowable other operating cost per diem increased by $2.67 before adding
the inflation in paragraph (d), clause (2), for the rate year beginning July 1,
1997.
(m) For the purpose of applying
the limit stated in paragraph (a), a nursing facility in Hennepin county
licensed for 181 beds on September 30, 1996, shall have the prior year's
allowable care-related per diem increased by $1.455 and the prior year's other
operating cost per diem increased by $0.439 before adding the inflation in
paragraph (d), clause (2), for the rate year beginning on July 1, 1998.
(n) For the purpose of applying
the limit stated in paragraph (a), a nursing facility in Hennepin county
licensed for 161 beds on September 30, 1996, shall have the prior year's
allowable care-related per diem increased by $1.154 and the prior year's other
operating cost per diem increased by $0.256 before adding the inflation in
paragraph (d), clause (2), for the rate year beginning on July 1, 1998.
(o) For the purpose of applying
the limit stated in paragraph (a), a nursing facility in Ramsey county licensed
for 176 beds on September 30, 1996, shall have the prior year's allowable
care-related per diem increased by $0.803 and the prior year's other operating
cost per diem increased by $0.272 before adding the inflation in paragraph (d),
clause (2), for the rate year beginning on July 1, 1998.
(p) For the purpose of applying
the limit stated in paragraph (a), a nursing facility in Brown county licensed
for 86 beds on September 30, 1996, shall have the prior year's allowable
care-related per diem increased by $0.850 and the prior year's other operating
cost per diem increased by $0.275 before adding the inflation in paragraph (d),
clause (2), for the rate year beginning on July 1, 1998.
(q) For the rate year beginning
July 1, 1998, the commissioner shall compute the payment rate for a nursing
facility, which was licensed for 110 beds on May 1, 1997, was granted approval
in January 1994 for a replacement and remodeling project under the moratorium
exception process in section 144A.073, and completed the approved replacement
and remodeling project on March 14, 1997, by increasing the other operating cost
spend-up limit under paragraph (a) by $1.64. After computing the facility's
payment rate for the rate year beginning July 1, 1998, according to this
section, the commissioner shall make a one-year positive rate adjustment of 48
cents for increased real estate taxes resulting from completion of the
moratorium exception project, without application of paragraphs (a) and (b).
Sec. 10. Minnesota Statutes 1996, section 256B.431, is
amended by adding a subdivision to read:
Subd. 27. [RULE 80 LIMITED
EXEMPTION.] For the rate year beginning July 1, 1998, the
commissioner shall compute the payment rate for a nursing facility exempted from
care-related limits under subdivision 2b, paragraph (d), clause (2), with a
minimum of three-quarters of its beds licensed to provide residential services
for the physically handicapped under Minnesota Rules, parts 9570.2000 to
9570.3400, with the care related spend-up limit under subdivision 26, paragraph
(a), increased by $13.21 for the rate year beginning July 1, 1998, without
application of subdivision 26, paragraph (b). For rate years beginning on or
after July 1, 1999, the commissioner shall exclude that amount in calculating
the facility's operating cost per diem for purposes of applying subdivision 26,
paragraph (b).
Sec. 11. [256B.435] [NURSING FACILITY REIMBURSEMENT
SYSTEM EFFECTIVE JULY 1, 2000.]
Subdivision 1. [IN GENERAL.]
Effective July 1, 2000, the commissioner shall implement
a performance-based contracting system to replace the current method of setting
operating cost payment rates under sections 256B.431 and 256B.434 and Minnesota
Rules, parts 9549.0010 to 9549.0080. A nursing facility in operation on May 1,
1998, with payment rates not established under section 256B.431 or 256B.434 on
that date, is ineligible for this performance-based contracting system. In
determining prospective payment rates of nursing facility services, the
commissioner shall distinguish between operating costs and property-related
costs. The operating cost portion of the payment rates shall be indexed annually
by an inflation factor as specified in subdivision 3, and in accordance with
section 256B.431, subdivision 21, paragraph (c). Property related payment rates,
including real estate taxes and special assessments, shall be determined under
section 256B.431 or 256B.434.
Subd. 2. [CONTRACT
PROVISIONS.] (a) The performance-based contract with each
nursing facility must include provisions that:
(1) apply the resident case mix
assessment provisions of Minnesota Rules, parts 9549.0051, 9549.0058, and
9549.0059, or another assessment system, with the goal of moving to a single
assessment system;
(2) monitor resident outcomes
through various methods, such as quality indicators based on the minimum data
set and other utilization and performance measures;
(3) require the establishment and
use of a continuous quality improvement process that integrates information from
quality indicators and regular resident and family satisfaction interviews;
(4) require annual reporting of
facility statistical information, including resident days by case mix category,
productive nursing hours, wages and benefits, and raw food costs for use by the
commissioner in the development of facility profiles that include trends in
payment and service utilization;
(5) require from each nursing
facility an annual certified audited financial statement consisting of a balance
sheet, income and expense statements, and an opinion from either a licensed or
certified public accountant, if a certified audit was prepared, or unaudited
financial statements if no certified audit was prepared; and
(6) establish additional
requirements and penalties for nursing facilities not meeting the standards set
forth in the performance-based contract.
(b) The commissioner may develop
additional incentive-based payments for achieving outcomes specified in each
contract. The specified facility-specific outcomes must be measurable and
approved by the commissioner.
(c) The commissioner may also
contract with nursing facilities in other ways through requests for proposals,
including contracts on a risk or nonrisk basis, with nursing facilities or
consortia of nursing facilities, to provide comprehensive long-term care
coverage on a premium or capitated basis.
Subd. 3. [PAYMENT RATE
PROVISIONS.] (a) For rate years beginning on or after
July 1, 2000, the commissioner shall determine operating cost payment rates for
each licensed and certified nursing facility by indexing its operating cost
payment rates in effect on June 30, 2000, for inflation. The inflation factor to
be used must be based on the change in the Consumer Price Index-All Items,
United States city average (CPI-U) as forecasted by Data Resources, Inc. in the
fourth quarter preceding the rate year. The CPI-U forecasted index for operating
cost payment rates shall be based on the 12-month period from the midpoint of
the nursing facility's prior rate year to the midpoint of the rate year for
which the operating payment rate is being determined.
(b) Beginning July 1, 2000, each
nursing facility subject to a performance-based contract under this section
shall choose one of two methods of payment for property related costs:
(1) the method established in
section 256B.434; or
(2) the method established in
section 256B.431.
Once the nursing facility has made
the election in paragraph (b), that election shall remain in effect for at least
four years or until an alternative property payment system is developed.
Sec. 12. [256B.5011] [ICF/MR REIMBURSEMENT SYSTEM
EFFECTIVE OCTOBER 1, 2000.]
Subdivision 1.
[PERFORMANCE-BASED CONTRACTING SYSTEM.] (a) Effective
October 1, 2000, the commissioner shall implement a performance-based
contracting system to replace the current method of setting total cost payment
rates under section 256B.501 and Minnesota Rules, parts 9553.0010 to 9553.0080.
In determining prospective payment rates of intermediate care facilities for
persons with mental retardation or related conditions, the commissioner shall
index each facility's total payment rate by an inflation factor as described in
subdivision 3. The commissioner of finance shall include annual inflation
adjustments in operating costs for intermediate care facilities for persons with
mental retardation and related conditions as a budget change request in each
biennial detailed expenditure budget submitted to the legislature under section
16A.11.
Subd. 2. [CONTRACT
PROVISIONS.] The performance-based contract with each
intermediate care facility must include provisions for:
(1) modifying payments when
significant changes occur in the needs of the consumers;
(2) monitoring service quality
using performance indicators that measure consumer outcomes;
(3) the establishment and use of
continuous quality improvement processes using the results attained through
service quality monitoring;
(4) the annual reporting of
facility statistical information on all supervisory personnel, direct care
personnel, specialized support personnel, hours, wages and benefits,
staff-to-consumer ratios, and staffing patterns;
(5) annual aggregate facility
financial information or an annual certified audited financial statement,
including a balance sheet and income and expense statements for each facility,
if a certified audit was prepared; and
(6) additional requirements and
penalties for intermediate care facilities not meeting the standards set forth
in the performance-based contract.
Subd. 3. [PAYMENT RATE
PROVISIONS.] For rate years beginning on or after October
1, 2000, the commissioner shall determine the total payment rate for each
licensed and certified intermediate care facility by indexing the total payment
rate in effect on September 30, 2000, for inflation. The inflation factor to be
used must be based on the change in the Consumer Price Index-All Items, United
States city average (CPI-U) as forecasted by Data Resources, Inc. in the first
quarter of the calendar year during which the rate year begins. The CPI-U
forecasted index for total payment rates shall be based on the 12-month period
from the midpoint of the ICFs/MR prior rate year to the midpoint of the rate
year for which the operating payment rate is being determined.
Sec. 13. [RECOMMENDATIONS TO IMPLEMENT NEW REIMBURSEMENT
SYSTEM.]
(a) By January 15, 1999, the
commissioner shall make recommendations to the chairs of the health and human
services policy and fiscal committees on the repeal of specific statutes and
rules as well as any other additional recommendations related to implementation
of sections 11 and 12.
(b) In developing recommendations
for nursing facility reimbursement, the commissioner shall consider making each
nursing facility's total payment rates, both operating and property rate
components, prospective. The commissioner shall involve nursing facility
industry and consumer representatives in the development of these
recommendations.
(c) In making recommendations for
ICF/MR reimbursement, the commissioner may consider methods of establishing
payment rates that take into account individual client costs and needs, include
provisions to establish links between performance indicators and reimbursement
and other performance incentives, and allow local control over resources
necessary for local agencies to set rates and contract with ICF/MR facilities.
In addition, the commissioner may establish methods that provide information to
consumers regarding service quality as measured by performance indicators. The
commissioner shall involve ICF/MR industry and consumer representatives in the
development of these recommendations.
Sec. 14. [APPROVAL EXTENDED.]
Minnesota Statutes, section
144A.073, subdivision 3, notwithstanding, the commissioner of health shall grant
an additional 18 months of approval for a proposed exception to the nursing home
licensure and certification moratorium, if the proposal is to replace a 96-bed
nursing home facility in Carlton county and if initial approval for the proposal
was granted in November 1996.
Sec. 15. [EFFECTIVE DATE.]
Sections 4 (256B.0951, subd. 7), 9
(256B.431, subd. 26), and 14 (approval extended) are effective the day following
final enactment.
Section 1. Minnesota Statutes 1997 Supplement, section
62J.69, subdivision 1, is amended to read:
Subdivision 1. [DEFINITIONS.] For purposes of this
section, the following definitions apply:
(a) "Medical education" means the accredited clinical
training of physicians (medical students and residents), doctor of pharmacy
practitioners, dentists, advanced practice nurses (clinical nurse specialist,
certified registered nurse anesthetists, nurse practitioners, and certified
nurse midwives), and physician assistants.
(b) "Clinical training" means accredited training for the health care practitioners listed in paragraph
(a) that is funded (c) "Trainee" means students involved in an accredited
clinical training program for medical education as defined in paragraph (a).
(d) "Eligible trainee" means a
student involved in an accredited training program for medical education as
defined in paragraph (a), which meets the definition of clinical training in
paragraph (b), who is in a training site that is located in Minnesota and which
has a medical assistance provider number.
(e) "Health care research"
means approved clinical, outcomes, and health services investigations that are
funded by patient out-of-pocket expenses or a third-party payer.
(h) "Accredited training" means
training provided by a program that is accredited through an organization
recognized by the department of education or the health care financing
administration as the official accrediting body for that program.
(i) "Sponsoring institution" means
a hospital, school, or consortium located in Minnesota that sponsors and
maintains primary organizational and financial responsibility for an accredited
medical education program in Minnesota and which is accountable to the
accrediting body.
Sec. 2. Minnesota Statutes 1997 Supplement, section
62J.69, subdivision 2, is amended to read:
Subd. 2. [ALLOCATION AND FUNDING FOR MEDICAL EDUCATION
AND RESEARCH.] (a) The commissioner may establish a trust fund for the purposes
of funding medical education and research activities in the state of Minnesota.
(b) By January 1, 1997, the commissioner may appoint an
advisory committee to provide advice and oversight on the distribution of funds
from the medical education and research trust fund. If a committee is appointed,
the commissioner shall: (1) consider the interest of all stakeholders when
selecting committee members; (2) select members that represent both urban and
rural interest; and (3) select members that include ambulatory care as well as
inpatient perspectives. The commissioner shall appoint to the advisory committee
representatives of the following groups: medical researchers, public and private
academic medical centers, managed care organizations, Blue Cross and Blue Shield
of Minnesota, commercial carriers, Minnesota Medical Association, Minnesota
Nurses Association, medical product manufacturers, employers, and other relevant
stakeholders, including consumers. The advisory committee is governed by section
15.059, for membership terms and removal of members and will sunset on June 30,
1999.
(c) Eligible applicants for funds are accredited medical
education teaching institutions, consortia, and programs operating in Minnesota.
Applications must be submitted by the sponsoring institution on behalf of the
teaching program, and must be received by September 30 of each year for
distribution in January of the following year. An application for funds must
include the following:
(1) the official name and address of the sponsoring
institution and the official name and address of the facility or (2) the name, title, and business address of those
persons responsible for administering the funds;
(3) (4) audited clinical training costs per trainee for each
medical education program where available or estimates of
clinical training costs based on audited financial data;
(5) a description of current sources of funding for
medical education costs including a description and dollar amount of all state
and federal financial support, including Medicare direct
and indirect payments;
(6) other revenue received for the purposes of clinical
training; and
(7) (d) The commissioner shall distribute medical education
funds to all qualifying applicants based on the following basic criteria: (1)
total medical education funds available; (2) total eligible trainees in each
eligible education program; and (3) the statewide average cost per trainee, by
type of trainee, in each medical education program. Funds distributed shall not
be used to displace current funding appropriations from federal or state
sources. Funds shall be distributed to the sponsoring institutions indicating
the amount to be paid to each of the sponsor's medical education programs based
on the criteria in this paragraph. Sponsoring institutions which receive funds
from the trust fund must distribute approved funds to the medical education
program according to the commissioner's approval letter. Further, programs must
distribute funds among the sites of training (e) Medical education programs receiving funds from the
trust fund must submit (1) the total number of eligible trainees in the program;
(2) the programs and residencies funded, the amounts of
trust fund payments to each program, and within each program, the (3) The commissioner, with advice from the advisory
committee, will provide an annual summary report to the legislature on program
implementation due February 15 of each year.
(f) The commissioner is authorized to distribute funds
made available through:
(1) voluntary contributions by employers or other
entities;
(2) allocations for the department of human services to
support medical education and research; and
(3) other sources as identified and deemed appropriate by
the legislature for inclusion in the trust fund.
(g) The advisory committee shall continue to study and
make recommendations on:
(1) the funding of medical research consistent with work
currently mandated by the legislature and under way at the department of health;
and
(2) the costs and benefits associated with medical
education and research.
Sec. 3. Minnesota Statutes 1997 Supplement, section
62J.69, is amended by adding a subdivision to read:
Subd. 4. [TRANSFERS FROM THE
COMMISSIONER OF HUMAN SERVICES.] (a) The amount
transferred according to section 256B.69, subdivision 5c, shall be distributed
to qualifying applicants based on a distribution formula that reflects a
summation of two factors:
(1) an education factor, which is
determined by the total number of eligible trainees and the total statewide
average costs per trainee, by type of trainee, in each program; and
(2) a public program volume
factor, which is determined by the total volume of public program revenue
received by each training site as a percentage of all public program revenue
received by all training sites in the trust fund pool.
In this formula, the education
factor shall be weighted at 50 percent and the public program volume factor
shall be weighted at 50 percent.
(b) Public program revenue for the
formula in paragraph (a) shall include revenue from medical assistance, prepaid
medical assistance, general assistance medical care, and prepaid general
assistance medical care.
(c) Training sites that receive no
public program revenue shall be ineligible for payments from the prepaid medical
assistance program transfer pool.
Sec. 4. Minnesota Statutes 1996, section 245.462,
subdivision 4, is amended to read:
Subd. 4. [CASE MANAGER.] "Case manager" means an
individual employed by the county or other entity authorized by the county board
to provide case management services specified in section 245.4711. A case
manager must clinical supervision of the case manager's activities.
Case managers with a bachelor's degree but without 2,000 hours of supervised
experience in the delivery of services to adults with mental illness must
complete 40 hours of training approved by the commissioner of human services in
case management skills and in the characteristics and needs of adults with
serious and persistent mental illness and must receive clinical supervision
regarding individual service delivery from a mental health professional at least
once each week until the requirement of 2,000 hours of supervised experience is
met. Case managers without a bachelor's degree but with
6,000 hours of supervised experience in the delivery of services to adults with
mental illness must complete 40 hours of training approved by the commissioner
of human services in case management skills and in the characteristics and needs
of adults with serious and persistent mental illness. Clinical supervision
must be documented in the client record.
Until June 30, 1999, Sec. 5. Minnesota Statutes 1996, section 245.462,
subdivision 8, is amended to read:
Subd. 8. [DAY TREATMENT SERVICES.] "Day treatment," "day
treatment services," or "day treatment program" means a structured program of
treatment and care provided to an adult in or by: (1)
a hospital accredited by the joint commission on accreditation of health
organizations and licensed under sections 144.50 to 144.55; (2) a community
mental health center under section 245.62; or (3) an entity that is under
contract with the county board to operate a program that meets the requirements
of section 245.4712, subdivision 2, and Minnesota Rules, parts 9505.0170 to
9505.0475. Day treatment consists of group psychotherapy and other intensive
therapeutic services that are provided at least one day a week Sec. 6. Minnesota Statutes 1996, section 245.4871,
subdivision 4, is amended to read:
Subd. 4. [CASE MANAGER.] (a) "Case manager" means an
individual employed by the county or other entity authorized by the county board
to provide case management services specified in subdivision 3 for the child
with severe emotional disturbance and the child's family. A case manager must
have experience and training in working with children.
(b) A case manager must meet the
qualifications for a mental health practitioner in subdivision 26:
(1) (c) The case manager may be a member of any professional
discipline that is part of the local system of care for children established by
the county board.
(d) The case manager must meet in person with a mental
health professional at least once each month to obtain clinical supervision.
(e) Case managers with a bachelor's degree but without
2,000 hours of supervised experience in the delivery of mental health services
to children with emotional disturbance must:
(1) begin 40 hours of training approved by the
commissioner of human services in case management skills and in the
characteristics and needs of children with severe emotional disturbance before
beginning to provide case management services; and
(2) receive clinical supervision regarding individual
service delivery from a mental health professional at least once each week until
the requirement of 2,000 hours of experience is met.
(f) Clinical supervision must be documented in the
child's record. When the case manager is not a mental health professional, the
county board must provide or contract for needed clinical supervision.
(g) The county board must ensure that the case manager
has the freedom to access and coordinate the services within the local system of
care that are needed by the child.
(h) Until June 30, 1999, (1) is actively pursuing credits toward the completion of
a bachelor's degree in one of the behavioral sciences or related fields at an
accredited college or university;
(2) completes 40 hours of training as specified in this
subdivision; and
(3) receives clinical supervision at least once a week
until the requirements of (i) Case managers without a
bachelor's degree but with 6,000 hours of supervised experience in the delivery
of mental health services to children with emotional disturbance must begin 40
hours of training approved by the commissioner of human services in case
management skills and in the characteristics and needs of children with severe
emotional disturbance before beginning to provide case management services.
Sec. 7. [256.9364] [POST-KIDNEY TRANSPLANT DRUG PROGRAM.]
Subdivision 1.
[ESTABLISHMENT.] The commissioner of human services shall
establish and administer a program to pay for costs of drugs prescribed
exclusively for post-kidney transplant maintenance when those costs are not
otherwise reimbursed by a third-party payer. The commissioner may contract with
a nonprofit entity to administer this program.
Subd. 2. [ELIGIBILITY
REQUIREMENTS.] To be eligible for the program, an
applicant must satisfy the following requirements:
(1) the applicant's family gross
income must not exceed 275 percent of the federal poverty level; and
(2) the applicant must be a
Minnesota resident who has resided in Minnesota for at least 12 months.
An applicant shall not be excluded
because the applicant received the transplant outside the state of Minnesota, so
long as the other requirements are met.
Subd. 3. [PAYMENT AMOUNTS.] (a) The amount of the payments made for each eligible
recipient shall be based on the following:
(1) available funds; and
(2) the cost of the post-kidney
transplant maintenance drugs.
(b) The payment rate under this
program must be no greater than the medical assistance reimbursement rate for
the prescribed drug.
(c) Payments shall be made to or
on behalf of an eligible recipient for the cost of the post-kidney transplant
maintenance drugs that is not covered, reimbursed, or eligible for reimbursement
by any other third party or government entity, including, but not limited to,
private or group health insurance, medical assistance, Medicare, the Veterans
Administration, the senior citizen drug program established under section
256.955, or under any waiver arrangement received by the state to provide a
prescription drug benefit for qualified Medicare beneficiaries or
service-limited Medicare beneficiaries.
(d) The commissioner may restrict
or categorize payments to meet the appropriation allocated for this program.
(e) Any cost of the post-kidney
transplant maintenance drugs that is not reimbursed under this program is the
responsibility of the program recipient.
Subd. 4. [DRUG FORMULARY.] The commissioner shall maintain a drug formulary that
includes all drugs eligible for reimbursement by the program. The commissioner
may use the drug formulary established under section 256B.0625, subdivision 13.
The commissioner shall establish an internal review procedure for updating the
formulary that allows for the addition and deletion of drugs to the formulary.
The drug formulary must be reviewed at least quarterly per fiscal year.
Subd. 5. [PRIVATE DONATIONS.]
The commissioner may accept funding from other public or
private sources.
Subd. 6. [SUNSET.] This program expires on July 1, 2000.
Sec. 8. Minnesota Statutes 1997 Supplement, section
256.9657, subdivision 3, is amended to read:
Subd. 3. [HEALTH MAINTENANCE ORGANIZATION; COMMUNITY
INTEGRATED SERVICE NETWORK SURCHARGE.] (a) Effective October 1, 1992, each
health maintenance organization with a certificate of authority issued by the
commissioner of health under chapter 62D and each community integrated service
network licensed by the commissioner under chapter 62N shall pay to the
commissioner of human services a surcharge equal to six-tenths of one percent of
the total premium revenues of the health maintenance organization or community
integrated service network as reported to the commissioner of health according
to the schedule in subdivision 4.
(b) For purposes of this subdivision, total premium
revenue means:
(1) premium revenue recognized on a prepaid basis from
individuals and groups for provision of a specified range of health services
over a defined period of time which is normally one month, excluding premiums
paid to a health maintenance organization or community integrated service
network from the Federal Employees Health Benefit Program;
(2) premiums from Medicare wrap-around subscribers for
health benefits which supplement Medicare coverage;
(3) Medicare revenue, as a result of an arrangement
between a health maintenance organization or a community integrated service
network and the health care financing administration of the federal Department
of Health and Human Services, for services to a Medicare beneficiary, excluding Medicare revenue that states are prohibited from
taxing under sections 4001 and 4002 of Public Law Number 105-33 received by a
health maintenance organization or community integrated service network through
risk sharing or Medicare Choice + contracts; and
(4) medical assistance revenue, as a result of an
arrangement between a health maintenance organization or community integrated
service network and a Medicaid state agency, for services to a medical
assistance beneficiary.
If advance payments are made under clause (1) or (2) to
the health maintenance organization or community integrated service network for
more than one reporting period, the portion of the payment that has not yet been
earned must be treated as a liability.
(c) When a health maintenance organization or community
integrated service network merges or consolidates with or is acquired by another
health maintenance organization or community integrated service network, the
surviving corporation or the new corporation shall be responsible for the annual
surcharge originally imposed on each of the entities or corporations subject to
the merger, consolidation, or acquisition, regardless of whether one of the
entities or corporations does not retain a certificate of authority under
chapter 62D or a license under chapter 62N.
(d) Effective July 1 of each year, the surviving
corporation's or the new corporation's surcharge shall be based on the revenues
earned in the second previous calendar year by all of the entities or
corporations subject to the merger, consolidation, or acquisition regardless of
whether one of the entities or corporations does not retain a certificate of
authority under chapter 62D or a license under chapter 62N until the total
premium revenues of the surviving corporation include the total premium revenues
of all the merged entities as reported to the commissioner of health.
(e) When a health maintenance organization or community
integrated service network, which is subject to liability for the surcharge
under this chapter, transfers, assigns, sells, leases, or disposes of all or
substantially all of its property or assets, liability for the surcharge imposed
by this chapter is imposed on the transferee, assignee, or buyer of the health
maintenance organization or community integrated service network.
(f) In the event a health maintenance organization or
community integrated service network converts its licensure to a different type
of entity subject to liability for the surcharge under this chapter, but
survives in the same or substantially similar form, the surviving entity remains
liable for the surcharge regardless of whether one of the entities or
corporations does not retain a certificate of authority under chapter 62D or a
license under chapter 62N.
(g) The surcharge assessed to a health maintenance
organization or community integrated service network ends when the entity ceases
providing services for premiums and the cessation is not connected with a
merger, consolidation, acquisition, or conversion.
Sec. 9. Minnesota Statutes 1997 Supplement, section
256.9685, subdivision 1, is amended to read:
Subdivision 1. [AUTHORITY.] The commissioner shall
establish procedures for determining medical assistance and general assistance
medical care payment rates under a prospective payment system for inpatient
hospital services in hospitals that qualify as vendors of medical assistance.
The commissioner shall establish, by rule, procedures for implementing this
section and sections 256.9686, 256.969, and 256.9695. Sec. 10. Minnesota Statutes 1996, section 256.969, is
amended by adding a subdivision to read:
Subd. 9c. [COUNTY BILLING.] Hospitals that have a disproportionate population adjustment
greater than eight percent shall be eligible for a special payment for
uncompensated care. These hospitals may bill a county of residence for services
provided to a resident of that county provided:
(1) the patient is from a county
other than that in which the hospital resides; and
(2) the hospital has made a
preliminary determination at the delivery of service that the patient was
indigent based on current medical assistance guidelines.
Counties that are billed under
this program must pay eligible hospitals at the rates established under the
medical assistance program. If the county can establish eligibility for medical
assistance after the service has been delivered, the state shall reimburse the
county for any funds paid to the eligible hospital.
Sec. 11. Minnesota Statutes 1996, section 256.969,
subdivision 16, is amended to read:
Subd. 16. [INDIAN HEALTH SERVICE FACILITIES.] sections 450f to 450n, Sec. 12. Minnesota Statutes 1996, section 256.969,
subdivision 17, is amended to read:
Subd. 17. [OUT-OF-STATE HOSPITALS IN LOCAL TRADE AREAS.]
Out-of-state hospitals that are located within a Minnesota local trade area and that have more than 20 admissions in the base year
shall have rates established using the same procedures and methods that apply to
Minnesota hospitals. For this subdivision and subdivision 18, local trade area
means a county contiguous to Minnesota and located in a
metropolitan statistical area as determined by Medicare for October 1 prior to
the most current rebased rate year. Hospitals that are not required by law
to file information in a format necessary to establish rates shall have rates
established based on the commissioner's estimates of the information. Relative
values of the diagnostic categories shall not be redetermined under this
subdivision until required by rule. Hospitals affected by this subdivision shall
then be included in determining relative values. However, hospitals that have
rates established based upon the commissioner's estimates of information shall
not be included in determining relative values. This subdivision is effective
for hospital fiscal years beginning on or after July 1, 1988. A hospital shall
provide the information necessary to establish rates under this subdivision at
least 90 days before the start of the hospital's fiscal year.
Sec. 13. Minnesota Statutes 1996, section 256B.03,
subdivision 3, is amended to read:
Subd. 3. [AMERICAN INDIAN HEALTH FUNDING.] (a) Notwithstanding subdivision 1 and sections 256B.0625
and 256D.03, subdivision 4, paragraph (b) A tribe that implements a
purchasing model under this subdivision shall report to the commissioner at
least annually on the operation of the model. The commissioner and the tribe
shall cooperatively determine the data elements, format, and timetable for the
report.
(c) For purposes of this
subdivision, "Indian tribe" means a tribe, band, or nation, or other organized
group or community of Indians that is recognized as eligible for the special
programs and services provided by the United States to Indians because of their
status as Indians and for which a reservation exists as is consistent with
Public Law Number 100-485, as amended.
(d) Payments under this
subdivision may not result in an increase in expenditures that would not
otherwise occur in the medical assistance program under this chapter or the
general assistance medical care program under chapter 256D.
Sec. 14. Minnesota Statutes 1996, section 256B.055, is
amended by adding a subdivision to read:
Subd. 7a. [SPECIAL CATEGORY
FOR DISABLED CHILDREN.] Medical assistance may be paid
for a person who is under age 18 and who meets income and asset eligibility
requirements of the Supplemental Security Income program if the person was
receiving Supplemental Security Income payments on the date of enactment of
section 211(a) of Public Law Number 104-193, the Personal Responsibility and
Work Opportunity Act of 1996, and the person would have continued to receive the
payments except for the change in the childhood disability criteria in section
211(a) of Public Law Number 104-193.
Sec. 15. Minnesota Statutes 1996, section 256B.057,
subdivision 3a, is amended to read:
Subd. 3a. [ELIGIBILITY FOR PAYMENT OF MEDICARE PART B
PREMIUMS.] A person who would otherwise be eligible as a qualified Medicare
beneficiary under subdivision 3, except the person's income is in excess of the
limit, is eligible for medical assistance reimbursement of Medicare Part B
premiums if the person's income is less than Sec. 16. Minnesota Statutes 1996, section 256B.057, is
amended by adding a subdivision to read:
Subd. 3b. [QUALIFIED
INDIVIDUALS.] Beginning July 1, 1998, to the extent of
the federal allocation to Minnesota, a person, who would otherwise be eligible
as a qualified Medicare beneficiary under subdivision 3, except that the
person's income is in excess of the limit, is eligible as a qualified individual
according to the following criteria:
(1) if the person's income is
greater than 120 percent, but less than 135 percent of the official federal
poverty guidelines for the applicable family size, the person is eligible for
medical assistance reimbursement of Medicare Part B premiums; or
(2) if the person's income is
greater than 135 percent but less than 175 percent of the official federal
poverty guidelines for the applicable family size, the person is eligible for
medical assistance reimbursement of that portion of the Medicare Part B premium
attributable to an increase in Part B expenditures which resulted from the shift
of home care services from Medicare Part A to Medicare Part B under section 4732
of Public Law Number 105-33, the Balanced Budget Act of 1997.
The commissioner shall limit
enrollment of qualifying individuals under this subdivision according to the
requirements of section 4732 of Public Law Number 105-33.
Sec. 17. Minnesota Statutes 1997 Supplement, section
256B.06, subdivision 4, is amended to read:
Subd. 4. [CITIZENSHIP REQUIREMENTS.] (a) Eligibility for
medical assistance is limited to citizens of the United States, qualified
noncitizens as defined in this subdivision, and other persons residing lawfully
in the United States.
(b) "Qualified noncitizen" means a person who meets one
of the following immigration criteria:
(1) admitted for lawful permanent residence according to
United States Code, title 8;
(2) admitted to the United States as a refugee according
to United States Code, title 8, section 1157;
(3) granted asylum according to United States Code, title
8, section 1158;
(4) granted withholding of deportation according to
United States Code, title 8, section 1253(h);
(5) paroled for a period of at least one year according
to United States Code, title 8, section 1182(d)(5);
(6) granted conditional entrant status according to
United States Code, title 8, section 1153(a)(7); (7) determined to be a battered noncitizen by the United
States Attorney General according to the Illegal Immigration Reform and
Immigrant Responsibility Act of 1996, title V of the Omnibus Consolidated
Appropriations Bill, Public Law Number 104-200;
(8) is a child of a noncitizen
determined to be a battered noncitizen by the United States Attorney General
according to the Illegal Immigration Reform and Immigrant Responsibility Act of
1996, title V of the Omnibus Consolidated Appropriations Bill, Public Law Number
104-200; or
(9) determined to be a Cuban or
Haitian entrant as defined in section 501(e) of Public Law Number 96-422, the
Refugee Education Assistance Act of 1980.
(c) All qualified noncitizens who were residing in the
United States before August 22, 1996, who otherwise meet the eligibility
requirements of chapter 256B, are eligible for medical assistance with federal
financial participation.
(d) All qualified noncitizens who entered the United
States on or after August 22, 1996, and who otherwise meet the eligibility
requirements of chapter 256B, are eligible for medical assistance with federal
financial participation through November 30, 1996.
Beginning December 1, 1996, qualified noncitizens who
entered the United States on or after August 22, 1996, and who otherwise meet
the eligibility requirements of chapter 256B are eligible for medical assistance
with federal participation for five years if they meet one of the following
criteria:
(i) refugees admitted to the United States according to
United States Code, title 8, section 1157;
(ii) persons granted asylum according to United States
Code, title 8, section 1158;
(iii) persons granted withholding of deportation
according to United States Code, title 8, section 1253(h);
(iv) veterans of the United States Armed Forces with an
honorable discharge for a reason other than noncitizen status, their spouses and
unmarried minor dependent children; or
(v) persons on active duty in the United States Armed
Forces, other than for training, their spouses and unmarried minor dependent
children.
Beginning December 1, 1996, qualified noncitizens who do
not meet one of the criteria in items (i) to (v) are eligible for medical
assistance without federal financial participation as described in paragraph
(j).
(e) Noncitizens who are not qualified noncitizens as
defined in paragraph (b), who are lawfully residing in the United States and who
otherwise meet the eligibility requirements of chapter 256B, are eligible for
medical assistance under clauses (1) to (3). These individuals must cooperate
with the Immigration and Naturalization Service to pursue any applicable
immigration status, including citizenship, that would qualify them for medical
assistance with federal financial participation.
(1) Persons who were medical assistance recipients on
August 22, 1996, are eligible for medical assistance with federal financial
participation through December 31, 1996.
(2) Beginning January 1, 1997, persons described in
clause (1) are eligible for medical assistance without federal financial
participation as described in paragraph (j).
(3) Beginning December 1, 1996, persons residing in the
United States prior to August 22, 1996, who were not receiving medical
assistance and persons who arrived on or after August 22, 1996, are eligible for
medical assistance without federal financial participation as described in
paragraph (j).
(f) Nonimmigrants who otherwise meet the eligibility
requirements of chapter 256B are eligible for the benefits as provided in
paragraphs (g) to (i). For purposes of this subdivision, a "nonimmigrant" is a
person in one of the classes listed in United States Code, title 8, section
1101(a)(15).
(g) Payment shall also be made for care and services that
are furnished to noncitizens, regardless of immigration status, who otherwise
meet the eligibility requirements of chapter 256B, if such care and services are
necessary for the treatment of an emergency medical condition, except for organ
transplants and related care and services and routine prenatal care.
(h) For purposes of this subdivision, the term "emergency
medical condition" means a medical condition that meets the requirements of
United States Code, title 42, section 1396b(v).
(i) Pregnant noncitizens who are undocumented or
nonimmigrants, who otherwise meet the eligibility requirements of chapter 256B,
are eligible for medical assistance payment without federal financial
participation for care and services through the period of pregnancy, and 60 days
postpartum, except for labor and delivery.
(j) Qualified noncitizens as described in paragraph (d),
and all other noncitizens lawfully residing in the United States as described in
paragraph (e), who are ineligible for medical assistance with federal financial
participation and who otherwise meet the eligibility requirements of chapter
256B and of this paragraph, are eligible for medical assistance without federal
financial participation. Qualified noncitizens as described in paragraph (d) are
only eligible for medical assistance without federal financial participation for
five years from their date of entry into the United States.
(k) The commissioner shall submit to the legislature by
December 31, 1998, a report on the number of recipients and cost of coverage of
care and services made according to paragraphs (i) and (j).
Sec. 18. Minnesota Statutes 1996, section 256B.0625, is
amended by adding a subdivision to read:
Subd. 17a. [PAYMENT FOR
AMBULANCE SERVICES.] Effective for services rendered on
or after July 1, 1999, medical assistance payments for ambulance services shall
be increased by ten percent.
Sec. 19. Minnesota Statutes 1996, section 256B.0625,
subdivision 20, is amended to read:
Subd. 20. [MENTAL (b) Entities meeting program
standards set out in rules governing family community support services as
defined in section 245.4871, subdivision 17, are eligible for medical assistance
reimbursement for case management services for children with severe emotional
disturbance when these services meet the program standards in Minnesota Rules,
parts 9520.0900 to 9520.0926 and 9505.0322, excluding (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 at least a face-to-face contact with the adult
or the adult's legal representative.
(d) Payment for mental health case
management provided by county or state staff shall be based on the monthly rate
methodology under section 256B.094, subdivision 6, paragraph (b), with separate
rates calculated for child welfare and mental health, and within mental health,
separate rates for children and adults.
(e) Payment for mental health case
management provided by county-contracted vendors shall be based on a monthly
rate negotiated by the host county. The negotiated rate must not exceed the rate
charged by the vendor for the same service to other payers. If the service is
provided by a team of contracted vendors, the county may negotiate a team rate
with a vendor who is a member of the team. The team shall determine how to
distribute the rate among its members. No reimbursement received by contracted
vendors shall be returned to the county, except to reimburse the county for
advance funding provided by the county to the vendor.
(f) If the service is provided by
a team which includes contracted vendors and county or state staff, the costs
for county or state staff participation in the team shall be included in the
rate for county-provided services. In this case, the contracted vendor and the
county may each receive separate payment for services provided by each entity in
the same month. In order to prevent duplication of services, the county must
document, in the recipient's file, the need for team case management and a
description of the roles of the team members.
(g) The commissioner shall
calculate the nonfederal share of actual medical assistance and general
assistance medical care payments for each county, based on the higher of
calendar year 1995 or 1996 by service date, trend that amount forward to 1999,
and transfer the result from medical assistance and general assistance medical
care to each county's mental health grants under sections 245.4886 and 256E.12
for calendar year 1999. The 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 total amount transferred shall become part of the base for future
mental health grants for each county.
(h) Any net increase in revenue to
the county as a result of the change in this section must be used to provide
expanded mental health services as defined in sections 245.461 to 245.4888, the
Comprehensive Adult and Children's Mental Health Acts, excluding inpatient and
residential treatment. For adults, increased revenue may also be used for
services and consumer supports which are part of adult mental health projects
approved under Laws 1997, chapter 203, article 7, section 25. For children,
increased revenue may also be used for respite care and nonresidential
individualized rehabilitation services as defined in section 245.492,
subdivisions 17 and 23. "Increased revenue" has the meaning given in Minnesota
Rules, part 9520.0903, subpart 3.
(i) Notwithstanding section
256B.19, subdivision 1, the nonfederal share of costs for mental health case
management shall be provided by the recipient's county of responsibility, as
defined in sections 256G.01 to 256G.12, from sources other than federal funds or
funds used to match other federal funds.
(j) The commissioner may suspend,
reduce, or terminate the reimbursement to a provider that does not meet the
reporting or other requirements of this section. The county of responsibility,
as defined in sections 256G.01 to 256G.12, is responsible for any federal
disallowances. The county may share this responsibility with its contracted
vendors.
(k) The commissioner shall set
aside a portion of the federal funds earned under this section to repay the
special revenue maximization account under section 256.01, subdivision 2, clause
(15). The repayment is limited to:
(1) the costs of developing and
implementing this section; and
(2) programming the information
systems.
(l) Notwithstanding section
256.025, subdivision 2, payments to counties for case management expenditures
under this section shall only be made from federal earnings from services
provided under this section. Payments to contracted vendors shall include both
the federal earnings and the county share.
(m) Notwithstanding section
256B.041, county payments for the cost of mental health case management services
provided by county or state staff shall not be made to the state treasurer. For
the purposes of mental health case management services provided by county or
state staff under this section, the centralized disbursement of payments to
counties under section 256B.041 consists only of federal earnings from services
provided under this section.
(n) Case management services under
this subdivision do not include therapy, treatment, legal, or outreach
services.
(o) If the recipient is a resident
of a nursing facility, intermediate care facility, or hospital, and the
recipient's institutional care is paid by medical assistance, payment for case
management services under this subdivision is limited to the last 30 days of the
recipient's residency in that facility and may not exceed more than two months
in a calendar year.
(p) Payment for case management
services under this subdivision shall not duplicate payments made under other
program authorities for the same purpose.
(q) By July 1, 2000, the
commissioner shall evaluate the effectiveness of the changes required by this
section, including changes in number of persons receiving mental health case
management, changes in hours of service per person, and changes in caseload
size.
Sec. 20. Minnesota Statutes 1997 Supplement, section
256B.0625, subdivision 31a, is amended to read:
Subd. 31a. [AUGMENTATIVE AND ALTERNATIVE COMMUNICATION
SYSTEMS.] (a) Medical assistance covers augmentative and alternative
communication systems consisting of electronic or nonelectronic devices and the
related components necessary to enable a person with severe expressive
communication limitations to produce or transmit messages or symbols in a manner
that compensates for that disability.
(b) (c) Reimbursement rates
established by this purchasing program are not subject to Minnesota Rules, part
9505.0445, item S or T.
Sec. 21. Minnesota Statutes 1996, section 256B.0625,
subdivision 34, is amended to read:
Subd. 34. [AMERICAN INDIAN HEALTH SERVICES FACILITIES.]
Medical assistance payments to Sec. 22. Minnesota Statutes 1996, section 256B.0625,
subdivision 38, is amended to read:
Subd. 38. [PAYMENTS FOR MENTAL HEALTH SERVICES.] Payments
for mental health services covered under the medical assistance program that are
provided by masters-prepared mental health professionals shall be 80 percent of
the rate paid to doctoral-prepared professionals. Payments for mental health
services covered under the medical assistance program that are provided by
masters-prepared mental health professionals employed by community mental health
centers shall be 100 percent of the rate paid to doctoral-prepared
professionals. For purposes of reimbursement of mental
health professionals under the medical assistance program, all social workers
who:
(1) have received a master's
degree in social work from a program accredited by the council on social work
education;
(2) are licensed at the level of
graduate social worker or independent social worker; and
(3) are practicing clinical social
work under appropriate supervision, as defined by section 148B.18; meet all
requirements under Minnesota Rules, part 9505.0323, subpart 24, and shall be
paid accordingly.
Sec. 23. Minnesota Statutes 1997 Supplement, section
256B.0627, subdivision 5, is amended to read:
Subd. 5. [LIMITATION ON PAYMENTS.] Medical assistance
payments for home care services shall be limited according to this subdivision.
(a) [LIMITS ON SERVICES WITHOUT PRIOR AUTHORIZATION.] A
recipient may receive the following home care services during a calendar year:
(1) any initial assessment;
(2) up to two reassessments per year done to determine a
recipient's need for personal care services; and
(3) up to five skilled nurse visits.
(b) [PRIOR AUTHORIZATION; EXCEPTIONS.] All home care
services above the limits in paragraph (a) must receive the commissioner's prior
authorization, except when:
(1) the home care services were required to treat an
emergency medical condition that if not immediately treated could cause a
recipient serious physical or mental disability, continuation of severe pain, or
death. The provider must request retroactive authorization no later than five
working days after giving the initial service. The provider must be able to
substantiate the emergency by documentation such as reports, notes, and
admission or discharge histories;
(2) the home care services were provided on or after the
date on which the recipient's eligibility began, but before the date on which
the recipient was notified that the case was opened. Authorization will be
considered if the request is submitted by the provider within 20 working days of
the date the recipient was notified that the case was opened;
(3) a third-party payor for home care services has denied
or adjusted a payment. Authorization requests must be submitted by the provider
within 20 working days of the notice of denial or adjustment. A copy of the
notice must be included with the request;
(4) the commissioner has determined that a county or
state human services agency has made an error; or
(5) the professional nurse determines an immediate need
for up to 40 skilled nursing or home health aide visits per calendar year and
submits a request for authorization within 20 working days of the initial
service date, and medical assistance is determined to be the appropriate payer.
(c) [RETROACTIVE AUTHORIZATION.] A request for
retroactive authorization will be evaluated according to the same criteria
applied to prior authorization requests.
(d) [ASSESSMENT AND SERVICE PLAN.] Assessments under
section 256B.0627, subdivision 1, paragraph (a), shall be conducted initially,
and at least annually thereafter, in person with the recipient and result in a
completed service plan using forms specified by the commissioner. Within 30 days
of recipient or responsible party request for home care services, the
assessment, the service plan, and other information necessary to determine
medical necessity such as diagnostic or testing information, social or medical
histories, and hospital or facility discharge summaries shall be submitted to
the commissioner. For personal care services:
(1) The amount and type of service authorized based upon
the assessment and service plan will follow the recipient if the recipient
chooses to change providers.
(2) If the recipient's medical need changes, the
recipient's provider may assess the need for a change in service authorization
and request the change from the county public health nurse. Within 30 days of
the request, the public health nurse will determine whether to request the
change in services based upon the provider assessment, or conduct a home visit
to assess the need and determine whether the change is appropriate.
(3) To continue to receive personal care services (e) [PRIOR AUTHORIZATION.] The commissioner, or the
commissioner's designee, shall review the assessment, the service plan, and any
additional information that is submitted. The commissioner shall, within 30 days
after receiving a complete request, assessment, and service plan, authorize home
care services as follows:
(1) [HOME HEALTH SERVICES.] All home health services
provided by a licensed nurse or a home health aide must be prior authorized by
the commissioner or the commissioner's designee. Prior authorization must be
based on medical necessity and cost-effectiveness when compared with other care
options. When home health services are used in combination with personal care
and private duty nursing, the cost of all home care services shall be considered
for cost-effectiveness. The commissioner shall limit nurse and home health aide
visits to no more than one visit each per day.
(2) [PERSONAL CARE SERVICES.] (i) All personal care
services and registered nurse supervision must be prior authorized by the
commissioner or the commissioner's designee except for the assessments
established in paragraph (a). The amount of personal care services authorized
must be based on the recipient's home care rating. A child may not be found to
be dependent in an activity of daily living if because of the child's age an
adult would either perform the activity for the child or assist the child with
the activity and the amount of assistance needed is similar to the assistance
appropriate for a typical child of the same age. Based on medical necessity, the
commissioner may authorize:
(A) up to two times the average number of direct care
hours provided in nursing facilities for the recipient's comparable case mix
level; or
(B) up to three times the average number of direct care
hours provided in nursing facilities for recipients who have complex medical
needs or are dependent in at least seven activities of daily living and need
physical assistance with eating or have a neurological diagnosis; or
(C) up to 60 percent of the average reimbursement rate,
as of July 1, 1991, for care provided in a regional treatment center for
recipients who have Level I behavior, plus any inflation adjustment as provided
by the legislature for personal care service; or
(D) up to the amount the commissioner would pay, as of
July 1, 1991, plus any inflation adjustment provided for home care services, for
care provided in a regional treatment center for recipients referred to the
commissioner by a regional treatment center preadmission evaluation team. For
purposes of this clause, home care services means all services provided in the
home or community that would be included in the payment to a regional treatment
center; or
(E) up to the amount medical assistance would reimburse
for facility care for recipients referred to the commissioner by a preadmission
screening team established under section 256B.0911 or 256B.092; and
(F) a reasonable amount of time for the provision of
nursing supervision of personal care services.
(ii) The number of direct care hours shall be determined
according to the annual cost report submitted to the department by nursing
facilities. The average number of direct care hours, as established by May 1,
1992, shall be calculated and incorporated into the home care limits on July 1,
1992. These limits shall be calculated to the nearest quarter hour.
(iii) The home care rating shall be determined by the
commissioner or the commissioner's designee based on information submitted to
the commissioner by the county public health nurse on forms specified by the
commissioner. The home care rating shall be a combination of current assessment
tools developed under sections 256B.0911 and 256B.501 with an addition for
seizure activity that will assess the frequency and severity of seizure activity
and with adjustments, additions, and clarifications that are necessary to
reflect the needs and conditions of recipients who need home care including
children and adults under 65 years of age. The commissioner shall establish
these forms and protocols under this section and shall use an advisory group,
including representatives of recipients, providers, and counties, for
consultation in establishing and revising the forms and protocols.
(iv) A recipient shall qualify as having complex medical
needs if the care required is difficult to perform and because of recipient's
medical condition requires more time than community-based standards allow or
requires more skill than would ordinarily be required and the recipient needs or
has one or more of the following:
(A) daily tube feedings;
(B) daily parenteral therapy;
(C) wound or decubiti care;
(D) postural drainage, percussion, nebulizer treatments,
suctioning, tracheotomy care, oxygen, mechanical ventilation;
(E) catheterization;
(F) ostomy care;
(G) quadriplegia; or
(H) other comparable medical conditions or treatments the
commissioner determines would otherwise require institutional care.
(v) A recipient shall qualify as having Level I behavior
if there is reasonable supporting evidence that the recipient exhibits, or that
without supervision, observation, or redirection would exhibit, one or more of
the following behaviors that cause, or have the potential to cause:
(A) injury to the recipient's own body;
(B) physical injury to other people; or
(C) destruction of property.
(vi) Time authorized for personal care relating to Level
I behavior in subclause (v), items (A) to (C), shall be based on the
predictability, frequency, and amount of intervention required.
(vii) A recipient shall qualify as having Level II
behavior if the recipient exhibits on a daily basis one or more of the following
behaviors that interfere with the completion of personal care services under
subdivision 4, paragraph (a):
(A) unusual or repetitive habits;
(B) withdrawn behavior; or
(C) offensive behavior.
(viii) A recipient with a home care rating of Level II
behavior in subclause (vii), items (A) to (C), shall be rated as comparable to a
recipient with complex medical needs under subclause (iv). If a recipient has
both complex medical needs and Level II behavior, the home care rating shall be
the next complex category up to the maximum rating under subclause (i), item
(B).
(3) [PRIVATE DUTY NURSING SERVICES.] All private duty
nursing services shall be prior authorized by the commissioner or the
commissioner's designee. Prior authorization for private duty nursing services
shall be based on medical necessity and cost-effectiveness when compared with
alternative care options. The commissioner may authorize medically necessary
private duty nursing services in quarter-hour units when:
(i) the recipient requires more individual and continuous
care than can be provided during a nurse visit; or
(ii) the cares are outside of the scope of services that
can be provided by a home health aide or personal care assistant.
The commissioner may authorize:
(A) up to two times the average amount of direct care
hours provided in nursing facilities statewide for case mix classification "K"
as established by the annual cost report submitted to the department by nursing
facilities in May 1992;
(B) private duty nursing in combination with other home
care services up to the total cost allowed under clause (2);
(C) up to 16 hours per day if the recipient requires more
nursing than the maximum number of direct care hours as established in item (A)
and the recipient meets the hospital admission criteria established under
Minnesota Rules, parts 9505.0500 to 9505.0540.
The commissioner may authorize up to 16 hours per day of
medically necessary private duty nursing services or up to 24 hours per day of
medically necessary private duty nursing services until such time as the
commissioner is able to make a determination of eligibility for recipients who
are cooperatively applying for home care services under the community
alternative care program developed under section 256B.49, or until it is
determined by the appropriate regulatory agency that a health benefit plan is or
is not required to pay for appropriate medically necessary health care services.
Recipients or their representatives must cooperatively assist the commissioner
in obtaining this determination. Recipients who are eligible for the community
alternative care program may not receive more hours of nursing under this
section than would otherwise be authorized under section 256B.49.
(4) [VENTILATOR-DEPENDENT RECIPIENTS.] If the recipient
is ventilator-dependent, the monthly medical assistance authorization for home
care services shall not exceed what the commissioner would pay for care at the
highest cost hospital designated as a long-term hospital under the Medicare
program. For purposes of this clause, home care services means all services
provided in the home that would be included in the payment for care at the
long-term hospital. "Ventilator-dependent" means an individual who receives
mechanical ventilation for life support at least six hours per day and is
expected to be or has been dependent for at least 30 consecutive days.
(f) [PRIOR AUTHORIZATION; TIME LIMITS.] The commissioner
or the commissioner's designee shall determine the time period for which a prior
authorization shall be effective. If the recipient continues to require home
care services beyond the duration of the prior authorization, the home care
provider must request a new prior authorization. Under no circumstances, other
than the exceptions in paragraph (b), shall a prior authorization be valid prior
to the date the commissioner receives the request or for more than 12 months. A
recipient who appeals a reduction in previously authorized home care services
may continue previously authorized services, other than temporary services under
paragraph (h), pending an appeal under section 256.045. The commissioner must
provide a detailed explanation of why the authorized services are reduced in
amount from those requested by the home care provider.
(g) [APPROVAL OF HOME CARE SERVICES.] The commissioner or
the commissioner's designee shall determine the medical necessity of home care
services, the level of caregiver according to subdivision 2, and the
institutional comparison according to this subdivision, the cost-effectiveness
of services, and the amount, scope, and duration of home care services
reimbursable by medical assistance, based on the assessment, primary payer
coverage determination information as required, the service plan, the
recipient's age, the cost of services, the recipient's medical condition, and
diagnosis or disability. The commissioner may publish additional criteria for
determining medical necessity according to section 256B.04.
(h) [PRIOR AUTHORIZATION REQUESTS; TEMPORARY SERVICES.]
The agency nurse, the independently enrolled private duty nurse, or county
public health nurse may request a temporary authorization for home care services
by telephone. The commissioner may approve a temporary level of home care
services based on the assessment, and service or care plan information, and
primary payer coverage determination information as required. Authorization for
a temporary level of home care services including nurse supervision is limited
to the time specified by the commissioner, but shall not exceed 45 days, unless
extended because the county public health nurse has not completed the required
assessment and service plan, or the commissioner's determination has not been
made. The level of services authorized under this provision shall have no
bearing on a future prior authorization.
(i) [PRIOR AUTHORIZATION REQUIRED IN FOSTER CARE
SETTING.] Home care services provided in an adult or child foster care setting
must receive prior authorization by the department according to the limits
established in paragraph (a).
The commissioner may not authorize:
(1) home care services that are the responsibility of the
foster care provider under the terms of the foster care placement agreement and
administrative rules. Requests for home care services for recipients residing in
a foster care setting must include the foster care placement agreement and
determination of difficulty of care;
(2) personal care services when the foster care license
holder is also the personal care provider or personal care assistant unless the
recipient can direct the recipient's own care, or case management is provided as
required in section 256B.0625, subdivision 19a;
(3) personal care services when the responsible party is
an employee of, or under contract with, or has any direct or indirect financial
relationship with the personal care provider or personal care assistant, unless
case management is provided as required in section 256B.0625, subdivision 19a;
(4) home care services when the number of foster care
residents is greater than four unless the county responsible for the recipient's
foster placement made the placement prior to April 1, 1992, requests that home
care services be provided, and case management is provided as required in
section 256B.0625, subdivision 19a; or
(5) home care services when combined with foster care
payments, other than room and board payments that exceed the total amount that
public funds would pay for the recipient's care in a medical institution.
Sec. 24. Minnesota Statutes 1997 Supplement, section
256B.0627, subdivision 8, is amended to read:
Subd. 8. [PERSONAL CARE ASSISTANT SERVICES; SHARED CARE.] (a) Medical
assistance payments for personal care assistance shared care shall be limited
according to this subdivision.
(b) Recipients of personal
care assistant services may share staff and the commissioner shall provide a
rate system for shared personal care assistant services. For two persons sharing care, the rate (c) Shared care is the provision
of personal care services by a personal care assistant to two or three
recipients at the same time and in the same setting. For the purposes of this
subdivision, "setting" means:
(1) the home or foster care home
of one of the individual recipients; or
(2) a child care program in which
all recipients served by one personal care assistant are participating, which is
licensed under chapter 245A or operated by a local school district or private
school.
The provisions of this subdivision
do not apply when a personal care assistant is caring for multiple recipients in
more than one setting.
(d) The recipient or the
recipient's responsible party, in conjunction with the county public health
nurse, shall determine:
(1) whether shared care is an
appropriate option based on the individual needs and preferences of the
recipient; and
(2) the amount of shared care
allocated as part of the overall authorization of personal care services.
The recipient or the responsible
party, in conjunction with the supervising registered nurse, shall approve the
setting, grouping, and arrangement of shared care based on the individual needs
and preferences of the recipients. Decisions on the selection of recipients to
share care must be based on the ages of the recipients, compatibility, and
coordination of their care needs.
(e) The following items must be
considered by the recipient or the responsible party and the supervising nurse,
and documented in the recipient's care plan:
(1) the additional qualifications
needed by the personal care assistant to provide care to several recipients in
the same setting;
(2) the additional training and
supervision needed by the personal care assistant to ensure that the needs of
the recipient are met appropriately and safely. The provider must provide
on-site supervision by a registered nurse within the first 14 days of shared
care, and monthly thereafter;
(3) the setting in which the
shared care will be provided;
(4) the ongoing monitoring and
evaluation of the effectiveness and appropriateness of the service and process
used to make changes in service or setting; and
(5) a contingency plan which
accounts for absence of the recipient in a shared care setting due to illness or
other circumstances and staffing contingencies.
(f) The provider must offer the
recipient or the responsible party the option of shared or individual personal
care assistant care. The recipient or the responsible party can withdraw from
participating in a shared care arrangement at any time.
(g) Notwithstanding provisions to
the contrary, all other statutory and regulatory provisions relating to personal
care services continue to be in effect.
Nothing in this subdivision shall be construed to reduce
the total number of hours authorized for an individual recipient.
Sec. 25. Minnesota Statutes 1997 Supplement, section
256B.0645, is amended to read:
256B.0645 [PROVIDER PAYMENTS; RETROACTIVE CHANGES IN
ELIGIBILITY.]
Payment to a provider for a health care service provided
to a general assistance medical care recipient who is later determined eligible
for medical assistance or MinnesotaCare according to section 256L.14 for the
period in which the health care service was provided, Sec. 26. Minnesota Statutes 1997 Supplement, section
256B.0911, subdivision 2, is amended to read:
Subd. 2. [PERSONS REQUIRED TO BE SCREENED; EXEMPTIONS.]
All applicants to Medicaid certified nursing facilities must be screened prior
to admission, regardless of income, assets, or funding sources, except the
following:
(1) patients who, having entered acute care facilities
from certified nursing facilities, are returning to a certified nursing
facility;
(2) residents transferred from other certified nursing
facilities located within the state of Minnesota;
(3) individuals who have a contractual right to have
their nursing facility care paid for indefinitely by the veteran's
administration;
(4) individuals who are enrolled in the Ebenezer/Group
Health social health maintenance organization project, or enrolled in a
demonstration project under section 256B.69, subdivision (5) individuals previously screened and currently being
served under the alternative care program or under a home and community-based
services waiver authorized under section 1915(c) of the Social Security Act; or
(6) individuals who are admitted to a certified nursing
facility for a short-term stay, which, based upon a physician's certification,
is expected to be 14 days or less in duration, and who have been screened and
approved for nursing facility admission within the previous six months. This
exemption applies only if the screener determines at the time of the initial
screening of the six-month period that it is appropriate to use the nursing
facility for short-term stays and that there is an adequate plan of care for
return to the home or community-based setting. If a stay exceeds 14 days, the
individual must be referred no later than the first county working day following
the 14th resident day for a screening, which must be completed within five
working days of the referral. Payment limitations in subdivision 7 will apply to
an individual found at screening to not meet the level of care criteria for
admission to a certified nursing facility.
Regardless of the exemptions in clauses (2) to (6),
persons who have a diagnosis or possible diagnosis of mental illness, mental
retardation, or a related condition must receive a preadmission screening before
admission unless the admission prior to screening is authorized by the local
mental health authority or the local developmental disabilities case manager, or
unless authorized by the county agency according to Public Law Number 101-508.
Before admission to a Medicaid certified nursing home or
boarding care home, all persons must be screened and approved for admission
through an assessment process. The nursing facility is authorized to conduct
case mix assessments which are not conducted by the county public health nurse
under Minnesota Rules, part 9549.0059. The designated county agency is
responsible for distributing the quality assurance and review form for all new
applicants to nursing homes.
Other persons who are not applicants to nursing
facilities must be screened if a request is made for a screening.
Sec. 27. Minnesota Statutes 1996, section 256B.0911,
subdivision 4, is amended to read:
Subd. 4. [RESPONSIBILITIES OF THE COUNTY AND THE
SCREENING TEAM.] (a) The county shall:
(1) provide information and education to the general
public regarding availability of the preadmission screening program;
(2) accept referrals from individuals, families, human
service and health professionals, and hospital and nursing facility personnel;
(3) assess the health, psychological, and social needs of
referred individuals and identify services needed to maintain these persons in
the least restrictive environments;
(4) determine if the individual screened needs nursing
facility level of care;
(5) assess specialized service needs based upon an
evaluation by:
(i) a qualified independent mental health professional
for persons with a primary or secondary diagnosis of a serious mental illness;
and
(ii) a qualified mental retardation professional for
persons with a primary or secondary diagnosis of mental retardation or related
conditions. For purposes of this clause, a qualified mental retardation
professional must meet the standards for a qualified mental retardation
professional in Code of Federal Regulations, title 42, section 483.430;
(6) make recommendations for individuals screened
regarding cost-effective community services which are available to the
individual;
(7) make recommendations for individuals screened
regarding nursing home placement when there are no cost-effective community
services available;
(8) develop an individual's community care plan and
provide follow-up services as needed; and
(9) prepare and submit reports that may be required by
the commissioner of human services.
(b) The screener shall document that the most
cost-effective alternatives available were offered to the individual or the
individual's legal representative. For purposes of this section, "cost-effective
alternatives" means community services and living arrangements that cost the
same or less than nursing facility care.
(c) Screeners shall cooperate with other public and private
agencies in the community, in order to offer a variety of cost-effective
services to the disabled and elderly. The screeners shall encourage the use of
volunteers from families, religious organizations, social clubs, and similar
civic and service organizations to provide services.
Sec. 28. Minnesota Statutes 1997 Supplement, section
256B.0911, subdivision 7, is amended to read:
Subd. 7. [REIMBURSEMENT FOR CERTIFIED NURSING
FACILITIES.] (a) Medical assistance reimbursement for nursing facilities shall
be authorized for a medical assistance recipient only if a preadmission
screening has been conducted prior to admission or the local county agency has
authorized an exemption. Medical assistance reimbursement for nursing facilities
shall not be provided for any recipient who the local screener has determined
does not meet the level of care criteria for nursing facility placement or, if
indicated, has not had a level II PASARR evaluation completed unless an
admission for a recipient with mental illness is approved by the local mental
health authority or an admission for a recipient with mental retardation or
related condition is approved by the state mental retardation authority. (b) (c) The local county mental health authority or the state
mental retardation authority under Public Law Numbers 100-203 and 101-508 may
prohibit admission to a nursing facility, if the individual does not meet the
nursing facility level of care criteria or needs specialized services as defined
in Public Law Numbers 100-203 and 101-508. For purposes of this section,
"specialized services" for a person with mental retardation or a related
condition means "active treatment" as that term is defined in Code of Federal
Regulations, title 42, section 483.440(a)(1).
(d) Upon the receipt by the commissioner of approval by
the Secretary of Health and Human Services of the waiver requested under
paragraph (a), the local screener shall deny medical assistance reimbursement
for nursing facility care for an individual whose long-term care needs can be
met in a community-based setting and whose cost of community-based home care
services is less than 75 percent of the average payment for nursing facility
care for that individual's case mix classification, and who is either:
(i) a current medical assistance recipient being screened
for admission to a nursing facility; or
(ii) an individual who would be eligible for medical
assistance within 180 days of entering a nursing facility and who meets a
nursing facility level of care.
(e) Appeals from the screening team's recommendation or
the county agency's final decision shall be made according to section 256.045,
subdivision 3.
Sec. 29. Minnesota Statutes 1997 Supplement, section
256B.0915, subdivision 1d, is amended to read:
Subd. 1d. [POSTELIGIBILITY TREATMENT OF INCOME AND
RESOURCES FOR ELDERLY WAIVER.] (a) Notwithstanding the provisions of section
256B.056, the commissioner shall make the following amendment to the medical
assistance elderly waiver program effective July 1, A recipient's maintenance needs will be an amount equal
to the Minnesota supplemental aid equivalent rate as defined in section 256I.03,
subdivision 5, plus the medical assistance personal needs allowance as defined
in section 256B.35, subdivision 1, paragraph (a), when applying posteligibility
treatment of income rules to the gross income of elderly waiver recipients,
except for individuals whose income is in excess of the special income standard
according to Code of Federal Regulations, title 42, section 435.236. Recipient maintenance needs shall be adjusted under this
provision each July 1.
(b) The commissioner of human services shall secure
approval of additional elderly waiver slots sufficient to serve persons who will
qualify under the revised income standard described in paragraph (a) before
implementing section 256B.0913, subdivision 16.
Sec. 30. Minnesota Statutes 1996, section 256B.41,
subdivision 1, is amended to read:
Subdivision 1. [AUTHORITY.] The commissioner shall
establish, by rule, procedures for determining rates for care of residents of
nursing facilities which qualify as vendors of medical assistance, and for
implementing the provisions of this section and sections 256B.421, 256B.431,
256B.432, 256B.433, 256B.47, 256B.48, 256B.50, and 256B.502. The procedures
shall Sec. 31. Minnesota Statutes 1996, section 256B.431,
subdivision 2b, is amended to read:
Subd. 2b. [OPERATING COSTS, AFTER JULY 1, 1985.] (a) For
rate years beginning on or after July 1, 1985, the commissioner shall establish
procedures for determining per diem reimbursement for operating costs.
(b) The commissioner shall contract with an econometric
firm with recognized expertise in and access to national economic change indices
that can be applied to the appropriate cost categories when determining the
operating cost payment rate.
(c) The commissioner shall analyze and evaluate each
nursing facility's cost report of allowable operating costs incurred by the
nursing facility during the reporting year immediately preceding the rate year
for which the payment rate becomes effective.
(d) The commissioner shall establish limits on actual
allowable historical operating cost per diems based on cost reports of allowable
operating costs for the reporting year that begins October 1, 1983, taking into
consideration relevant factors including resident needs, geographic location, and size of the nursing facility of residents in an efficiently and economically operated
nursing facility (1) allow nursing facilities that have an average length
of stay of 180 days or less in their skilled nursing level of care, 125 percent
of the care related limit and 105 percent of the other operating cost limit
established by rule; and
(2) exempt nursing facilities licensed on July 1, 1983,
by the commissioner to provide residential services for the physically
handicapped under Minnesota Rules, parts 9570.2000 to 9570.3600, from the care
related limits and allow 105 percent of the other operating cost limit
established by rule.
For the purpose of calculating the other operating cost
efficiency incentive for nursing facilities referred to in clause (1) or (2),
the commissioner shall use the other operating cost limit established by rule
before application of the 105 percent.
(e) The commissioner shall establish a composite index or
indices by determining the appropriate economic change indicators to be applied
to specific operating cost categories or combination of operating cost
categories.
(f) Each nursing facility shall receive an operating cost
payment rate equal to the sum of the nursing facility's operating cost payment
rates for each operating cost category. The operating cost payment rate for an
operating cost category shall be the lesser of the nursing facility's historical
operating cost in the category increased by the appropriate index established in
paragraph (e) for the operating cost category plus an efficiency incentive
established pursuant to paragraph (d) or the limit for the operating cost
category increased by the same index. If a nursing facility's actual historic
operating costs are greater than the prospective payment rate for that rate
year, there shall be no retroactive cost settle-up. In establishing payment
rates for one or more operating cost categories, the commissioner may establish
separate rates for different classes of residents based on their relative care
needs.
(g) The commissioner shall include the reported actual
real estate tax liability or payments in lieu of real estate tax of each nursing
facility as an operating cost of that nursing facility. Allowable costs under
this subdivision for payments made by a nonprofit nursing facility that are in
lieu of real estate taxes shall not exceed the amount which the nursing facility
would have paid to a city or township and county for fire, police, sanitation
services, and road maintenance costs had real estate taxes been levied on that
property for those purposes. For rate years beginning on or after July 1, 1987,
the reported actual real estate tax liability or payments in lieu of real estate
tax of nursing facilities shall be adjusted to include an amount equal to
one-half of the dollar change in real estate taxes from the prior year. The
commissioner shall include a reported actual special assessment, and reported
actual license fees required by the Minnesota department of health, for each
nursing facility as an operating cost of that nursing facility. For rate years
beginning on or after July 1, 1989, the commissioner shall include
a nursing facility's reported public employee retirement
act contribution for the reporting year as apportioned to the care-related
operating cost categories and other operating cost categories multiplied by the
appropriate composite index or indices established pursuant to paragraph (e) as
costs under this paragraph. Total adjusted real estate tax liability, payments
in lieu of real estate tax, actual special assessments paid, the indexed public
employee retirement act contribution, and license fees paid as required by the
Minnesota department of health, for each nursing facility (1) shall be divided
by actual resident days in order to compute the operating cost payment rate for
this operating cost category, (2) shall not be used to compute the care-related
operating cost limits or other operating cost limits established by the
commissioner, and (3) shall not be increased by the composite index or indices
established pursuant to paragraph (e), unless otherwise indicated in this
paragraph.
(h) For rate years beginning on or after July 1, 1987,
the commissioner shall adjust the rates of a nursing facility that meets the
criteria for the special dietary needs of its residents and the requirements in
section 31.651. The adjustment for raw food cost shall be the difference between
the nursing facility's allowable historical raw food cost per diem and 115
percent of the median historical allowable raw food cost per diem of the
corresponding geographic group.
The rate adjustment shall be reduced by the applicable
phase-in percentage as provided under subdivision 2h.
Sec. 32. Minnesota Statutes 1996, section 256B.431, is
amended by adding a subdivision to read:
Subd. 27. [SPEND-UP AND HIGH
COST LIMITS INDEXED; NOT REBASED.] (a) For rate years
beginning on or after July 1, 1998, the commissioner shall modify the
determination of the spend-up limits referred to in subdivision 26, paragraph
(a), by indexing each group's previous year's median value by the factor in
subdivision 26, paragraph (d), clause (2), plus one percentage point.
(b) For rate years beginning on or
after July 1, 1998, the commissioner shall modify the determination of the high
cost limits referred to in subdivision 26, paragraph (b), by indexing each
group's previous year's high cost per diem limits at .5 and one standard
deviations above the median by the factor in subdivision 26, paragraph (d),
clause (2), plus one percentage point.
Sec. 33. Minnesota Statutes 1996, section 256B.501,
subdivision 2, is amended to read:
Subd. 2. [AUTHORITY.] The commissioner shall establish
procedures and rules for determining rates for care of residents of intermediate
care facilities for persons with mental retardation or related conditions which
qualify as providers of medical assistance and waivered services. Sec. 34. Minnesota Statutes 1997 Supplement, section
256B.69, subdivision 2, is amended to read:
Subd. 2. [DEFINITIONS.] For the purposes of this section,
the following terms have the meanings given.
(a) "Commissioner" means the commissioner of human
services. For the remainder of this section, the commissioner's responsibilities
for methods and policies for implementing the project will be proposed by the
project advisory committees and approved by the commissioner.
(b) "Demonstration provider" means a health maintenance
organization (c) "Eligible individuals" means those persons eligible
for medical assistance benefits as defined in sections 256B.055, 256B.056, and
256B.06.
(d) "Limitation of choice" means suspending freedom of
choice while allowing eligible individuals to choose among the demonstration
providers.
(e) This paragraph supersedes paragraph (c) as long as
the Minnesota health care reform waiver remains in effect. When the waiver
expires, this paragraph expires and the commissioner of human services shall
publish a notice in the State Register and notify the revisor of statutes.
"Eligible individuals" means those persons eligible for medical assistance
benefits as defined in sections 256B.055, 256B.056, and 256B.06. Notwithstanding
sections 256B.055, 256B.056, and 256B.06, an individual who becomes ineligible
for the program because of failure to submit income reports or recertification
forms in a timely manner, shall remain enrolled in the prepaid health plan and
shall remain eligible to receive medical assistance coverage through the last
day of the month following the month in which the enrollee became ineligible for
the medical assistance program.
Sec. 35. Minnesota Statutes 1997 Supplement, section
256B.69, subdivision 3a, is amended to read:
Subd. 3a. [COUNTY AUTHORITY.] (a) The commissioner, when
implementing the general assistance medical care, or medical assistance
prepayment program within a county, must include the county board in the process
of development, approval, and issuance of the request for proposals to provide
services to eligible individuals within the proposed county. County boards must
be given reasonable opportunity to make recommendations regarding the
development, issuance, review of responses, and changes needed in the request
for proposals. The commissioner must provide county boards the opportunity to
review each proposal based on the identification of community needs under
chapters 145A and 256E and county advocacy activities. If a county board finds
that a proposal does not address certain community needs, the county board and
commissioner shall continue efforts for improving the proposal and network prior
to the approval of the contract. The county board shall make recommendations
regarding the approval of local networks and their operations to ensure adequate
availability and access to covered services. The provider or health plan must
respond directly to county advocates and the state prepaid medical assistance
ombudsperson regarding service delivery and must be accountable to the state
regarding contracts with medical assistance and general assistance medical care
funds. The county board may recommend a maximum number of participating health
plans after considering the size of the enrolling population; ensuring adequate
access and capacity; considering the client and county administrative
complexity; and considering the need to promote the viability of locally
developed health plans. The county board or a single entity representing a group
of county boards and the commissioner shall mutually select health plans for
participation at the time of initial implementation of the prepaid medical
assistance program in that county or group of counties and at the time of
contract renewal. The commissioner shall also seek input for contract
requirements from the county or single entity representing a group of county
boards at each contract renewal and incorporate those recommendations into the
contract negotiation process. The commissioner, in conjunction with the county
board, shall actively seek to develop a mutually agreeable timetable prior to
the development of the request for proposal, but counties must agree to initial
enrollment beginning on or before January 1, 1999, in either the prepaid medical
assistance and general assistance medical care programs or county-based
purchasing under section 256B.692. At least 90 days before enrollment in the
medical assistance and general assistance medical care prepaid programs begins
in a county in which the prepaid programs have not been established, the
commissioner shall provide a report to the chairs of senate and house committees
having jurisdiction over state health care programs which verifies that the
commissioner complied with the requirements for county involvement that are
specified in this subdivision.
(b) The commissioner shall seek a federal waiver to allow
a fee-for-service plan option to MinnesotaCare enrollees. The commissioner shall
develop an increase of the premium fees required under section 256L.06 up to 20
percent of the premium fees for the enrollees who elect the fee-for-service
option. Prior to implementation, the commissioner shall submit this fee schedule
to the chair and ranking minority member of the senate health care committee,
the senate health care and family services funding division, the house of
representatives health and human services committee, and the house of
representatives health and human services finance division.
(c) At the option of the county board, the board may
develop contract requirements related to the achievement of local public health
goals to meet the health needs of medical assistance and general assistance
medical care enrollees. These requirements must be reasonably related to the
performance of health plan functions and within the scope of the medical
assistance and general assistance medical care benefit sets. If the county board
and the commissioner mutually agree to such requirements, the department shall
include such requirements in all health plan contracts governing the prepaid
medical assistance and general assistance medical care programs in that county
at initial implementation of the program in that county and at the time of
contract renewal. The county board may participate in the enforcement of the
contract provisions related to local public health goals.
(d) For counties in which prepaid medical assistance and
general assistance medical care programs have not been established, the
commissioner shall not implement those programs if a county board submits
acceptable and timely preliminary and final proposals under section 256B.692,
until county-based purchasing is no longer operational in that county. For
counties in which prepaid medical assistance and general assistance medical care
programs are in existence on or after September 1, 1997, the commissioner must
terminate contracts with health plans according to section 256B.692, subdivision
5, if the county board submits and the commissioner accepts preliminary and
final proposals according to that subdivision. The commissioner is not required
to terminate contracts that begin on or after September 1, 1997, according to
section 256B.692 until two years have elapsed from the date of initial
enrollment.
(e) In the event that a county board or a single entity
representing a group of county boards and the commissioner cannot reach
agreement regarding: (i) the selection of participating health plans in that
county; (ii) contract requirements; or (iii) implementation and enforcement of
county requirements including provisions regarding local public health goals,
the commissioner shall resolve all disputes after taking into account the
recommendations of a three-person mediation panel. The panel shall be composed
of one designee of the president of the association of Minnesota counties, one
designee of the commissioner of human services, and one designee of the
commissioner of health.
(f) If a county which elects to implement county-based
purchasing ceases to implement county-based purchasing, it is prohibited from
assuming the responsibility of county-based purchasing for a period of five
years from the date it discontinues purchasing.
(g) Notwithstanding the
requirement in paragraph (a) that a county must agree to initial enrollment on
or before January 1, 1999, the commissioner shall grant a delay of up to 12
months in the implementation of the county-based purchasing authorized in
section 256B.692 if the county or group of counties has submitted a preliminary
proposal for county-based purchasing by September 1, 1997, has not already
implemented the prepaid medical assistance program before January 1, 1998, and
has submitted a written request for the delay to the commissioner by July 1,
1998. In order for the delay to be continued, the county or group of counties
must also submit to the commissioner the following information by December 1,
1998:
(1) identify the proposed date of
implementation, not later than January 1, 2000;
(2) include copies of the county
board resolutions which demonstrate the continued commitment to the
implementation of county-based purchasing by the proposed date of
implementation. County board authorization may remain contingent on the
submission of a final proposal which meets the requirements of section 256B.692,
subdivision 5, paragraph (b);
(3) if more than one county is
involved in the proposal, demonstrate actions taken for the establishment of a
governance structure between the participating counties and describe how the
fiduciary responsibilities of county-based purchasing will be allocated between
the counties;
(4) describe actions taken to
identify how the risk of a deficit will be managed in the event expenditures are
greater than total capitation payments. This description must identify how any
of the following strategies will be assessed:
(i) risk contracts with licensed
health plans;
(ii) risk arrangements with
providers who are not licensed health plans;
(iii) risk arrangements with other
licensed insurance entities; and
(iv) funding from other county
resources;
(5) include, if county-based
purchasing will not contract with licensed health plans or provider networks,
letters of interest from local providers in at least the categories of hospital,
physician, mental health, and pharmacy which express interest in contracting for
services; and
(6) describe the options being
considered to obtain the administrative services required in section 256B.692,
subdivision 3, clauses (3) and (5).
For counties which receive a delay
under this subdivision, the final proposals required under section 256B.692,
subdivision 5, paragraph (b), must be submitted at least six months prior to the
requested implementation date. Authority to implement county-based purchasing
remains contingent on approval of the final proposal as required under section
256B.692.
Sec. 36. Minnesota Statutes 1996, section 256B.69, is
amended by adding a subdivision to read:
Subd. 25. [AMERICAN INDIAN
RECIPIENTS.] (a) Beginning on or after January 1, 1999,
for American Indian recipients of medical assistance who are required to enroll
with a demonstration provider under subdivision 4 or in a county-based
purchasing entity, if applicable, under section 256B.692, medical assistance
shall cover health care services provided at Indian health services facilities
and facilities operated by a tribe or tribal organization under funding
authorized by United States Code, title 25, sections 450f to 450n, or title III
of the Indian Self-Determination and Education Assistance Act, Public Law Number
93-638, if those services would otherwise be covered under section 256B.0625.
Payments for services provided under this subdivision shall be made on a
fee-for-service basis, and may, at the option of the tribe or tribal
organization, be made in accordance with rates authorized under sections
256.969, subdivision 16, and 256B.0625, subdivision 34. Implementation of this
subdivision is contingent on federal approval.
(b) The commissioner of human
services, in consultation with the tribal governments, shall develop a plan for
tribes to assist in the enrollment process for American Indian recipients
enrolled in the prepaid medical assistance program under this section or the
prepaid general assistance medical care program under section 256D.03,
subdivision 4, paragraph (d). This plan also shall address how tribes will be
included in ensuring the coordination of care for American Indian recipients
between Indian health service or tribal providers and other providers.
(c) For purposes of this
subdivision, "American Indian" has the meaning given to persons to whom services
will be provided for in Code of Federal Regulations, title 42, section
36.12.
(d) This subdivision also applies
to American Indian recipients of general assistance medical care and to the
prepaid general assistance medical care program under section 256D.03,
subdivision 4, paragraph (d).
Sec. 37. Minnesota Statutes 1997 Supplement, section
256B.692, subdivision 2, is amended to read:
Subd. 2. [DUTIES OF THE COMMISSIONER OF HEALTH.]
Notwithstanding chapters 62D and 62N, a county that elects to purchase medical
assistance and general assistance medical care in return for a fixed sum without
regard to the frequency or extent of services furnished to any particular
enrollee is not required to obtain a certificate of authority under chapter 62D
or 62N. A county that elects to purchase medical assistance and general
assistance medical care services under this section must satisfy the
commissioner of health that the requirements of chapter 62D, applicable to
health maintenance organizations, or chapter 62N, applicable to community
integrated service networks, will be met. A county must also assure the
commissioner of health that the requirements of Sec. 38. Minnesota Statutes 1997 Supplement, section
256B.692, subdivision 5, is amended to read:
Subd. 5. [COUNTY PROPOSALS.] (a) On or before September
1, 1997, a county board that wishes to purchase or provide health care under
this section must submit a preliminary proposal that substantially demonstrates
the county's ability to meet all the requirements of this section in response to
criteria for proposals issued by the department on or before
July 1, 1997. Counties submitting preliminary proposals
must establish a local planning process that involves input from medical
assistance and general assistance medical care recipients, recipient advocates,
providers and representatives of local school districts, labor, and tribal
government to advise on the development of a final proposal and its
implementation.
(b) The county board must submit a final proposal on or
before July 1, 1998, that demonstrates the ability to meet all the requirements
of this section, including beginning enrollment on January 1, 1999, unless a delay has been granted under section 256B.69,
subdivision 3a, paragraph (g).
(c) After January 1, 1999, for a county in which the
prepaid medical assistance program is in existence, the county board must submit
a preliminary proposal at least 15 months prior to termination of health plan
contracts in that county and a final proposal six months prior to the health
plan contract termination date in order to begin enrollment after the
termination. Nothing in this section shall impede or delay implementation or
continuation of the prepaid medical assistance and general assistance medical
care programs in counties for which the board does not submit a proposal, or
submits a proposal that is not in compliance with this section.
(d) The commissioner is not required to terminate
contracts for the prepaid medical assistance and prepaid general assistance
medical care programs that begin on or after September 1, 1997, in a county for
which a county board has submitted a proposal under this paragraph, until two
years have elapsed from the date of initial enrollment in the prepaid medical
assistance and prepaid general assistance medical care programs.
Sec. 39. Minnesota Statutes 1997 Supplement, section
256B.77, subdivision 3, is amended to read:
Subd. 3. [ASSURANCES TO THE COMMISSIONER OF HEALTH.] A
county authority that elects to participate in a demonstration project for
people with disabilities under this section is not required to obtain a
certificate of authority under chapter 62D or 62N. A county authority that
elects to participate in a demonstration project for people with disabilities
under this section must assure the commissioner of health that the requirements
of chapters 62D Sec. 40. Minnesota Statutes 1997 Supplement, section
256B.77, subdivision 7a, is amended to read:
Subd. 7a. [ELIGIBLE INDIVIDUALS.] (a) Persons are
eligible for the demonstration project as provided in this subdivision.
(b) "Eligible individuals" means those persons living in
the demonstration site who are eligible for medical assistance and are disabled
based on a disability determination under section 256B.055, subdivisions 7 and
12, or who are eligible for medical assistance and have been diagnosed as
having:
(1) serious and persistent mental illness as defined in
section 245.462, subdivision 20;
(2) severe emotional disturbance as defined in section
245.487, subdivision 6; or
(3) mental retardation, or being a
mentally retarded person as defined in section 252A.02, or a related
condition as defined in section 252.27, subdivision 1a.
Other individuals may be included at the option of the
county authority based on agreement with the commissioner.
(c) Eligible individuals residing on a federally
recognized Indian reservation may be excluded from participation in the
demonstration project at the discretion of the tribal government based on
agreement with the commissioner, in consultation with the county authority.
(d) Eligible individuals include individuals in excluded
time status, as defined in chapter 256G. Enrollees in excluded time at the time
of enrollment shall remain in excluded time status as long as they live in the
demonstration site and shall be eligible for 90 days after placement outside the
demonstration site if they move to excluded time status in a county within
Minnesota other than their county of financial responsibility.
(e) A person who is a sexual psychopathic personality as
defined in section 253B.02, subdivision 18a, or a sexually dangerous person as
defined in section 253B.02, subdivision 18b, is excluded from enrollment in the
demonstration project.
Sec. 41. Minnesota Statutes 1997 Supplement, section
256B.77, subdivision 10, is amended to read:
Subd. 10. [CAPITATION PAYMENT.] (a) The commissioner
shall pay a capitation payment to the county authority and, when applicable
under subdivision 6, paragraph (a), to the service delivery organization for
each medical assistance eligible enrollee. The commissioner shall develop
capitation payment rates for the initial contract period for each demonstration
site in consultation with an independent actuary, to ensure that the cost of
services under the demonstration project does not exceed the estimated cost for
medical assistance services for the covered population under the fee-for-service
system for the demonstration period. For each year of the demonstration project,
the capitation payment rate shall be based on 96 percent of the projected per
person costs that would otherwise have been paid under medical assistance
fee-for-service during each of those years. Rates shall be adjusted within the
limits of the available risk adjustment technology, as mandated by section
62Q.03. In addition, the commissioner shall implement appropriate risk and
savings sharing provisions with county administrative entities and, when
applicable under subdivision 6, paragraph (a), service delivery organizations
within the projected budget limits. Capitation rates
shall be adjusted at least annually to include any rate increases and payments
for expanded or newly covered services for eligible individuals. The initial
demonstration project rate shall include an amount in addition to the fee for
service payments to adjust for underutilization of dental services. Any
savings beyond those allowed for the county authority, county administrative
entity, or service delivery organization shall be first used to meet the unmet
needs of eligible individuals. Payments to providers participating in the
project are exempt from the requirements of sections 256.966 and 256B.03,
subdivision 2.
(b) The commissioner shall monitor and evaluate annually
the effect of the discount on consumers, the county authority, and providers of
disability services. Findings shall be reported and recommendations made, as
appropriate, to ensure that the discount effect does not adversely affect the
ability of the county administrative entity or providers of services to provide
appropriate services to eligible individuals, and does not result in cost
shifting of eligible individuals to the county authority.
Sec. 42. Minnesota Statutes 1997 Supplement, section
256B.77, subdivision 12, is amended to read:
Subd. 12. [SERVICE COORDINATION.] (a) For purposes of
this section, "service coordinator" means an individual selected by the enrollee
or the enrollee's legal representative and authorized by the county
administrative entity or service delivery organization to work in partnership
with the enrollee to develop, coordinate, and in some instances, provide
supports and services identified in the personal support plan. Service
coordinators may only provide services and supports if the enrollee is informed
of potential conflicts of interest, is given alternatives, and gives informed
consent. Eligible service coordinators are individuals age 18 or older who meet
the qualifications as described in paragraph (b). Enrollees, their legal
representatives, or their advocates are eligible to be service coordinators if
they have the capabilities to perform the activities and functions outlined in
paragraph (b). Providers licensed under chapter 245A to provide residential
services, or providers who are providing residential services covered under the
group residential housing program may not act as service coordinator for
enrollees for whom they provide residential services. This does not apply to
providers of short-term detoxification services. Each county administrative
entity or service delivery organization may develop further criteria for
eligible vendors of service coordination during the demonstration period and
shall determine whom it contracts with or employs to provide service
coordination. County administrative entities and service delivery organizations
may pay enrollees or their advocates or legal representatives for service
coordination activities.
(b) The service coordinator shall act as a facilitator,
working in partnership with the enrollee to ensure that their needs are
identified and addressed. The level of involvement of the service coordinator
shall depend on the needs and desires of the enrollee. The service coordinator
shall have the knowledge, skills, and abilities to, and is responsible for:
(1) arranging for an initial assessment, and periodic
reassessment as necessary, of supports and services based on the enrollee's
strengths, needs, choices, and preferences in life domain areas;
(2) developing and updating the personal support plan
based on relevant ongoing assessment;
(3) arranging for and coordinating the provisions of
supports and services, including knowledgeable and skilled specialty services
and prevention and early intervention services, within the limitations
negotiated with the county administrative entity or service delivery
organization;
(4) assisting the enrollee and the enrollee's legal
representative, if any, to maximize informed choice of and control over services
and supports and to exercise the enrollee's rights and advocate on behalf of the
enrollee;
(5) monitoring the progress toward achieving the
enrollee's outcomes in order to evaluate and adjust the timeliness and adequacy
of the implementation of the personal support plan;
(6) facilitating meetings and effectively collaborating
with a variety of agencies and persons, including attending individual family
service plan and individual education plan meetings when requested by the
enrollee or the enrollee's legal representative;
(7) soliciting and analyzing relevant information;
(8) communicating effectively with the enrollee and with
other individuals participating in the enrollee's plan;
(9) educating and communicating effectively with the
enrollee about good health care practices and risk to the enrollee's health with
certain behaviors;
(10) having knowledge of basic enrollee protection
requirements, including data privacy;
(11) informing, educating, and assisting the enrollee in
identifying available service providers and accessing needed resources and
services beyond the limitations of the medical assistance benefit set covered
services; and
(12) providing other services as identified in the
personal support plan.
(c) For the demonstration project, the qualifications and
standards for service coordination in this section shall replace comparable
existing provisions of existing statutes and rules governing case management for
eligible individuals.
(d) The provisions of this subdivision apply only to the
demonstration sites All other demonstration sites must
comply with laws and rules governing case management services for eligible
individuals in effect when the site begins the demonstration project.
Sec. 43. Minnesota Statutes 1997 Supplement, section
256D.03, subdivision 3, is amended to read:
Subd. 3. [GENERAL ASSISTANCE MEDICAL CARE; ELIGIBILITY.]
(a) General assistance medical care may be paid for any person who is not
eligible for medical assistance under chapter 256B, including eligibility for
medical assistance based on a spenddown of excess income according to section
256B.056, subdivision 5, or MinnesotaCare as defined in clause (1) who is receiving assistance under section 256D.05,
except for families with children who are eligible under Minnesota family
investment program-statewide (MFIP-S), who is having a payment made on the
person's behalf under sections 256I.01 to 256I.06, or who resides in group
residential housing as defined in chapter 256I and can meet a spenddown using
the cost of remedial services received through group residential housing; or
(2)(i) who is a resident of Minnesota; and whose equity
in assets is not in excess of $1,000 per assistance unit. Exempt assets, the
reduction of excess assets, and the waiver of excess assets must conform to the
medical assistance program in chapter 256B, with the following exception: the
maximum amount of undistributed funds in a trust that could be distributed to or
on behalf of the beneficiary by the trustee, assuming the full exercise of the
trustee's discretion under the terms of the trust, must be applied toward the
asset maximum; and
(ii) who has countable income not in excess of the
assistance standards established in section 256B.056, subdivision 4, or whose
excess income is spent down according to section 256B.056, subdivision 5, using
a six-month budget period. The method for calculating earned income disregards
and deductions for a person who resides with a dependent child under age 21
shall follow section 256B.056, subdivision 1a. However, if a disregard of $30
and one-third of the remainder has
been applied to the wage earner's income, the disregard
shall not be applied again until the wage earner's income has not been
considered in an eligibility determination for general assistance, general
assistance medical care, medical assistance, or MFIP-S for 12 consecutive
months. The earned income and work expense deductions for a person who does not
reside with a dependent child under age 21 shall be the same as the method used
to determine eligibility for a person under section 256D.06, subdivision 1,
except the disregard of the first $50 of earned income is not allowed; (3) who would be eligible for medical assistance except
that the person resides in a facility that is determined by the commissioner or
the federal Health Care Financing Administration to be an institution for mental
diseases; or
(4) who is receiving care and
rehabilitation services from a nonprofit center established to serve victims of
torture. These individuals are eligible for general assistance medical care only
for the period during which they are receiving services from the center. During
this period of eligibility, individuals eligible under this clause shall not be
required to participate in prepaid general assistance medical care.
(i) adults with dependent children under 21 whose gross
family income is equal to or less than 275 percent of the federal poverty
guidelines; or
(ii) adults without children with earned income and whose
family gross income is between 75 percent of the federal poverty guidelines and
the amount set by section 256L.04, subdivision 7, shall be terminated from
general assistance medical care upon enrollment in MinnesotaCare.
(b) For services rendered on or after July 1, 1997,
eligibility is limited to one month prior to application if the person is
determined eligible in the prior month. A redetermination of eligibility must
occur every 12 months. Beginning July 1, 1998, Minnesota health care program
applications completed by recipients and applicants who are persons described in
paragraph (a), clause (c) The date of an initial Minnesota health care program
application necessary to begin a determination of eligibility shall be the date
the applicant has provided a name, address, and social security number, signed
and dated, to the county agency or the department of human services. If the
applicant is unable to provide an initial application when health care is
delivered due to a medical condition or disability, a health care provider may
act on the person's behalf to complete the initial application. The applicant
must complete the remainder of the application and provide necessary
verification before eligibility can be determined. The county agency must assist
the applicant in obtaining verification if necessary.
(d) County agencies are authorized to use all automated
databases containing information regarding recipients' or applicants' income in
order to determine eligibility for general assistance medical care or
MinnesotaCare. Such use shall be considered sufficient in order to determine
eligibility and premium payments by the county agency.
(e) General assistance medical care is not available for
a person in a correctional facility unless the person is detained by law for
less than one year in a county correctional or detention facility as a person
accused or convicted of a crime, or admitted as an inpatient to a hospital on a
criminal hold order, and the person is a recipient of general assistance medical
care at the time the person is detained by law or admitted on a criminal hold
order and as long as the person continues to meet other eligibility requirements
of this subdivision.
(f) General assistance medical care is not available for
applicants or recipients who do not cooperate with the county agency to meet the
requirements of medical assistance. General assistance medical care is limited
to payment of emergency services only for applicants or recipients as described
in paragraph (a), clause (g) In determining the amount of assets of an individual,
there shall be included any asset or interest in an asset, including an asset
excluded under paragraph (a), that was given away, sold, or disposed of for less
than fair market value within the 60 months preceding application for general
assistance medical care or during the period of eligibility. Any transfer
described in this paragraph shall be presumed to have been for the purpose of
establishing eligibility for general assistance medical care, unless the
individual furnishes convincing evidence to establish that the transaction was
exclusively for another purpose. For purposes of this paragraph, the value of
the asset or interest shall be the fair market value at the time it was given
away, sold, or disposed of, less the amount of compensation received. For any
uncompensated transfer, the number of months of ineligibility, including partial
months, shall be calculated by dividing the uncompensated transfer amount by the
average monthly per person payment made by the medical assistance program to
skilled nursing facilities for the previous calendar year. The individual shall
remain ineligible until this fixed period has expired. The period of
ineligibility may exceed 30 months, and a reapplication for benefits after 30
months from the date of the transfer shall not result in eligibility unless and
until the period of ineligibility has expired. The period of ineligibility
begins in the month the transfer was reported to the county agency, or if the
transfer was not reported, the month in which the county agency discovered the
transfer, whichever comes first. For applicants, the period of ineligibility
begins on the date of the first approved application.
(h) When determining eligibility for any state benefits
under this subdivision, the income and resources of all noncitizens shall be
deemed to include their sponsor's income and resources as defined in the
Personal Responsibility and Work Opportunity Reconciliation Act of 1996, title
IV, Public Law Number 104-193, sections 421 and 422, and subsequently set out in
federal rules.
(i)(1) An undocumented
noncitizen or a nonimmigrant is ineligible for general assistance medical care
other than emergency services. For purposes of this subdivision, a nonimmigrant
is an individual in one or more of the classes listed in United States Code,
title 8, section 1101(a)(15), and an undocumented noncitizen is an individual
who resides in the United States without the approval or acquiescence of the
Immigration and Naturalization Service.
Sec. 44. Minnesota Statutes 1996, section 256D.03,
subdivision 4, is amended to read:
Subd. 4. [GENERAL ASSISTANCE MEDICAL CARE; SERVICES.] (a)
For a person who is eligible under subdivision 3, paragraph (a), clause (3),
general assistance medical care covers, except as provided in paragraph (c):
(1) inpatient hospital services;
(2) outpatient hospital services;
(3) services provided by Medicare certified
rehabilitation agencies;
(4) prescription drugs and other products recommended
through the process established in section 256B.0625, subdivision 13;
(5) equipment necessary to administer insulin and
diagnostic supplies and equipment for diabetics to monitor blood sugar level;
(6) eyeglasses and eye examinations provided by a
physician or optometrist;
(7) hearing aids;
(8) prosthetic devices;
(9) laboratory and X-ray services;
(10) physician's services;
(11) medical transportation;
(12) chiropractic services as covered under the medical
assistance program;
(13) podiatric services;
(14) dental services;
(15) outpatient services provided by a mental health
center or clinic that is under contract with the county board and is established
under section 245.62;
(16) day treatment services for mental illness provided
under contract with the county board;
(17) prescribed medications for persons who have been
diagnosed as mentally ill as necessary to prevent more restrictive
institutionalization;
(18) (b) Except as provided in paragraph (c), for a recipient
who is eligible under subdivision 3, paragraph (a), clause (1) or (2), general
assistance medical care covers the services listed in paragraph (a) with the
exception of special transportation services.
(c) Gender reassignment surgery and related services are
not covered services under this subdivision unless the individual began
receiving gender reassignment services prior to July 1, 1995.
(d) In order to contain costs, the commissioner of human
services shall select vendors of medical care who can provide the most
economical care consistent with high medical standards and shall where possible
contract with organizations on a prepaid capitation basis to provide these
services. The commissioner shall consider proposals by counties and vendors for
prepaid health plans, competitive bidding programs, block grants, or other
vendor payment mechanisms designed to
provide services in an economical manner or to control
utilization, with safeguards to ensure that necessary services are provided.
Before implementing prepaid programs in counties with a county operated or
affiliated public teaching hospital or a hospital or clinic operated by the
University of Minnesota, the commissioner shall consider the risks the prepaid
program creates for the hospital and allow the county or hospital the
opportunity to participate in the program in a manner that reflects the risk of
adverse selection and the nature of the patients served by the hospital,
provided the terms of participation in the program are competitive with the
terms of other participants considering the nature of the population served.
Payment for services provided pursuant to this subdivision shall be as provided
to medical assistance vendors of these services under sections 256B.02,
subdivision 8, and 256B.0625. For payments made during fiscal year 1990 and
later years, the commissioner shall consult with an independent actuary in
establishing prepayment rates, but shall retain final control over the rate
methodology. Notwithstanding the provisions of subdivision 3, an individual who
becomes ineligible for general assistance medical care because of failure to
submit income reports or recertification forms in a timely manner, shall remain
enrolled in the prepaid health plan and shall remain eligible for general
assistance medical care coverage through the last day of the month in which the
enrollee became ineligible for general assistance medical care.
(e) The commissioner of human services may reduce
payments provided under sections 256D.01 to 256D.21 and 261.23 in order to
remain within the amount appropriated for general assistance medical care,
within the following restrictions (i) For the period July 1,
1985 to December 31, 1985, reductions below the cost per service unit allowable
under section 256.966, are permitted only as follows: payments for inpatient and
outpatient hospital care provided in response to a primary diagnosis of chemical
dependency or mental illness may be reduced no more than 30 percent; payments
for all other inpatient hospital care may be reduced no more than 20 percent.
Reductions below the payments allowable under general assistance medical care
for the remaining general assistance medical care services allowable under this
subdivision may be reduced no more than ten percent.
(ii) For the period January 1,
1986 to December 31, 1986, reductions below the cost per service unit allowable
under section 256.966 are permitted only as follows: payments for inpatient and
outpatient hospital care provided in response to a primary diagnosis of chemical
dependency or mental illness may be reduced no more than 20 percent; payments
for all other inpatient hospital care may be reduced no more than 15 percent.
Reductions below the payments allowable under general assistance medical care
for the remaining general assistance medical care services allowable under this
subdivision may be reduced no more than five percent.
(iii) For the period January
1, 1987 to June 30, 1987, reductions below the cost per service unit allowable
under section 256.966 are permitted only as follows: payments for inpatient and
outpatient hospital care provided in response to a primary diagnosis of chemical
dependency or mental illness may be reduced no more than 15 percent; payments
for all other inpatient hospital care may be reduced no more than ten percent.
Reductions below the payments allowable under medical assistance for the
remaining general assistance medical care services allowable under this
subdivision may be reduced no more than five percent.
(iv) For the period July 1,
1987 to June 30, 1988, reductions below the cost per service unit allowable
under section 256.966 are permitted only as follows: payments for inpatient and
outpatient hospital care provided in response to a primary diagnosis of chemical
dependency or mental illness may be reduced no more than 15 percent; payments
for all other inpatient hospital care may be reduced no more than five percent.
Reductions below the payments allowable under medical assistance for the
remaining general assistance medical care services allowable under this
subdivision may be reduced no more than five percent.
(v) For the period July 1,
1988 to June 30, 1989, reductions below the cost per service unit allowable
under section 256.966 are permitted only as follows: payments for inpatient and
outpatient hospital care provided in response to a primary diagnosis of chemical
dependency or mental illness may be reduced no more than 15 percent; payments
for all other inpatient hospital care may not be reduced. Reductions below the
payments allowable under medical assistance for the remaining general assistance
medical care services allowable under this subdivision may be reduced no more
than five percent.
(f) There shall be no
copayment required of any recipient of benefits for any services provided under
this subdivision. A hospital receiving a reduced payment as a result of this
section may apply the unpaid balance toward satisfaction of the hospital's bad
debts.
Sec. 45. Minnesota Statutes 1996, section 256D.03, is
amended by adding a subdivision to read:
Subd. 9. [PAYMENT FOR
AMBULANCE SERVICES.] Effective July 1, 1999, general
assistance medical care payments for ambulance services shall be increased by
ten percent.
Sec. 46. Minnesota Statutes 1997 Supplement, section
256L.07, subdivision 2, is amended to read:
Subd. 2. [MUST NOT HAVE ACCESS TO EMPLOYER-SUBSIDIZED
COVERAGE.] (a) To be eligible for subsidized premium payments based on a sliding
scale, a family or individual must not have access to subsidized health coverage
through an employer, and must not have had access to subsidized health coverage
through an employer for the 18 months prior to application for subsidized
coverage under the MinnesotaCare program. The requirement that the family or
individual must not have had access to employer-subsidized coverage during the
previous 18 months does not apply if: (1) employer-subsidized coverage was lost
due to the death of an employee or divorce; (2) employer-subsidized coverage was
lost because an individual became ineligible for coverage as a child or
dependent; or (3) employer-subsidized coverage was lost for reasons that would
not disqualify the individual for unemployment benefits under section 268.09 and
the family or individual has not had access to employer-subsidized coverage
since the loss of coverage. If employer-subsidized coverage was lost for reasons
that disqualify an individual for unemployment benefits under section 268.09,
children of that individual are exempt from the requirement of no access to
employer subsidized coverage for the 18 months prior to application, as long as
the children have not had access to employer subsidized coverage since the
disqualifying event. The requirement that the family or individual must not have
had access to employer-subsidized coverage during the previous 18 months does
apply if employer-subsidized coverage is lost due to an employer terminating
health care coverage as an employee benefit, unless that
coverage was provided under section 256M.03.
(b) For purposes of this requirement, subsidized health
coverage means health coverage for which the employer pays at least 50 percent
of the cost of coverage for the employee, excluding dependent coverage, or a
higher percentage as specified by the commissioner. Children are eligible for
employer-subsidized coverage through either parent, including the noncustodial
parent. The commissioner must treat employer contributions to Internal Revenue
Code Section 125 plans as qualified employer subsidies toward the cost of health
coverage for employees for purposes of this subdivision.
Sec. 47. Minnesota Statutes 1997 Supplement, section
256L.07, subdivision 3, is amended to read:
Subd. 3. [PERIOD UNINSURED.] To be eligible for
subsidized premium payments based on a sliding scale, families and individuals
initially enrolled in the MinnesotaCare program under section 256L.04,
subdivisions 5 and 7, must have had no health coverage for at least four months
prior to application. The commissioner may change this eligibility criterion for
sliding scale premiums in order to remain within the limits of available
appropriations. The requirement of at least four months of no health coverage
prior to application for the MinnesotaCare program does not apply to:
(1) families, children, and individuals who apply for the
MinnesotaCare program upon termination from or as required by the medical
assistance program, general assistance medical care program, or coverage under a
regional demonstration project for the uninsured funded under section 256B.73,
the Hennepin county assured care program, or the Group Health, Inc., community
health plan;
(2) families and individuals initially enrolled under
section 256L.04, subdivisions 1, paragraph (a), and 3;
(3) children enrolled pursuant to Laws 1992, chapter 549,
article 4, section 17; (4) individuals currently serving or who have served in
the military reserves, and dependents of these individuals, if these
individuals: (i) reapply for MinnesotaCare coverage after a period of active
military service during which they had been covered by the Civilian Health and
Medical Program of the Uniformed Services (CHAMPUS); (ii) were covered under
MinnesotaCare immediately prior to obtaining coverage under CHAMPUS; and (iii)
have maintained continuous coverage; or
(5) children who lose coverage
under section 256M.03 due to an employer terminating health coverage as an
employee benefit or due to an employee layoff.
Sec. 48. [256M.01] [DEFINITIONS.]
Subdivision 1.
[APPLICABILITY.] For purposes of this chapter, the terms
defined in this section have the meanings given.
Subd. 2. [COMMISSIONER.] "Commissioner" means the commissioner of human services.
Subd. 3. [EMPLOYER-SUBSIDIZED
INSURANCE.] "Employer-subsidized insurance" has the
meaning provided in section 256L.07, subdivision 2.
Sec. 49. [256M.03] [COVERAGE OF CHILDREN INELIGIBLE FOR
MINNESOTACARE.]
Subdivision 1. [PAYMENTS FOR
EMPLOYER-SUBSIDIZED COVERAGE.] A child who would
otherwise be eligible for coverage under MinnesotaCare, except for the
availability of employer-subsidized coverage, is eligible for payment of the
employee share of employer-subsidized coverage for the child under the state
children's health insurance program established in title 21 of the Social
Security Act, according to the sliding scale in subdivision 2. In order to be
eligible under this subdivision, a child must not have employer-subsidized
coverage at the time of application for payment, and the employer-subsidized
coverage must qualify as benchmark coverage or benchmark equivalent coverage
under title 21 of the Social Security Act, section 2103. Payments shall be made
directly to the employer providing employer-subsidized insurance.
Subd. 2. [SLIDING SCALE
PAYMENTS.] Upon federal approval of the plan, the
commissioner shall pay the difference of the MinnesotaCare sliding premium scale
as specified in Minnesota Statutes, section 256L.08, up to a maximum of five
percent of the qualifying family's income and the employee share of the
coverage.
Subd. 3. [LIMITATION.] The availability of payments under this section is subject
to the limits of available appropriations. The commissioner may set limits on
the number of children receiving payments under this section, or modify payment
levels, in order to remain within the limits of appropriations.
Subd. 4. [ADVISORY TASK
FORCE.] The commissioner shall convene an advisory task
force comprised of representatives of small businesses, health plan companies,
and insurance agents in order to develop a plan to implement this section.
Sec. 50. [256M.05] [MAINTENANCE OF EMPLOYER SUBSIDY.]
Employers providing
employer-subsidized coverage to employees who receive payments on behalf of an
employee eligible under section 256M.03, subdivision 1, shall maintain at least
the same percentage level of subsidy for employee and family coverage that was
in place on July 1, 1998, for a period of one year following receipt of the
initial payment for an eligible employee. After the initial year, an employer
may not decrease the percentage level of subsidy to employee and family coverage
by more than five percentage points.
Sec. 51. Laws 1997, chapter 195, section 5, is amended to
read:
Sec. 5. [PERSONAL CARE ASSISTANT PROVIDERS.]
The commissioner of health shall create a unique category
of licensure as appropriate for providers offering, providing, or arranging
personal care assistant services to more than one individual. The commissioner
shall work with the department of human services, providers, consumers, and
advocates in developing the licensure standards. The
licensure standards must include requirements for providers to provide consumers
advance written notice of service termination, a service transition plan, and an
appeal process. If the commissioner determines there are costs related to
rulemaking under this section, the commissioner shall include a budget request
for this item in the 2000-2001 biennial budget. Prior to promulgating the
rule, the commissioner shall submit the proposed rule to the legislature by
January 15, 1999.
Sec. 52. Laws 1997, chapter 203, article 4, section 64,
is amended to read:
Sec. 64. [STUDY OF ELDERLY WAIVER EXPANSION.]
The commissioner of human services shall appoint a task
force that includes representatives of counties, health plans, consumers, and
legislators to study the impact of the expansion of the elderly waiver program
under section 4 and to make recommendations for any changes in law necessary to
facilitate an efficient and equitable relationship between the elderly waiver
program and the Minnesota senior health options project. Based on the results of
the task force study, the commissioner may seek any federal waivers needed to
improve the relationship between the elderly waiver and the Minnesota senior
health options project. The commissioner shall report the results of the task
force study to the legislature by Sec. 53. Laws 1997, chapter 225, article 2, section 64,
is amended to read:
Sec. 64. [EFFECTIVE DATE.]
Section 8 is effective for
payments made for MinnesotaCare services on or after July 1, 1996. Section
23 is effective the day following final enactment. Section 46 is effective
January 1, 1998, and applies to high deductible health plans issued or renewed
on or after that date.
Sec. 54. [SUBMITTAL OF PLAN TO ACCESS STATE CHILDREN'S
HEALTH INSURANCE FUNDING.]
The commissioner of human services
shall submit a plan to implement Minnesota Statutes, sections 256M.01 to
256M.05, to the secretary of health and human services, in order to obtain
funding through the state children's health insurance program established in
title 21 of the Social Security Act. The commissioner shall also request a
waiver to purchase family coverage as specified in title 21 of the Social
Security Act, section 2105(c)(3). Upon approval of the waiver, the commissioner
shall expand the definition of those eligible for coverage under Minnesota
Statutes, section 256M.03, to include all adults eligible for coverage under the
employee's policy.
Sec. 55. [OFFSET OF HMO SURCHARGE.]
Beginning October 1, 1998, and
ending December 31, 1998, the commissioner of human services shall offset
monthly charges for the health maintenance organization surcharge by the monthly
amount the health maintenance organization overpaid from August 1, 1997, to
September 30, 1998, due to taxation of Medicare revenues prohibited by section
256.9657, subdivision 3.
Sec. 56. [MR/RC WAIVER PROPOSAL.]
By November 15, 1998, the
commissioner of human services shall provide to the chairs of the house health
and human services finance division and the senate health and family security
finance division a detailed budget proposal for providing services under the
home and community-based waiver for persons with mental retardation or related
conditions to those individuals who are screened and waiting for services.
Sec. 57. [COVERAGE OF REHABILITATIVE AND THERAPEUTIC
SERVICES.]
(a) The threshold limits for
fee-for-service medical assistance rehabilitative and therapeutic services for
January 1, 1998 through June 30, 1999, shall be the limits prescribed in the
department of human services health care programs provider manual for calendar
year 1997. Rehabilitative and therapeutic services are: occupational therapy
services provided to medical assistance recipients pursuant to Minnesota
Statutes, section 256B.0625, subdivision 8; physical therapy services provided
to medical assistance recipients pursuant to Minnesota Statutes, section
256B.0625, subdivision 8a; and speech language pathology services provided to
medical assistance recipients pursuant to Minnesota Rules, part 9505.0390.
(b) The commissioner of human
services, in consultation with the department of human services rehabilitative
work group, shall report to the chair of the senate health and family security
committee and the chair of the house health and human services committee by
January 15, 1999, recommendations and proposed legislation for the appropriate
level of rehabilitative services delivered to medical assistance recipients
before prior authorization. The recommendations shall also include proposed
legislation to clarify the rehabilitative and therapeutic benefit set for
medical assistance, as well as the appropriate response time for requests for
prior authorization.
Sec. 58. [DISPROPORTIONATE SHARE ADJUSTMENT FOR DENTAL
SERVICES.]
The commissioner of human services
shall develop a disproportionate share adjustment for dental services provided
under the medical assistance, general assistance medical care, and MinnesotaCare
programs. The adjustment must provide progressive increases above current
fee-for-service rates for dental providers whose medical assistance, general
assistance medical care, and MinnesotaCare caseloads in total comprise more than
specified percentages of their total caseloads. The disproportionate share
adjustment must also apply to managed care capitation rates.
The commissioner shall present
recommendations and proposed legislation for a disproportionate share adjustment
to the legislature by December 15, 1998.
Sec. 59. [REPORT ON COUNTY ALLOCATIONS.]
Beginning August 1, 1998, the
commissioner of human services shall issue an annual report on the home and
community-based waiver for persons with mental retardation or a related
condition, which includes a list of the counties in which less than 95 percent
of the allocation provided, excluding the county waivered services reserve, has
been committed for two or more quarters during the previous state fiscal year.
For each listed county, the report shall include the amount of funds allocated
but not used, the number and ages of individuals screened and waiting for
services, the services needed, a description of the technical assistance
provided by the commissioner to assist the county in jointly planning with other
counties in order to serve more persons, and additional actions which will be
taken to serve those screened and waiting for services.
Sec. 60. [DENTAL ACCESS.]
The commissioner of human services
shall make recommendations to the legislature by February 1, 1999, on how access
to dental services for medical assistance, general assistance medical care, and
MinnesotaCare enrollees could be expanded. In preparing the recommendations, the
commissioner shall consult with consumers, the board of dentistry, dental
providers, the dental hygiene association, consumer advocates, legislators, and
other affected parties.
Sec. 61. [REPORT BY UNIVERSITY OF MINNESOTA ACADEMIC
HEALTH CENTER.]
The University of Minnesota
academic health center, after consultation with the health care community and
the medical education and research cost (MERC) advisory committee, is requested
to report to the commissioner of health and the legislative commission on health
care access by January 15, 1999, on plans for the strategic direction and vision
of the academic health center. The report shall address plans for the ongoing
assessment of health provider workforce needs; plans for the ongoing assessment
of the educational needs of health professionals and the implications for their
education and training programs; and plans for ongoing, meaningful input from
the health care community on health-related research and education programs
administered by the academic health center.
Sec. 62. [COUNTY BILLING BY CLINICS.]
Clinics that (1) serve the primary
health care needs of low-income population groups; (2) use a sliding fee scale
based on ability to pay and do not limit access to care because of financial
limitations of the client; and (3) are nonprofit under Minnesota Statutes,
chapter 317, or are federally qualified health centers, shall be eligible for a
special payment for uncompensated care. The clinics may bill a county of
residence for services provided to a resident of that county provided:
(1) the patient is from a county
other than that in which the clinic resides; and
(2) the clinic has made a
preliminary determination at the delivery of service that the patient was
indigent based on current medical assistance guidelines.
Counties that are billed under
this program shall pay eligible clinics at the rates established under the
medical assistance program. If the county can establish eligibility for medical
assistance after the service has been delivered, the state shall reimburse the
county for any funds paid to the eligible clinic.
Sec. 63. [RECOMMENDATIONS FOR RECYCLING PROGRAM.]
The commissioner of human services
shall develop recommendations for a recycling program for used augmentative and
alternative communications systems that would allow these systems to be reissued
and used for trials and short-term use, when appropriate. The commissioner shall
present recommendations to the legislature by December 15, 1998.
Sec. 64. [REPEALER.]
Minnesota Statutes 1996, section
144.0721, subdivision 3a; and Minnesota Statutes 1997 Supplement, sections
144.0721, subdivision 3; and 256B.0913, subdivision 15, are repealed.
Sec. 65. [EFFECTIVE DATES.]
(a) Section 8 (256.9657,
subdivision 3) is effective retroactive to August 1, 1997.
(b) Sections 14 (256B.055,
subdivision 7a) and 17 (256B.06, subdivision 4) are effective retroactive to
July 1, 1997.
(c) Sections 12 (256.969,
subdivision 17), 19 (256B.0625, subdivision 20), and 44 (256D.03, subdivision 4)
are effective January 1, 1999.
(d) Section 25 (256B.0645) is
effective for changes in eligibility that occur on or after July 1, 1998.
(e) Sections 5 (245.462,
subdivision 8) and 36 (256B.69, subdivision 25) are effective 30 days after
final enactment.
(f) Section 24 (256B.0627,
subdivision 8), related to shared care, and section 57 (coverage of rehab.) are
effective the day following final enactment.
(g) Sections 18 and 45 (256B.0625,
subdivision 17a, and 256D.03, subdivision 9) are effective July 1, 1999.
(h) Sections 46 to 50 (256L.07,
subdivision 2; 256L.07, subdivision 3; 256M.01; 256M.03; 256M.05) are effective
only if federal funding under the state children's health insurance program is
made available to the state and legislative approval has been obtained. If the
funding is made available and legislative approval has been obtained, sections
46 to 50 are effective on the date specified in the state plan. The commissioner
of human services shall publish a notice in the State Register if federal
funding is made available to implement sections 46 to 50 and shall notify the
revisor of statutes. Section 54 (Submittal of plan) is effective the day
following final enactment.
Section 1. Minnesota Statutes 1997 Supplement, section
60A.15, subdivision 1, is amended to read:
Subdivision 1. [DOMESTIC AND FOREIGN COMPANIES.] (a) On
or before April 1, June 1, and December 1 of each year, every domestic and
foreign company, including town and farmers' mutual insurance companies,
domestic mutual insurance companies, marine insurance companies, health
maintenance organizations, community integrated service networks, and nonprofit
health service plan corporations, shall pay to the commissioner of revenue
installments equal to one-third of the insurer's total estimated tax for the
current year. Except as provided in paragraphs (d), (e), (h), and (i),
installments must be based on a sum equal to two percent of the premiums
described in paragraph (b).
(b) Installments under paragraph (a), (d), or (e) are
percentages of gross premiums less return premiums on all direct business
received by the insurer in this state, or by its agents for it, in cash or
otherwise, during such year.
(c) Failure of a company to make payments of at least
one-third of either (1) the total tax paid during the previous calendar year or
(2) 80 percent of the actual tax for the current calendar year shall subject the
company to the penalty and interest provided in this section, unless the total
tax for the current tax year is $500 or less.
(d) For health maintenance organizations, nonprofit
health service plan corporations, and community integrated service networks, the
installments must be based on an amount determined under paragraph (h) or (i).
(e) For purposes of computing installments for town and
farmers' mutual insurance companies and for mutual property casualty companies
with total assets on December 31, 1989, of $1,600,000,000 or less, the following
rates apply:
(1) for all life insurance, two percent;
(2) for town and farmers' mutual insurance companies and
for mutual property and casualty companies with total assets of $5,000,000 or
less, on all other coverages, one percent; and
(3) for mutual property and casualty companies with total
assets on December 31, 1989, of $1,600,000,000 or less, on all other coverages,
1.26 percent.
(f) If the aggregate amount of premium tax payments under
this section and the fire marshal tax payments under section 299F.21 made during
a calendar year is equal to or exceeds $120,000, all tax payments in the
subsequent calendar year must be paid by means of a funds transfer as defined in
section 336.4A-104, paragraph (a). The funds transfer payment date, as defined
in section 336.4A-401, must be on or before the date the payment is due. If the
date the payment is due is not a funds transfer business day, as defined in
section 336.4A-105, paragraph (a), clause (4), the payment date must be on or
before the funds transfer business day next following the date the payment is
due.
(g) Premiums under medical assistance, general assistance
medical care, the MinnesotaCare program, and the Minnesota comprehensive health
insurance plan and all payments, revenues, and reimbursements received from the
federal government for Medicare-related coverage as defined in section 62A.31,
subdivision 3, paragraph (e), are not subject to tax under this section.
(h) For calendar years 1997,
1998, and 1999, the installments for health
maintenance organizations, community integrated service networks, and nonprofit
health service plan corporations must be based on an amount equal to one percent
of premiums described under paragraph (b). Health maintenance organizations,
community integrated service networks, and nonprofit health service plan
corporations that have met the cost containment goals established under section
62J.04 in the individual and small employer market for calendar year 1996 are
exempt from payment of the tax imposed under this section for premiums paid
after March 30, 1997, and before April 1, 1998. Health maintenance
organizations, community integrated service networks, and nonprofit health
service plan corporations that have met the cost containment goals established
under section 62J.04 in the individual and small employer market for calendar
year 1997 are exempt from payment of the tax imposed under this section for
premiums paid after March 30, 1998, and before April 1, 1999. Health maintenance
organizations, community integrated service networks, and
nonprofit health service plan corporations that have met the cost containment
goals established under section 62J.04 in the individual and small employer
market for calendar year 1998 are exempt from payment of the tax imposed under
this section for premiums paid after March 30, 1999, and before January 1,
2000. (i) For calendar years after 1999, the commissioner of
finance shall determine the balance of the health care access fund on September
1 of each year beginning September 1, 1999. If the commissioner determines that
there is no structural deficit for the next fiscal year, no tax shall be imposed
under paragraph (d) for the following calendar year. If the commissioner
determines that there will be a structural deficit in the fund for the following
fiscal year, then the commissioner, in consultation with the commissioner of
revenue, shall determine the amount needed to eliminate the structural deficit
and a tax shall be imposed under paragraph (d) for the following calendar year.
The commissioner shall determine the rate of the tax as either one-quarter of
one percent, one-half of one percent, three-quarters of one percent, or one
percent of premiums described in paragraph (b), whichever is the lowest of those
rates that the commissioner determines will produce sufficient revenue to
eliminate the projected structural deficit. The commissioner of finance shall
publish in the State Register by October 1 of each year the amount of tax to be
imposed for the following calendar year.
(j) In approving the premium rates as required in
sections 62L.08, subdivision 8, and 62A.65, subdivision 3, the commissioners of
health and commerce shall ensure that any exemption from the tax as described in
paragraphs (h) and (i) is reflected in the premium rate.
Sec. 2. Minnesota Statutes 1997 Supplement, section
256B.04, subdivision 18, is amended to read:
Subd. 18. [APPLICATIONS FOR MEDICAL ASSISTANCE.] The
state agency may take applications for medical assistance and conduct
eligibility determinations for MinnesotaCare enrollees Sec. 3. Minnesota Statutes 1996, section 256B.057, is
amended by adding a subdivision to read:
Subd. 7. [WAIVER OF
MAINTENANCE OF EFFORT REQUIREMENT.] Unless a federal
waiver of the maintenance of effort requirement of section 2105(d) of title XXI
of the Balanced Budget Act of 1997, Public Law Number 105-33, Statutes at Large,
volume 111, page 251, is granted by the federal Department of Health and Human
Services by September 30, 1998, eligibility for children under age 21 must be
determined without regard to asset standards established in section 256B.056,
subdivision 3. The commissioner of human services shall publish a notice in the
State Register upon receipt of a federal waiver.
Sec. 4. Minnesota Statutes 1996, section 256B.057, is
amended by adding a subdivision to read:
Subd. 8. [CHILDREN UNDER AGE
TWO.] Medical assistance may be paid for a child under
two years of age whose countable family income is above 275 percent of the
federal poverty guidelines for the same size family but less than or equal to
280 percent of the federal poverty guidelines for the same size family.
Sec. 5. Minnesota Statutes 1997 Supplement, section
256D.03, subdivision 3, is amended to read:
Subd. 3. [GENERAL ASSISTANCE MEDICAL CARE; ELIGIBILITY.]
(a) General assistance medical care may be paid for any person who is not
eligible for medical assistance under chapter 256B, including eligibility for
medical assistance based on a spenddown of excess income according to section
256B.056, subdivision 5, or MinnesotaCare as defined in clause (4), except as
provided in paragraph (b); and:
(1) who is receiving assistance under section 256D.05,
except for families with children who are eligible under Minnesota family
investment program-statewide (MFIP-S), who is having a payment made on the
person's behalf under sections 256I.01 to 256I.06, or who resides in group
residential housing as defined in chapter 256I and can meet a spenddown using
the cost of remedial services received through group residential housing; or
(2)(i) who is a resident of Minnesota; and whose equity
in assets is not in excess of $1,000 per assistance unit. Exempt assets, the
reduction of excess assets, and the waiver of excess assets must conform to the
medical assistance program in chapter 256B, with the following exception: the
maximum amount of undistributed funds in a trust that could be distributed to or
on behalf of the beneficiary by the trustee, assuming the full exercise of the
trustee's discretion under the terms of the trust, must be applied toward the
asset maximum; and
(ii) who has countable income not in excess of the
assistance standards established in section 256B.056, subdivision 4, or whose
excess income is spent down according to section 256B.056, subdivision 5, using
a six-month budget period. The method for calculating earned income disregards
and deductions for a person who resides with a dependent child under age 21
shall follow section 256B.056, subdivision 1a. However, if a disregard of $30
and one-third of the remainder has been applied to the wage earner's income, the
disregard shall not be applied again until the wage earner's income has not been
considered in an eligibility determination for general assistance, general
assistance medical care, medical assistance, or MFIP-S for 12 consecutive
months. The earned income and work expense deductions for a person who does not
reside with a dependent child under age 21 shall be the same as the method used
to determine eligibility for a person under section 256D.06, subdivision 1,
except the disregard of the first $50 of earned income is not allowed; or
(3) who would be eligible for medical assistance except
that the person resides in a facility that is determined by the commissioner or
the federal Health Care Financing Administration to be an institution for mental
diseases.
(4) Beginning (i) adults with dependent children under 21 whose gross
family income is equal to or less than 275 percent of the federal poverty
guidelines; or
(ii) adults without children with earned income and whose
family gross income is between 75 percent of the federal poverty guidelines and
the amount set by section 256L.04, subdivision 7, shall be terminated from
general assistance medical care upon enrollment in MinnesotaCare.
(b) For services rendered on or after July 1, 1997,
eligibility is limited to one month prior to application if the person is
determined eligible in the prior month. A redetermination of eligibility must
occur every 12 months. Beginning (c) The date of an initial Minnesota health care program
application necessary to begin a determination of eligibility shall be the date
the applicant has provided a name, address, and social security number, signed
and dated, to the county agency or the department of human services. If the
applicant is unable to provide an initial application when health care is
delivered due to a medical condition or disability, a health care provider may
act on the person's behalf to complete the initial application. The applicant
must complete the remainder of the application and provide necessary
verification before eligibility can be determined. The county agency must assist
the applicant in obtaining verification if necessary.
(d) County agencies are authorized to use all automated
databases containing information regarding recipients' or applicants' income in
order to determine eligibility for general assistance medical care or
MinnesotaCare. Such use shall be considered sufficient in order to determine
eligibility and premium payments by the county agency.
(e) General assistance medical care is not available for
a person in a correctional facility unless the person is detained by law for
less than one year in a county correctional or detention facility as a person
accused or convicted of a crime, or admitted as an inpatient to a hospital on a
criminal hold order, and the person is a recipient of general assistance medical
care at the time the person is detained by law or admitted on a criminal hold
order and as long as the person continues to meet other eligibility requirements
of this subdivision.
(f) General assistance medical care is not available for
applicants or recipients who do not cooperate with the county agency to meet the
requirements of medical assistance. General assistance medical care is limited
to payment of emergency services only for applicants or recipients as described
in paragraph (a), clause (4), whose MinnesotaCare coverage is denied or
terminated for nonpayment of premiums as required by sections 256L.06 (g) In determining the amount of assets of an individual,
there shall be included any asset or interest in an asset, including an asset
excluded under paragraph (a), that was given away, sold, or disposed of for less
than fair market value within the 60 months preceding application for general
assistance medical care or during the period of eligibility. Any transfer
described in this paragraph shall be presumed to have been for the purpose of
establishing eligibility for general assistance medical care, unless the
individual furnishes convincing evidence to establish that the transaction was
exclusively for another purpose. For purposes of this paragraph, the value of
the asset or interest shall be the fair market value at the time it was given
away, sold, or disposed of, less the amount of compensation received. For any
uncompensated transfer, the number of months of ineligibility, including partial
months, shall be calculated by dividing the uncompensated transfer amount by the
average monthly per person payment made by the medical assistance program to
skilled nursing facilities for the previous calendar year. The individual shall
remain ineligible until this fixed period has expired. The period of
ineligibility may exceed 30 months, and a reapplication for benefits after 30
months from the date of the transfer shall not result in eligibility unless and
until the period of ineligibility has expired. The period of ineligibility
begins in the month the transfer was reported to the county agency, or if the
transfer was not reported, the month in which the county agency discovered the
transfer, whichever comes first. For applicants, the period of ineligibility
begins on the date of the first approved application.
(h) When determining eligibility for any state benefits
under this subdivision, the income and resources of all noncitizens shall be
deemed to include their sponsor's income and resources as defined in the
Personal Responsibility and Work Opportunity Reconciliation Act of 1996, title
IV, Public Law Number 104-193, sections 421 and 422, and subsequently set out in
federal rules.
(i) An undocumented noncitizen or a nonimmigrant is
ineligible for general assistance medical care other than emergency services.
For purposes of this subdivision, a nonimmigrant is an individual in one or more
of the classes listed in United States Code, title 8, section 1101(a)(15), and
an undocumented noncitizen is an individual who resides in the United States
without the approval or acquiescence of the Immigration and Naturalization
Service.
(j) This paragraph does not apply to a child under age
18, to a Cuban or Haitian entrant as defined in Public Law Number 96-422,
section 501(e)(1) or (2)(a), or to a noncitizen who is aged, blind, or disabled
as defined in Code of Federal Regulations, title 42, sections 435.520, 435.530,
435.531, 435.540, and 435.541, who cooperates with the Immigration and
Naturalization Service to pursue any applicable immigration status, including
citizenship, that would qualify the individual for medical assistance with
federal financial participation.
(k) For purposes of paragraphs (f) and (i), "emergency
services" has the meaning given in Code of Federal Regulations, title 42,
section 440.255(b)(1), except that it also means services rendered because of
suspected or actual pesticide poisoning.
(l) Notwithstanding any other provision of law, a
noncitizen who is ineligible for medical assistance due to the deeming of a
sponsor's income and resources, is ineligible for general assistance medical
care.
Sec. 6. Minnesota Statutes 1997 Supplement, section
256L.01, is amended to read:
256L.01 [DEFINITIONS.]
Subdivision 1. [SCOPE.] For purposes of sections 256L.01
to Subd. 1a. [CHILD.] "Child" means an individual under 21 years of age, including
the unborn child of a pregnant woman, an emancipated minor, and an emancipated
minor's spouse.
Subd. 2. [COMMISSIONER.] "Commissioner" means the
commissioner of human services.
Subd. 3. [ELIGIBLE PROVIDERS.] "Eligible providers" means
those health care providers who provide covered health services to medical
assistance recipients under rules established by the commissioner for that
program.
Subd. 3a. [FAMILY WITH
CHILDREN.] (a) "Family with children" means:
(1) parents, their children, and
dependent siblings residing in the same household; or
(2) grandparents, foster parents,
relative caretakers as defined in the medical assistance program, or legal
guardians; their wards who are children; and dependent siblings residing in the
same household.
(b) The term includes children and
dependent siblings who are temporarily absent from the household in settings
such as schools, camps, or visitation with noncustodial parents.
(c) For purposes of this
subdivision, a dependent sibling means an unmarried child who is a full-time
student under the age of 25 years who is financially dependent upon a parent,
grandparent, foster parent, relative caretaker, or legal guardian. Proof of
school enrollment is required.
Subd. 4. [GROSS INDIVIDUAL OR
GROSS FAMILY INCOME.] "Gross individual or gross
family income" for farm and nonfarm self-employed means income calculated using
as the baseline the adjusted gross income reported on the applicant's federal
income tax form for the previous year and adding back in reported depreciation,
carryover loss, and net operating loss amounts that apply to the business in
which the family is currently engaged. Applicants shall report the most recent
financial situation of the family if it has changed from the period of time
covered by the federal income tax form. The report may be in the form of
percentage increase or decrease.
Subd. 5. [INCOME.] "Income" has the meaning given for earned and unearned
income for families and children in the medical assistance program, according to
the state's aid to families with dependent children plan in effect as of July
16, 1996. The definition does not include medical assistance income
methodologies and deeming requirements. The earned income of full-time and
part-time students under age 19 is not counted as income. Public assistance
payments and supplemental security income are not excluded income.
Sec. 7. Minnesota Statutes 1997 Supplement, section
256L.02, subdivision 3, is amended to read:
Subd. 3. [FINANCIAL MANAGEMENT.] (a) The commissioner
shall manage spending for the MinnesotaCare program in a manner that maintains a
minimum reserve in accordance with section 16A.76. As
part of each state revenue and expenditure forecast, the commissioner must
make (b) The adjustments the commissioner shall use must be
implemented in this order: first, stop enrollment of single adults and
households without children; second, upon 45 days' notice, stop coverage of
single adults and households without children already enrolled in the
MinnesotaCare program; third, upon 90 days' notice, decrease the premium subsidy
amounts by ten percent for families with gross annual income above 200 percent
of the federal poverty guidelines; fourth, upon 90 days' notice, decrease the
premium subsidy amounts by ten percent for families with gross annual income at
or below 200 percent; and fifth, require applicants to be uninsured for at least
six months prior to eligibility in the MinnesotaCare program. If these measures
are insufficient to limit the expenditures to the estimated amount of revenue,
the commissioner shall further limit enrollment or decrease premium subsidies.
Sec. 8. Minnesota Statutes 1997 Supplement, section
256L.02, is amended by adding a subdivision to read:
Subd. 4. [FUNDING FOR PREGNANT
WOMEN AND CHILDREN UNDER AGE TWO.] For fiscal years
beginning on or after July 1, 1999, the state cost of health care services
provided to MinnesotaCare enrollees who are pregnant women or children under age
two shall be paid out of the general fund rather than the health care access
fund. If the commissioner of finance decides to pay for these costs using a
source other than the general fund, the commissioner shall include the change as
a budget initiative in the biennial or supplemental budget, and shall not change
the funding source through a forecast modification.
Sec. 9. Minnesota Statutes 1997 Supplement, section
256L.03, subdivision 1, is amended to read:
Subdivision 1. [COVERED HEALTH SERVICES.] "Covered health
services" means the health services reimbursed under chapter 256B, with the
exception of inpatient hospital services, special education services, private
duty nursing services, adult dental care services other than preventive
services, orthodontic services, nonemergency medical transportation services,
personal care assistant and case management services, nursing home or
intermediate care facilities services, inpatient mental health services, and
chemical dependency services. Effective July 1, 1998, adult dental care for
nonpreventive services with the exception of orthodontic services is available
to persons who qualify under section 256L.04, subdivisions 1 to 7, No public funds shall be used for coverage of abortion
under MinnesotaCare except where the life of the female would be endangered or
substantial and irreversible impairment of a major bodily function would result
if the fetus were carried to term; or where the pregnancy is the result of rape
or incest.
Covered health services shall be expanded as provided in
this section.
Sec. 10. Minnesota Statutes 1997 Supplement, section
256L.03, is amended by adding a subdivision to read:
Subd. 1a. [COVERED SERVICES
FOR PREGNANT WOMEN AND CHILDREN UNDER MINNESOTACARE HEALTH CARE REFORM WAIVER.]
Children and pregnant women are eligible for coverage of
all services that are eligible for reimbursement under the medical assistance
program according to chapter 256B, except that abortion services under
MinnesotaCare shall be limited as provided under section 256L.03, subdivision 1.
Pregnant women and children are exempt from the provisions of subdivision 5,
regarding copayments. Pregnant women and children who are lawfully residing in
the United States but who are not "qualified noncitizens" under title IV of the
Personal Responsibility and Work Opportunity Reconciliation Act of 1996, Public
Law Number 104-193, Statutes at Large, volume 110, page 2105, are eligible for
coverage of all services provided under the medical assistance program according
to chapter 256B.
Sec. 11. Minnesota Statutes 1997 Supplement, section
256L.03, is amended by adding a subdivision to read:
Subd. 1b. [PREGNANT WOMEN;
ELIGIBILITY FOR FULL MEDICAL ASSISTANCE SERVICES.] A
woman who is enrolled in MinnesotaCare when her pregnancy is diagnosed is
eligible for coverage of all services provided under the medical assistance
program according to chapter 256B retroactive to the date the pregnancy is
medically diagnosed. Copayments totaling $30 or more, paid after the date the
pregnancy is diagnosed, shall be refunded.
Sec. 12. Minnesota Statutes 1997 Supplement, section
256L.03, subdivision 3, is amended to read:
Subd. 3. [INPATIENT HOSPITAL SERVICES.] (a) (b) (1) all admissions must be certified, except those
authorized under rules established under section 254A.03, subdivision 3, or
approved under Medicare; and
(2) payment under section 256L.11, subdivision 3, shall
be reduced by five percent for admissions for which certification is requested
more than 30 days after the day of admission. The hospital may not seek payment
from the enrollee for the amount of the payment reduction under this clause.
Sec. 13. Minnesota Statutes 1997 Supplement, section
256L.03, subdivision 4, is amended to read:
Subd. 4. [COORDINATION WITH MEDICAL ASSISTANCE.] The
commissioner shall coordinate the provision of hospital inpatient services under
the MinnesotaCare program with enrollee eligibility under the medical assistance
spenddown Sec. 14. Minnesota Statutes 1997 Supplement, section
256L.03, subdivision 5, is amended to read:
Subd. 5. [COPAYMENTS AND COINSURANCE.] The MinnesotaCare
benefit plan shall include the following copayments and coinsurance
requirements:
(1) ten percent of the paid charges for inpatient
hospital services for adult enrollees (2) $3 per prescription for adult enrollees;
(3) $25 for eyeglasses for adult enrollees; and
(4) effective July 1, 1998, 50 percent of the
fee-for-service rate for adult dental care services other than preventive care
services for persons eligible under section 256L.04, subdivisions 1 to 7, When a MinnesotaCare enrollee becomes a member of a
prepaid health plan, or changes from one prepaid health plan to another during a
calendar year, any charges submitted towards the $10,000 annual inpatient
benefit limit, and any out-of-pocket expenses incurred by the enrollee for
inpatient services, that were submitted or incurred prior to enrollment, or
prior to the change in health plans, shall be disregarded.
Sec. 15. Minnesota Statutes 1997 Supplement, section
256L.04, subdivision 1, is amended to read:
Subdivision 1. [ (b) Sec. 16. Minnesota Statutes 1997 Supplement, section
256L.04, subdivision 2, is amended to read:
Subd. 2. [COOPERATION IN
ESTABLISHING THIRD PARTY LIABILITY, PATERNITY, AND OTHER MEDICAL SUPPORT.]
(a) To be eligible for MinnesotaCare, individuals and families must cooperate with the state agency to
identify potentially liable third party payers and assist the state in obtaining
third party payments. "Cooperation" includes, but is not limited to, identifying
any third party who may be liable for care and services provided under
MinnesotaCare to the enrollee, providing relevant information to assist the
state in pursuing a potentially liable third party, and completing forms
necessary to recover third party payments.
(b) A parent, guardian, or child
enrolled in the MinnesotaCare program must cooperate with the department of
human services and the local agency in establishing the paternity of an enrolled
child and in obtaining medical care support and payments for the child and any
other person for whom the person can legally assign rights, in accordance with
applicable laws and rules governing the medical assistance program. A child
shall not be ineligible for or disenrolled from the MinnesotaCare program solely
because the child's parent or guardian fails to cooperate in establishing
paternity or obtaining medical support.
Sec. 17. Minnesota Statutes 1997 Supplement, section
256L.04, subdivision 7, is amended to read:
Subd. 7. [ Sec. 18. Minnesota Statutes 1997 Supplement, section
256L.04, is amended by adding a subdivision to read:
Subd. 7a. [INELIGIBILITY.] Applicants whose income is greater than the limits
established under this section may not enroll in the MinnesotaCare program.
Sec. 19. Minnesota Statutes 1997 Supplement, section
256L.04, subdivision 8, is amended to read:
Subd. 8. [APPLICANTS POTENTIALLY ELIGIBLE FOR MEDICAL
ASSISTANCE.] (a) Individuals who (b) The enrollee must
cooperate with the county social service agency in determining medical
assistance eligibility within the 60-day enrollment period. Enrollees who do not
(c) Beginning January 1, 2000,
counties that choose to become MinnesotaCare enrollment sites shall consider
MinnesotaCare applications of individuals described in paragraph (a) to also be
applications for medical assistance and shall first determine whether medical
assistance eligibility exists. Adults with children with family income under 175
percent of the federal poverty guidelines for the applicable family size,
pregnant women, and children who qualify under subdivision 1 who are potentially
eligible for medical assistance without a spenddown may choose to enroll in
either MinnesotaCare or medical assistance.
(d) The commissioner shall
redetermine provider payments made under MinnesotaCare to the appropriate
medical assistance payments for those enrollees who subsequently become eligible
for medical assistance.
Sec. 20. Minnesota Statutes 1997 Supplement, section
256L.04, subdivision 9, is amended to read:
Subd. 9. [GENERAL ASSISTANCE MEDICAL CARE.] A person
cannot have coverage under both MinnesotaCare and general assistance medical
care in the same month. Eligibility for MinnesotaCare
cannot be replaced by eligibility for general assistance medical care, and
eligibility for general assistance medical care cannot be replaced by
eligibility for MinnesotaCare.
Sec. 21. Minnesota Statutes 1997 Supplement, section
256L.04, subdivision 10, is amended to read:
Subd. 10. [SPONSOR'S INCOME AND RESOURCES DEEMED
AVAILABLE; DOCUMENTATION.] When determining
eligibility for any federal or state benefits under sections 256L.01 to Sec. 22. Minnesota Statutes 1997 Supplement, section
256L.04, is amended by adding a subdivision to read:
Subd. 12. [PERSONS IN
DETENTION.] An applicant residing in a correctional or
detention facility is not eligible for MinnesotaCare. An enrollee residing in a
correctional or detention facility is not eligible at renewal of eligibility
under section 256L.05, subdivision 3b.
Sec. 23. Minnesota Statutes 1997 Supplement, section
256L.04, is amended by adding a subdivision to read:
Subd. 13. [FAMILIES WITH
GRANDPARENTS, RELATIVE CARETAKERS, FOSTER PARENTS, OR LEGAL GUARDIANS.] In families that include a grandparent, relative caretaker
as defined in the medical assistance program, foster parent, or legal guardian,
the grandparent, relative caretaker, foster parent, or legal guardian may apply
as a family or may apply separately for the child. If the grandparent, relative
caretaker, foster parent, or legal guardian applies with the family, their
income is included in the gross family income for determining eligibility and
premium amount.
Sec. 24. Minnesota Statutes 1997 Supplement, section
256L.05, is amended by adding a subdivision to read:
Subd. 1a. [PERSON AUTHORIZED
TO APPLY ON APPLICANT'S BEHALF.] A family member who is
age 18 or over or who is an authorized representative, as defined in the medical
assistance program, may apply on an applicant's behalf.
Sec. 25. Minnesota Statutes 1997 Supplement, section
256L.05, subdivision 2, is amended to read:
Subd. 2. [COMMISSIONER'S DUTIES.] The commissioner shall
use individuals' social security numbers as identifiers for purposes of
administering the plan and conduct data matches to verify income. Applicants
shall submit evidence of individual and family
income, earned and unearned, Sec. 26. Minnesota Statutes 1997 Supplement, section
256L.05, subdivision 3, is amended to read:
Subd. 3. [EFFECTIVE DATE OF COVERAGE.] The effective date
of coverage is the first day of the month following the month in which
eligibility is approved and the first premium payment has been received. As provided in section 256B.057, coverage for newborns is
automatic from the date of birth and must be coordinated with other health
coverage. The effective date of coverage for Sec. 27. Minnesota Statutes 1997 Supplement, section
256L.05, is amended by adding a subdivision to read:
Subd. 3a. [RENEWAL OF
ELIGIBILITY.] An enrollee's eligibility must be renewed
every 12 months. The 12-month period begins in the month after the month the
application is approved. An enrollee must meet all applicable eligibility
criteria at the time of renewal. An enrollee whose income exceeds the income
limits specified in section 256L.04, subdivision 1 or 7 is subject to section
256L.07, subdivision 1.
Sec. 28. Minnesota Statutes 1997 Supplement, section
256L.05, is amended by adding a subdivision to read:
Subd. 3b. [REAPPLICATION.] Families and individuals must reapply after a lapse in
coverage of one calendar month or more and must meet all eligibility
criteria.
Sec. 29. Minnesota Statutes 1997 Supplement, section
256L.05, subdivision 4, is amended to read:
Subd. 4. [APPLICATION PROCESSING.] The commissioner of
human services shall determine an applicant's eligibility for MinnesotaCare no
more than 30 days from the date that the application is received by the
department of human services. Beginning January 1, 2000, this requirement also
applies to local county human services agencies that determine eligibility for
MinnesotaCare. To prevent processing delays, applicants
who appear to meet eligibility requirements shall be enrolled. The enrollee must
provide all required verifications within 30 days of enrollment or coverage from
the program shall be terminated. Enrollees who are determined to be ineligible
when verifications are provided shall be terminated.
Sec. 30. Minnesota Statutes 1997 Supplement, section
256L.06, subdivision 3, is amended to read:
Subd. 3. [ADMINISTRATION AND COMMISSIONER'S DUTIES.] (a) Premiums are dedicated to the commissioner for
MinnesotaCare. (b) The commissioner shall
develop and implement procedures to: (1) require enrollees to report changes in
income; (2) adjust sliding scale premium payments, based upon changes in
enrollee income; and (3) disenroll enrollees from MinnesotaCare for failure to
pay required premiums. Failure to pay includes payment
with a dishonored check. The commissioner may demand a guaranteed form of
payment as the only means to replace a dishonored check.
(c) Premiums are calculated on
a calendar month basis and may be paid on a monthly, quarterly, or annual basis,
with the first payment due upon notice from the commissioner of the premium
amount required. The commissioner shall inform applicants
and enrollees of these premium payment options. Premium payment is required
before enrollment is complete and to maintain eligibility in MinnesotaCare.
(d) Nonpayment of the premium
will result in disenrollment from the plan within one calendar month after the
due date. Persons disenrolled for nonpayment or who
voluntarily terminate coverage from the program may not reenroll until four
calendar months have elapsed. Persons disenrolled for nonpayment or who voluntarily terminate coverage from the program
may not reenroll for four calendar months unless the person demonstrates good
cause for nonpayment. Good cause does not exist if a person chooses to pay other
family expenses instead of the premium. The commissioner shall define good cause
in rule.
Sec. 31. Minnesota Statutes 1997 Supplement, section
256L.07, is amended to read:
256L.07 [ELIGIBILITY FOR SUBSIDIZED PREMIUMS BASED ON
SLIDING SCALE.]
Subdivision 1. [GENERAL REQUIREMENTS.] Families Subd. 2. [MUST NOT HAVE ACCESS TO EMPLOYER-SUBSIDIZED
COVERAGE.] (a) To be eligible for subsidized premium payments based on a sliding
scale, a family or individual must not have access to subsidized health coverage
through an employer (b) For purposes of this requirement, subsidized health
coverage means health coverage for which the employer pays at least 50 percent
of the cost of coverage for the employee Subd. 3. [ (b) For purposes of this section,
medical assistance, general assistance medical care, and civilian health and
medical program of the uniformed service (CHAMPUS) are not considered insurance
or health coverage.
(c) For purposes of this section,
Medicare part A or B coverage under title XVIII of the Social Security Act,
United States Code, title 42, sections 1395c to 1395w-4, is considered health
coverage. An applicant or enrollee may not refuse Medicare coverage to establish
eligibility for MinnesotaCare.
Subd. 4. [EXEMPTION FOR
PERSONS WITH CONTINUATION COVERAGE.] (a) Families,
children, and individuals who want to apply for the MinnesotaCare program upon
termination from continuation coverage required under federal or state law are
exempt from the requirements of subdivisions 2 and 3.
(b) For purposes of paragraph (a),
"termination from continuation coverage" means involuntary termination for any
reason, other than nonpayment of premium by the family, child, or individual.
Involuntary termination includes termination of coverage due to reaching the end
of the maximum period for continuation coverage required under federal or state
law.
Sec. 32. Minnesota Statutes 1997 Supplement, section
256L.09, subdivision 2, is amended to read:
Subd. 2. [RESIDENCY REQUIREMENT.] (a) Sec. 33. Minnesota Statutes 1997 Supplement, section
256L.09, subdivision 4, is amended to read:
Subd. 4. [ELIGIBILITY AS MINNESOTA RESIDENT.] (a) For purposes of this section, a permanent Minnesota
resident is a person who has demonstrated, through persuasive and objective
evidence, that the person is domiciled in the state and intends to live in the
state permanently.
(b) To be eligible as a permanent resident, (1) showing that the applicant maintains a residence at a
verified address other than a place of public accommodation, through the use of
evidence of residence described in section 256D.02, subdivision 12a, clause (1);
(2) demonstrating that the applicant has been
continuously domiciled in the state for no less than 180 days immediately before
the application; and
(3) signing an affidavit declaring that (A) the applicant
currently resides in the state and intends to reside in the state permanently;
and (B) the applicant did not come to the state for the primary purpose of
obtaining medical coverage or treatment.
(c) A person who is temporarily
absent from the state does not lose eligibility for MinnesotaCare. "Temporarily
absent from the state" means the person is out of the state for a temporary
purpose and intends to return when the purpose of the absence has been
accomplished. A person is not temporarily absent from the state if another state
has determined that the person is a resident for any purpose. If temporarily
absent from the state, the person must follow the requirements of the health
plan in which he or she is enrolled to receive services.
Sec. 34. Minnesota Statutes 1997 Supplement, section
256L.09, subdivision 6, is amended to read:
Subd. 6. [12-MONTH PREEXISTING EXCLUSION.] If the 180-day
requirement in subdivision 4, paragraph (b), clause
(2), is determined by a court to be unconstitutional, the commissioner of human
services shall impose a 12-month preexisting condition exclusion on coverage for
persons who have been domiciled in the state for less than 180 days.
Sec. 35. Minnesota Statutes 1997 Supplement, section
256L.11, subdivision 6, is amended to read:
Subd. 6. [ENROLLEES 18 OR OLDER.] Payment by the
MinnesotaCare program for inpatient hospital services provided to MinnesotaCare
enrollees eligible under section 256L.04, subdivision 7, or who qualify under
section 256L.04, subdivisions 1 (a) If the medical assistance rate minus any copayment
required under section 256L.03, subdivision 4, is less than or equal to the
amount remaining in the enrollee's benefit limit under section 256L.03,
subdivision 3, payment must be the medical assistance rate minus any copayment
required under section 256L.03, subdivision 4. The hospital must not seek
payment from the enrollee in addition to the copayment. The MinnesotaCare
payment plus the copayment must be treated as payment in full.
(b) If the medical assistance rate minus any copayment
required under section 256L.03, subdivision 4, is greater than the amount
remaining in the enrollee's benefit limit under section 256L.03, subdivision 3,
payment must be the lesser of:
(1) the amount remaining in the enrollee's benefit limit;
or
(2) charges submitted for the inpatient hospital services
less any copayment established under section 256L.03, subdivision 4.
The hospital may seek payment from the enrollee for the
amount by which usual and customary charges exceed the payment under this
paragraph. If payment is reduced under section 256L.03, subdivision 3, paragraph
(c) For admissions occurring during the period of July 1,
1997, through June 30, 1998, for adults who are not pregnant and are eligible
under section 256L.04, subdivisions 1 Sec. 36. Minnesota Statutes 1997 Supplement, section
256L.12, subdivision 5, is amended to read:
Subd. 5. [ELIGIBILITY FOR OTHER STATE PROGRAMS.]
MinnesotaCare enrollees who become eligible for medical assistance or general
assistance medical care will remain in the same managed care plan if the managed
care plan has a contract for that population. Effective January 1, 1998,
MinnesotaCare enrollees who were formerly eligible for general assistance
medical care pursuant to section 256D.03, subdivision 3, within six months of
MinnesotaCare enrollment and were enrolled in a prepaid health plan pursuant to
section 256D.03, subdivision 4, paragraph (d), must remain in the same managed
care plan if the managed care plan has a contract for that population. Sec. 37. Minnesota Statutes 1997 Supplement, section
256L.15, is amended to read:
256L.15 [PREMIUMS.]
Subdivision 1. [PREMIUM DETERMINATION.] Families Subd. 1a. [PAYMENT OPTIONS.]
The commissioner may offer the following payment options
to an enrollee:
(1) payment by check;
(2) payment by credit card;
(3) payment by recurring automatic
checking withdrawal;
(4) payment by one-time electronic
transfer of funds; or
(5) payment by wage withholding
with the consent of the employer and the employee.
Subd. 1b. [PAYMENTS
NONREFUNDABLE.] MinnesotaCare premiums and enrollment
fees are not refundable.
Subd. 2. [SLIDING SCALE TO DETERMINE PERCENTAGE OF GROSS
INDIVIDUAL OR FAMILY INCOME.] The commissioner shall
establish a sliding fee scale to determine the percentage of gross individual or family income that households at different
income levels must pay to obtain coverage through the MinnesotaCare program. The
sliding fee scale must be based on the enrollee's gross individual or family income during the previous four
months. The sliding fee scale begins with a premium of 1.5 percent of gross individual or family income for individuals or families with incomes below the limits
for the medical assistance program for families and children and proceeds
through the following evenly spaced steps: 1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 7.4,
and 8.8 percent. These percentages are matched to evenly spaced income steps
ranging from the medical assistance income limit for families and children to
275 percent of the federal poverty guidelines for the applicable family size. An adult without children whose income is equal to or less
than 175 percent of the federal poverty guidelines shall pay premiums according
to the sliding fee scale. When an enrollee's income exceeds the eligibility
limit established for families with children under section 256L.04, subdivision
1, the enrollee must pay the full cost of coverage as required under section
256L.07, subdivision 1. The sliding fee scale and percentages are not
subject to the provisions of chapter 14. If a family or
individual reports increased income after enrollment, premiums shall not be
adjusted until eligibility renewal.
Subd. 4. [CHILDREN IN FAMILIES
WITH INCOME AT OR LESS THAN 150 PERCENT OF FEDERAL POVERTY GUIDELINES.] Children in families with income at or below 150 percent of
the federal poverty guidelines, when only the children are enrolled, may pay an
annual enrollment fee of $48 per child. Payment of the $48 annual enrollment fee
in families with only the children enrolled guarantees eligibility for 12 months
regardless of changes in circumstances. If the entire family is enrolled, the
children are required to pay a monthly premium of $4.
Sec. 38. Minnesota Statutes 1997 Supplement, section
256L.17, is amended by adding a subdivision to read:
Subd. 6. [WAIVER OF
MAINTENANCE OF EFFORT REQUIREMENT.] Unless a federal
waiver of the maintenance of effort requirements of section 2105(d) of title XXI
of the Balanced Budget Act of 1997, Public Law Number 105-33, Statutes at Large,
volume 111, page 251, is granted by the federal Department of Health and Human
Services by September 30, 1998, this section does not apply to children. The
commissioner shall publish a notice in the State Register upon receipt of a
federal waiver.
Sec. 39. [256L.19] [STATE CHILDREN'S HEALTH INSURANCE
PROGRAM.]
Subdivision 1. [AUTHORITY.] The commissioner is authorized to claim enhanced federal
matching funds under sections 2105(a)(2) and 2110 of the Balanced Budget Act of
1997, Public Law Number 105-33, for any and all state or local expenditures
eligible as child health assistance for targeted low income children and health
service initiatives for low income children. If required by federal law or
regulations, the commissioner is authorized to establish accounts, make
appropriate payments, and receive reimbursement from state and local entities
providing child health assistance or health services for low income children, in
order to obtain enhanced federal matching funds. Enhanced federal matching funds
received as a result of authority exercised under this section shall be
deposited in the general fund.
Subd. 2. [ENHANCED MATCHING
FUNDS FOR CHILDREN'S HEALTH CARE INITIATIVES.] The
commissioner shall submit to the health care financing administration all plans
and waiver requests necessary to obtain enhanced matching funds under the state
children's health insurance program established as Title 21 of the Balanced
Budget Act of 1997, Public Law Number 105-33, for: (1) expenditures made under
section 256B.057, subdivision 9; and (2) expenditures made under the
MinnesotaCare program. The commissioner shall submit to the legislature, by
January 15, 1999, all statutory changes to the MinnesotaCare program necessary
to receive enhanced federal matching funds.
Sec. 40. [UNCOMPENSATED CARE STUDY.]
The commissioner of health, in
consultation with the commissioner of human services, shall present to the
legislative commission on health care access, by January 15, 1999, a report and
recommendations on the provision and financing of uncompensated care in
Minnesota. The report must:
(1) document the extent of
uncompensated care provided in Minnesota;
(2) discuss options for financing
uncompensated care;
(3) describe other state
approaches to monitoring and financing uncompensated care; and
(4) describe alternative
approaches to encourage health care coverage.
Sec. 41. [SPECIAL PREMIUM TAX PAYMENT.]
Health maintenance organizations,
community integrated service networks, and nonprofit health service plan
corporations that have met the cost containment goals established in Minnesota
Statutes, section 62J.04, in the individual and small employer market for
calendar year 1996 shall pay a special, one-time 1999 premium tax payment. The
tax payment must be based on an amount equal to one percent of gross premiums
less return premiums on all direct business received by the insurer in this
state, or by its agents for it, in cash or otherwise after March 30, 1997, and
before January 1, 1998. Payment of the tax under this section is due January 2,
1999. Provisions relating to the payment, assessment, and collection of the tax
assessed under Minnesota Statutes, section 60A.15, shall apply to the special
tax payment assessed under this section.
Sec. 42. [REVISOR'S INSTRUCTION.]
In each section of Minnesota
Statutes referred to in column A, the revisor of statutes shall delete the
reference in column B and insert the reference in column C.
Column A Column B Column C
256B.057, subd. 1a 256L.08 256L.15
256B.0645 256L.14 256L.03, subd. 1a
256L.16 256L.14 256L.03, subd. 1a
Sec. 43. [REPEALER.]
Minnesota Statutes 1997
Supplement, sections 256B.057, subdivision 1a; 256L.04, subdivisions 3, 4, 5,
and 6; 256L.06, subdivisions 1 and 2; 256L.08; 256L.09, subdivision 3; 256L.13;
256L.14; and 256L.15, subdivision 3, are repealed.
Sec. 44. [EFFECTIVE DATE.]
(a) Sections 2 (256B.04,
subdivision 18), 5 to 7, 9 to 37, 42 (Revisor Instruction), and 43 (Repealer)
are effective January 1, 1999.
(b) Sections 3 (256B.057,
subdivision 7), 4 (256B.057, subdivision 8), 38 (256L.17, subdivision 6), and 39
(256L.19) are effective September 30, 1998.
Section 1. Minnesota Statutes 1997 Supplement, section
119B.01, subdivision 16, is amended to read:
Subd. 16. [TRANSITION YEAR FAMILIES.] "Transition year
families" means families who have received AFDC, or who
were eligible to receive AFDC after choosing to discontinue receipt of the cash
portion of MFIP-S assistance under section 256J.31, subdivision 12, for at
least three of the last six months before losing eligibility for AFDC due to
increased hours of employment, increased income from employment or child or
spousal support, or the loss of income disregards due to time limitations.
Sec. 2. Minnesota Statutes 1996, section 245A.03, is
amended by adding a subdivision to read:
Subd. 2b. [EXCEPTION.] The provision in subdivision 2, clause (2), does not apply
to:
(1) a child care provider who as
an applicant for licensure or as a licenseholder has received a license denial
under section 245A.05, a fine under section 245A.06, or a sanction under 245A.07
from the commissioner that has not been reversed on appeal; or
(2) a child care provider, or a
child care provider who has a household member who, as a result of a licensing
process, has a disqualification under chapter 245A that has not been set aside
by the commissioner.
Sec. 3. Minnesota Statutes 1996, section 245A.03, is
amended by adding a subdivision to read:
Subd. 4. [EXCLUDED CHILD CARE
PROGRAMS; RIGHT TO SEEK LICENSURE.] Nothing in this
section shall prohibit a child care program that is excluded from licensure
under subdivision 2, clause (2), or under Laws 1997, chapter 248, section 46, as
amended by Laws 1997, First Special Session chapter 5, section 10, from seeking
a license under this chapter. The commissioner shall ensure that any application
received from such an excluded provider is processed in the same manner as all
other applications for licensed family day care.
Sec. 4. Minnesota Statutes 1996, section 245A.14,
subdivision 4, is amended to read:
Subd. 4. [SPECIAL FAMILY DAY CARE HOMES.] Nonresidential
child care programs serving 14 or fewer children that
are conducted at a location other than the license holder's own residence shall
be licensed under this section and the rules
governing family day care or group family day care if:
(a) the license holder is the primary provider of care (b) the license holder is an
employer who may or may not be the primary provider of care, and the purpose for
the child care program is to provide child care services to children of the
license holder's employees.
Sec. 5. Minnesota Statutes 1997 Supplement, section
256.01, subdivision 2, is amended to read:
Subd. 2. [SPECIFIC POWERS.] Subject to the provisions of
section 241.021, subdivision 2, the commissioner of human services shall:
(1) Administer and supervise all forms of public
assistance provided for by state law and other welfare activities or services as
are vested in the commissioner. Administration and supervision of human services
activities or services includes, but is not limited to, assuring timely and
accurate distribution of benefits, completeness of service, and quality program
management. In addition to administering and supervising human services
activities vested by law in the department, the commissioner shall have the
authority to:
(a) require county agency participation in training and
technical assistance programs to promote compliance with statutes, rules,
federal laws, regulations, and policies governing human services;
(b) monitor, on an ongoing basis, the performance of
county agencies in the operation and administration of human services, enforce
compliance with statutes, rules, federal laws, regulations, and policies
governing welfare services and promote excellence of administration and program
operation;
(c) develop a quality control program or other monitoring
program to review county performance and accuracy of benefit determinations;
(d) require county agencies to make an adjustment to the
public assistance benefits issued to any individual consistent with federal law
and regulation and state law and rule and to issue or recover benefits as
appropriate;
(e) delay or deny payment of all or part of the state and
federal share of benefits and administrative reimbursement according to the
procedures set forth in section 256.017; (f) make contracts with and grants to public and private
agencies and organizations, both profit and nonprofit, and individuals, using
appropriated funds; and
(g) enter into contractual
agreements with federally recognized Indian tribes with a reservation in
Minnesota to the extent necessary for the tribe to operate a federally approved
family assistance program or any other program under the supervision of the
commissioner. The commissioner may establish necessary accounts for the purposes
of receiving and disbursing funds as necessary for the operation of the
programs.
(2) Inform county agencies, on a timely basis, of changes
in statute, rule, federal law, regulation, and policy necessary to county agency
administration of the programs.
(3) Administer and supervise all child welfare
activities; promote the enforcement of laws protecting handicapped, dependent,
neglected and delinquent children, and children born to mothers who were not
married to the children's fathers at the times of the conception nor at the
births of the children; license and supervise child-caring and child-placing
agencies and institutions; supervise the care of children in boarding and foster
homes or in private institutions; and generally perform all functions relating
to the field of child welfare now vested in the state board of control.
(4) Administer and supervise all noninstitutional service
to handicapped persons, including those who are visually impaired, hearing
impaired, or physically impaired or otherwise handicapped. The commissioner may
provide and contract for the care and treatment of qualified indigent children
in facilities other than those located and available at state hospitals when it
is not feasible to provide the service in state hospitals.
(5) Assist and actively cooperate with other departments,
agencies and institutions, local, state, and federal, by performing services in
conformity with the purposes of Laws 1939, chapter 431.
(6) Act as the agent of and cooperate with the federal
government in matters of mutual concern relative to and in conformity with the
provisions of Laws 1939, chapter 431, including the administration of any
federal funds granted to the state to aid in the performance of any functions of
the commissioner as specified in Laws 1939, chapter 431, and including the
promulgation of rules making uniformly available medical care benefits to all
recipients of public assistance, at such times as the federal government
increases its participation in assistance expenditures for medical care to
recipients of public assistance, the cost thereof to be borne in the same
proportion as are grants of aid to said recipients.
(7) Establish and maintain any administrative units
reasonably necessary for the performance of administrative functions common to
all divisions of the department.
(8) Act as designated guardian of both the estate and the
person of all the wards of the state of Minnesota, whether by operation of law
or by an order of court, without any further act or proceeding whatever, except
as to persons committed as mentally retarded. For children under the
guardianship of the commissioner whose interests would be best served by
adoptive placement, the commissioner may contract with a licensed child-placing
agency to provide adoption services. A contract with a licensed child-placing
agency must be designed to supplement existing county efforts and may not
replace existing county programs, unless the replacement is agreed to by the
county board and the appropriate exclusive bargaining representative or the
commissioner has evidence that child placements of the county continue to be
substantially below that of other counties.
(9) Act as coordinating referral and informational center
on requests for service for newly arrived immigrants coming to Minnesota.
(10) The specific enumeration of powers and duties as
hereinabove set forth shall in no way be construed to be a limitation upon the
general transfer of powers herein contained.
(11) Establish county, regional, or statewide schedules
of maximum fees and charges which may be paid by county agencies for medical,
dental, surgical, hospital, nursing and nursing home care and medicine and
medical supplies under all programs of medical care provided by the state and
for congregate living care under the income maintenance programs.
(12) Have the authority to conduct and administer
experimental projects to test methods and procedures of administering assistance
and services to recipients or potential recipients of public welfare. To carry
out such experimental projects, it is further provided that the commissioner of
human services is authorized to waive the enforcement of existing specific
statutory program requirements, rules, and standards in one or more counties.
The order establishing the waiver shall provide alternative methods and
procedures of administration, shall not be in conflict with the basic purposes,
coverage, or benefits provided by law, and in no event shall the duration of a
project exceed four years. It is further provided that no order establishing an
experimental project as authorized by the provisions of this section shall
become effective until the following conditions have been met:
(a) The secretary of health, education, and welfare of
the United States has agreed, for the same project, to waive state plan
requirements relative to statewide uniformity.
(b) A comprehensive plan, including estimated project
costs, shall be approved by the legislative advisory commission and filed with
the commissioner of administration.
(13) According to federal requirements, establish
procedures to be followed by local welfare boards in creating citizen advisory
committees, including procedures for selection of committee members.
(14) Allocate federal fiscal disallowances or sanctions
which are based on quality control error rates for the aid to families with
dependent children, Minnesota family investment program-statewide, medical
assistance, or food stamp program in the following manner:
(a) One-half of the total amount of the disallowance
shall be borne by the county boards responsible for administering the programs.
For the medical assistance, MFIP-S, and AFDC programs, disallowances shall be
shared by each county board in the same proportion as that county's expenditures
for the sanctioned program are to the total of all counties' expenditures for
the AFDC, MFIP-S, and medical assistance programs. For the food stamp program,
sanctions shall be shared by each county board, with 50 percent of the sanction
being distributed to each county in the same proportion as that county's
administrative costs for food stamps are to the total of all food stamp
administrative costs for all counties, and 50 percent of the sanctions being
distributed to each county in the same proportion as that county's value of food
stamp benefits issued are to the total of all benefits issued for all counties.
Each county shall pay its share of the disallowance to the state of Minnesota.
When a county fails to pay the amount due hereunder, the commissioner may deduct
the amount from reimbursement otherwise due the county, or the attorney general,
upon the request of the commissioner, may institute civil action to recover the
amount due.
(b) Notwithstanding the provisions of paragraph (a), if
the disallowance results from knowing noncompliance by one or more counties with
a specific program instruction, and that knowing noncompliance is a matter of
official county board record, the commissioner may require payment or recover
from the county or counties, in the manner prescribed in paragraph (a), an
amount equal to the portion of the total disallowance which resulted from the
noncompliance, and may distribute the balance of the disallowance according to
paragraph (a).
(15) Develop and implement special projects that maximize
reimbursements and result in the recovery of money to the state. For the purpose
of recovering state money, the commissioner may enter into contracts with third
parties. Any recoveries that result from projects or contracts entered into
under this paragraph shall be deposited in the state treasury and credited to a
special account until the balance in the account reaches $1,000,000. When the
balance in the account exceeds $1,000,000, the excess shall be transferred and
credited to the general fund. All money in the account is appropriated to the
commissioner for the purposes of this paragraph.
(16) Have the authority to make direct payments to
facilities providing shelter to women and their children according to section
256D.05, subdivision 3. Upon the written request of a shelter facility that has
been denied payments under section 256D.05, subdivision 3, the commissioner
shall review all relevant evidence and make a determination within 30 days of
the request for review regarding issuance of direct payments to the shelter
facility. Failure to act within 30 days shall be considered a determination not
to issue direct payments.
(17) Have the authority to establish and enforce the
following county reporting requirements:
(a) The commissioner shall establish fiscal and
statistical reporting requirements necessary to account for the expenditure of
funds allocated to counties for human services programs. When establishing
financial and statistical reporting requirements, the commissioner shall
evaluate all reports, in consultation with the counties, to determine if the
reports can be simplified or the number of reports can be reduced.
(b) The county board shall submit monthly or quarterly
reports to the department as required by the commissioner. Monthly reports are
due no later than 15 working days after the end of the month. Quarterly reports
are due no later than 30 calendar days after the end of the quarter, unless the
commissioner determines that the deadline must be shortened to 20 calendar days
to avoid jeopardizing compliance with federal deadlines or risking a loss of
federal funding. Only reports that are complete, legible, and in the required
format shall be accepted by the commissioner.
(c) If the required reports are not received by the
deadlines established in clause (b), the commissioner may delay payments and
withhold funds from the county board until the next reporting period. When the
report is needed to account for the use of federal funds and the late report
results in a reduction in federal funding, the commissioner shall withhold from
the county boards with late reports an amount equal to the reduction in federal
funding until full federal funding is received.
(d) A county board that submits reports that are late,
illegible, incomplete, or not in the required format for two out of three
consecutive reporting periods is considered noncompliant. When a county board is
found to be noncompliant, the commissioner shall notify the county board of the
reason the county board is considered noncompliant and request that the county
board develop a corrective action plan stating how the county board plans to
correct the problem. The corrective action plan must be submitted to the
commissioner within 45 days after the date the county board received notice of
noncompliance.
(e) The final deadline for fiscal reports or amendments
to fiscal reports is one year after the date the report was originally due. If
the commissioner does not receive a report by the final deadline, the county
board forfeits the funding associated with the report for that reporting period
and the county board must repay any funds associated with the report received
for that reporting period.
(f) The commissioner may not delay payments, withhold
funds, or require repayment under paragraph (c) or (e) if the county
demonstrates that the commissioner failed to provide appropriate forms,
guidelines, and technical assistance to enable the county to comply with the
requirements. If the county board disagrees with an action taken by the
commissioner under paragraph (c) or (e), the county board may appeal the action
according to sections 14.57 to 14.69.
(g) Counties subject to withholding of funds under
paragraph (c) or forfeiture or repayment of funds under paragraph (e) shall not
reduce or withhold benefits or services to clients to cover costs incurred due
to actions taken by the commissioner under paragraph (c) or (e).
(18) Allocate federal fiscal disallowances or sanctions
for audit exceptions when federal fiscal disallowances or sanctions are based on
a statewide random sample for the foster care program under title IV-E of the
Social Security Act, United States Code, title 42, in direct proportion to each
county's title IV-E foster care maintenance claim for that period.
(19) Be responsible for ensuring the detection,
prevention, investigation, and resolution of fraudulent activities or behavior
by applicants, recipients, and other participants in the human services programs
administered by the department.
(20) Require county agencies to identify overpayments,
establish claims, and utilize all available and cost-beneficial methodologies to
collect and recover these overpayments in the human services programs
administered by the department.
(21) Have the authority to administer a drug rebate
program for drugs purchased pursuant to the senior citizen drug program
established under section 256.955 after the beneficiary's satisfaction of any
deductible established in the program. The commissioner shall require a rebate
agreement from all manufacturers of covered drugs as defined in section
256B.0625, subdivision 13. For each drug, the amount of the rebate shall be
equal to the basic rebate as defined for purposes of the federal rebate program
in United States Code, title 42, section 1396r-8(c)(1). This basic rebate shall
be applied to single-source and multiple-source drugs. The manufacturers must
provide full payment within 30 days of receipt of the state
invoice for the rebate within the terms and conditions
used for the federal rebate program established pursuant to section 1927 of
title XIX of the Social Security Act. The manufacturers must provide the
commissioner with any information necessary to verify the rebate determined per
drug. The rebate program shall utilize the terms and conditions used for the
federal rebate program established pursuant to section 1927 of title XIX of the
Social Security Act.
Sec. 6. Minnesota Statutes 1996, section 256.014,
subdivision 1, is amended to read:
Subdivision 1. [ESTABLISHMENT OF SYSTEMS.] The
commissioner of human services shall establish and enhance computer systems
necessary for the efficient operation of the programs the commissioner
supervises, including:
(1) management and administration of the food stamp and
income maintenance programs, including the electronic distribution of benefits;
(2) management and administration of the child support
enforcement program; and
(3) administration of medical assistance and general
assistance medical care.
The commissioner shall distribute the nonfederal share of
the costs of operating and maintaining the systems to the commissioner and to
the counties participating in the system in a manner that reflects actual system
usage, except that the nonfederal share of the costs of the MAXIS computer
system and child support enforcement systems shall be borne entirely by the
commissioner. Development costs must not be assessed against county agencies.
The commissioner may enter into
contractual agreements with federally recognized Indian tribes with a
reservation in Minnesota to participate in state-operated computer systems
related to the management and administration of the food stamp, income
maintenance, child support enforcement, medical assistance, and general
assistance medical care programs to the extent necessary for the tribe to
operate a federally approved family assistance program or any other program
under the supervision of the commissioner.
Sec. 7. Minnesota Statutes 1997 Supplement, section
256.031, subdivision 6, is amended to read:
Subd. 6. [END OF FIELD TRIALS.] (a) Upon agreement with the federal government, the
field trials of the Minnesota family investment plan will end June 30, 1998.
(b) Families in the comparison
group under subdivision 3, paragraph (d), clause (i), receiving aid to families
with dependent children under sections 256.72 to 256.87, and STRIDE services
under section 256.736 will continue in those programs until June 30, 1998. After
June 30, 1998, families who cease receiving assistance under the Minnesota
family investment plan and comparison group families who cease receiving
assistance under AFDC and STRIDE who are eligible for the Minnesota family
investment program-statewide (MFIP-S), medical assistance, general assistance
medical care, or the food stamp program shall be placed with their consent on
the programs for which they are eligible.
(c) Families who cease receiving
assistance under the MFIP and comparison families who cease receiving assistance
under AFDC and STRIDE who are ineligible for MFIP-S due to increased income from
employment, or increased child or spousal support or a combination of employment
income and child or spousal support, shall be eligible for extended medical
assistance under section 256B.0635. For the purpose of determining receipt of
extended medical assistance, receipt of AFDC and MFIP shall be considered to be
the same as receipt of MFIP-S.
Sec. 8. Minnesota Statutes 1997 Supplement, section
256.741, is amended by adding a subdivision to read:
Subd. 2a. [FAMILIES-FIRST
DISTRIBUTION OF CHILD SUPPORT ARREARAGES.] Child support
collected on behalf of a family that formerly received assistance under AFDC,
MFIP, MFIP-R, MFIP-S, or Work First must be distributed as follows:
(1) to the extent that the amount
collected does not exceed the amount required to be paid to the family for the
month in which collected, the state shall distribute the amount to the family;
and
(2) to the extent that the amount
collected exceeds the amount required to be paid to the family for the month in
which collected, the state shall distribute the amount as follows:
(i) the state shall first
distribute the amount collected to the family to the extent necessary to satisfy
any support arrearages accrued after the family ceased to receive assistance
from the state; and
(ii) the state shall then
distribute the amount collected to the family to the extent necessary to satisfy
any support arrearages with respect to the family that accrued before the family
received assistance from the state.
Sec. 9. Minnesota Statutes 1997 Supplement, section
256.9864, is amended to read:
256.9864 [REPORTS BY RECIPIENT.]
(a) An assistance unit with a recent work history or with
earned income shall report monthly to the county agency on income received and
other circumstances affecting eligibility or assistance amounts. All other
assistance units shall report on income and other circumstances affecting
eligibility and assistance amounts, as specified by the state agency.
(b) An assistance unit required to submit a report on the
form designated by the commissioner and within ten days of the due date or the
date of the significant change, whichever is later, or otherwise report
significant changes which would affect eligibility or assistance amounts, is
considered to have continued its application for assistance effective the date
the required report is received by the county agency, if a complete report is
received within a calendar month in which assistance was received Sec. 10. Minnesota Statutes 1997 Supplement, section
256B.062, is amended to read:
256B.062 [CONTINUED ELIGIBILITY.]
Medical assistance may be paid for persons who received
aid to families with dependent children in at least three of the six months
preceding the month in which the person became ineligible for aid to families
with dependent children, if the ineligibility was due to an increase in hours of
employment or employment income or due to the loss of an earned income
disregard. A person who is eligible for extended medical assistance is entitled
to six months of assistance without reapplication, unless the assistance unit
ceases to include a dependent child. For a person under 21 years of age, medical
assistance may not be discontinued within the six-month period of extended
eligibility until it has been determined that the person is not otherwise
eligible for medical assistance. Medical assistance may be continued for an
additional six months if the person meets all requirements for the additional
six months, according to Title XIX of the Social Security Act, as amended by
section 303 of the Family Support Act of 1988, Public Law Number 100-485. This
section is repealed effective Sec. 11. Minnesota Statutes 1997 Supplement, section
256B.0635, is amended by adding a subdivision to read:
Subd. 3. [EXTENDED MEDICAL
ASSISTANCE FOR MFIP-S PARTICIPANTS WHO OPT TO DISCONTINUE MONTHLY CASH
ASSISTANCE.] Upon federal approval, medical assistance is
available to persons who received MFIP-S in at least three of the six months
preceding the month in which the person opted to discontinue receiving MFIP-S
cash assistance under section 256J.31, subdivision 12. A person who is eligible
for medical assistance under this section may receive medical assistance without
reapplication as long as the person meets MFIP-S eligibility requirements,
unless the assistance unit does not include a dependent child. Medical
assistance may be paid pursuant to subdivisions 1 and 2 for persons who are no
longer eligible for MFIP-S due to increased employment or child support.
Sec. 12. Minnesota Statutes 1997 Supplement, section
256D.05, subdivision 8, is amended to read:
Subd. 8. [CITIZENSHIP.] (a) Effective July 1, 1997,
citizenship requirements for applicants and recipients under sections 256D.01 to
256D.03, subdivision 2, and 256D.04 to 256D.21 shall be determined the same as
under section 256J.11 date, and are otherwise eligible for general assistance
can receive benefits under this section (b) As a condition of eligibility, each legal adult
noncitizen in the assistance unit who has resided in the country for four years
or more and who is under 70 years of age must:
(1) be enrolled in a literacy class, English as a second
language class, or a citizen class;
(2) be applying for admission to a literacy class,
English as a second language class, and is on a waiting list;
(3) be in the process of applying for a waiver from the
Immigration and Naturalization Service of the English language or civics
requirements of the citizenship test;
(4) have submitted an application for citizenship to the
Immigration and Naturalization Service and is waiting for a testing date or a
subsequent swearing in ceremony; or
(5) have been denied citizenship due to a failure to pass
the test after two attempts or because of an inability to understand the rights
and responsibilities of becoming a United States citizen, as documented by the
Immigration and Naturalization Service or the county.
If the county social service agency determines that a
legal noncitizen subject to the requirements of this subdivision will require
more than one year of English language training, then the requirements of clause
(1) or (2) shall be imposed after the legal noncitizen has resided in the
country for three years. Individuals who reside in a facility licensed under
chapter 144A, 144D, 245A, or 256I are exempt from the requirements of this
section.
Sec. 13. Minnesota Statutes 1996, section 256D.051, is
amended by adding a subdivision to read:
Subd. 18. [WAIVER OF SERVICE
COST REIMBURSEMENT LIMIT FOR PARTICIPANTS WITH SIGNIFICANT BARRIERS TO
EMPLOYMENT.]
(a) To the extent of available
resources, the commissioner may waive the $400 service cost limit specified in
subdivision 6 for county agencies who propose to provide enhanced services under
the food stamp employment and training program to hard-to-employ individuals. A
"hard-to-employ individual" is defined as:
(1) a recipient of general
assistance under chapter 256D; or
(2) an individual with at least
one of the following three barriers to employment:
(i) the individual has not
completed secondary school or obtained a general equivalency development diploma
or an adult diploma, and has low skills in reading or mathematics;
(ii) the individual requires
substance abuse treatment for employment; and
(iii) the individual has a poor
work history.
(b) To obtain a waiver, the county
agency must submit a waiver request to the commissioner. The request must
specify:
(1) the number of hard-to-employ
individuals the agency plans to serve;
(2) the nature of the enhanced
employment and training services the agency will provide; and
(3) the agency's plan for
providing referrals for substance abuse assessment and treatment for
hard-to-employ individuals who require substance abuse treatment for
employment.
Sec. 14. [256D.053] [MINNESOTA FOOD ASSISTANCE PROGRAM.]
Subdivision 1. [PROGRAM
ESTABLISHED.] For the period from July 1, 1998, to June
30, 1999, the Minnesota food assistance program is established to provide food
assistance to legal noncitizens residing in this state who are ineligible to
participate in the federal food stamp program solely due to the provisions of
section 402 or 403 of Public Law Number 104-193, as authorized by Title VII of
the 1997 Emergency Supplemental Appropriations Act, Public Law Number
105-18.
Subd. 2. [ELIGIBILITY
REQUIREMENTS.] To be eligible for the Minnesota food
assistance program, all of the following conditions must be met:
(1) the applicant must meet the
initial and ongoing eligibility requirements for the federal food stamp program,
except for the applicant's ineligible immigration status;
(2) the applicant must be either a
qualified noncitizen as defined in section 256J.08, subdivision 73, or a
noncitizen otherwise residing lawfully in the United States;
(3) the applicant must be a
resident of the state; and
(4) the applicant must not be
receiving assistance under the Minnesota family investment program-statewide or
the work first program.
Subd. 3. [PROGRAM
ADMINISTRATION.] (a) The rules for the Minnesota food
assistance program shall follow exactly the regulations for the federal food
stamp program, except for the provisions pertaining to immigration status under
section 402 or 403 of Public Law Number 104-193.
(b) The county agency shall use
the income, budgeting, and benefit allotment regulations of the federal food
stamp program to calculate an eligible recipient's monthly Minnesota food
assistance program benefit. Until September 30, 1998, eligible recipients under
this subdivision shall receive the average per person food stamp issuance in
Minnesota in the fiscal year ending June 30, 1997. Beginning October 1, 1998,
eligible recipients shall receive the same level of benefits as those provided
by the federal food stamp program to similarly situated citizen recipients. The
monthly Minnesota food assistance program benefits shall not exceed an amount
equal to the amount of federal food stamp benefits the household would receive
if all members of the household were eligible for the federal food stamp
program.
(c) Minnesota food assistance
program benefits must be disregarded as income in all programs that do not count
food stamps as income.
(d) The county agency must
redetermine a Minnesota food assistance program recipient's eligibility for the
federal food stamp program when the agency receives information that the
recipient's legal immigration status has changed in such a way that would make
the recipient potentially eligible for the federal food stamp program.
(e) Until October 1, 1998, the
commissioner may provide benefits under this section in cash.
Subd. 4. [STATE PLAN
REQUIRED.] The commissioner shall submit a state plan to
the secretary of agriculture to allow the commissioner to purchase federal food
stamp benefits for each Minnesota food assistance program recipient who is
ineligible to participate in the federal food stamp program solely due to the
provisions of section 402 or 403 of Public Law Number 104-193, as authorized by
Title VII of the 1997 Emergency Supplemental Appropriations Act, Public Law
Number 105-18. The commissioner shall enter into a contract as necessary with
the secretary to use the existing federal food stamp benefit delivery system for
the purposes of administering the Minnesota food assistance program under this
section.
Sec. 15. Minnesota Statutes 1996, section 256D.46,
subdivision 2, is amended to read:
Subd. 2. [INCOME AND RESOURCE TEST.] All income and
resources available to the recipient must be considered in determining the
recipient's ability to meet the emergency need. Property that can be liquidated
in time to resolve the emergency and income, Sec. 16. Minnesota Statutes 1997 Supplement, section
256J.02, subdivision 4, is amended to read:
Subd. 4. [AUTHORITY TO TRANSFER.] Subject to limitations
of title I of Public Law Number 104-193, the Personal Responsibility and Work
Opportunity Reconciliation Act of 1996, as amended,
the legislature may transfer money from the TANF block grant to the child care
fund under chapter 119B, or the Title XX block grant under section 256E.07.
Sec. 17. Minnesota Statutes 1997 Supplement, section
256J.03, is amended to read:
256J.03 [TANF RESERVE ACCOUNT.]
Subdivision 1. The Funds deposited in the reserve
account Subd. 2. [AUTHORIZATION TO
ACCELERATE EXPENDITURE OF TANF FUNDS.] The commissioner
may expend federal Temporary Assistance to Needy Families block grant funds in
excess of appropriated levels for the purpose of accelerating federal funding of
the MFIP program. By the end of the fiscal year in which the additional federal
expenditures are made, the commissioner must deposit into the reserve account an
amount of unexpended state funds appropriated for assistance to families grants,
aid to families with dependent children, and Minnesota family investment plan
equal to the additional federal expenditures. Reserve funds may be spent as TANF
appropriations if insufficient TANF funds are available because of
acceleration.
Subd. 3. [ALLOWED TRANSFER
PURPOSE.] Funds from the reserve account may be used for
the following purposes:
(1) unanticipated Temporary
Assistance to Needy Families block grant maintenance of effort shortfalls;
(2) MFIP cost increases due to
reduced federal revenues and federal law changes;
(3) one-half of the MFIP general
fund cost increase in fiscal year 2000 and subsequent fiscal years due to
caseload increases over fiscal year 1999; and
(4) transfers allowed under
section 256J.02, subdivision 4.
Sec. 18. Minnesota Statutes 1997 Supplement, section
256J.08, subdivision 11, is amended to read:
Subd. 11. [CAREGIVER.] "Caregiver" means a minor child's
natural or adoptive parent or parents and stepparent
who live in the home with the minor child. For purposes of determining
eligibility for this program, caregiver also means any of the following
individuals, if adults, who live with and provide care and support to a minor
child when the minor child's natural or adoptive parent or parents or stepparent do not reside in the same home: legal Sec. 19. Minnesota Statutes 1997 Supplement, section
256J.08, is amended by adding a subdivision to read:
Subd. 24a. [DISQUALIFIED.] "Disqualified" means being ineligible to receive MFIP-S due
to noncooperation with program requirements. Except for persons whose
disqualification is based on fraud, a disqualified person can take action to
correct the reason for ineligibility.
[NOTICE ON CHANGES IN ASSET TEST.]
The commissioner shall provide a notice by July 15, 1997, to all recipients
affected by the changes in this act in asset standards for families with
children notifying them:
(1) what asset limits will apply
to them;
(2) when the new limits will
apply;
(3) what options they have to
spenddown assets; and
(4) what options they have to
enroll in MinnesotaCare, including an explanation of the MinnesotaCare premium
structure.
[AUGMENTATIVE AND ALTERNATIVE
COMMUNICATION SYSTEMS.] Augmentative and alternative communication systems and
related components that are prior authorized by the department through pass
through vendors during the period from January 1, 1997, until the augmentative
and alternative communication system purchasing program or other alternatives
are operational shall be paid under the medical assistance program at the actual
price charged the pass through vendor plus 20 percent to cover administrative
costs of prior authorization and billing and shipping charges.
determined on a pro rata basis $2,659,000.
$276,741,000 $240,936,000 in fiscal year 1998 and $265,795,000 $272,083,000 in
fiscal year 1999. Additional TANF funds may be expended,
but only to the extent that an equal amount of state funds have been transferred
to the TANF reserve under Minnesota Statutes 1997 Supplement, section
256J.03.
alternative dispute resolution arbitration to appeal a health maintenance
organization's internal appeal decision. The health
maintenance organization must also inform enrollees that they have the right to
use arbitration to appeal a health maintenance organization's internal appeal
decision not to certify an admission, procedure, service, or extension of stay
under section 62M.06. If an enrollee chooses to use an alternative dispute resolution process arbitration, the health maintenance organization must
participate.
or
a health plan an
entity that is subject to this section from taking action against a provider
if the health plan entity
has evidence that the provider's actions are illegal, constitute medical
malpractice, or are contrary to accepted medical practices.
health plan or health plan company entity that is subject to this section.
. Notwithstanding
any other law to the contrary, the disclosure statement may voluntarily be filed
with the commissioner for approval and must be filed
with and approved by the commissioner prior to its use.
voluntarily been filed with the commissioner for
approval under chapter 72C or voluntarily filed with the
commissioner for approval for purposes other than pursuant to chapter 72C paragraph (c) is deemed approved 30 days after the date
of filing, unless approved or disapproved by the commissioner on or before the
end of that 30-day period.
1998 1999, an informal
complaint resolution process that meets the requirements of this section. A
health plan company must make reasonable efforts to resolve enrollee complaints,
and must inform complainants in writing of the company's decision within 30 days
of receiving the complaint. The complaint resolution process must treat the
complaint and information related to it as required under sections 72A.49 to
72A.505.
1998 1999. If the
disputed issue relates to whether a service is appropriate and necessary, the
commissioner shall issue an order only after consulting with appropriate experts
knowledgeable, trained, and practicing in the area in dispute, reviewing
pertinent literature, and considering the availability of satisfactory
alternatives. The commissioner shall take steps including but not limited to
fining, suspending, or revoking the license of a health plan company that is the
subject of repeated orders by the commissioner that suggests a pattern of
inappropriate underutilization.
or, a single petroleum bulk storage site excluding tank
farms, or a single agricultural chemical facility
site, the construction permit fee is $120, which includes the state core
function fee, per site regardless of the number of wells constructed on the
site, and the annual fee for a maintenance permit for unsealed monitoring wells
is $100 per site regardless of the number of monitoring wells located on site;
Fees received pursuant to this subdivision shall be
deposited in the general fund of the state treasury. Upon the withdrawal of
approval of a reporting organization, or the decision of the commissioner to not
renew a reporting organization, fees collected under section 144.702 shall be
submitted to the commissioner and deposited in the
general fund. Fees received under this subdivision
shall be deposited in a revolving fund and are appropriated to the commissioner
of health for the purposes of sections 144.695 to 144.703. The commissioner
shall report the termination or nonrenewal of the voluntary reporting
organization to the chair of the health and human services subdivision of the
appropriations committee of the house of representatives, to the chair of the
health and human services division of the finance committee of the senate, and
the commissioner of finance.
section 144.701, subdivision 4 1, but not expended shall
be deposited in the general fund a revolving fund and are appropriated to the commissioner of
health for the purposes of sections 144.695 to 144.703.
childhood Lead Poisoning Prevention Act."
in response to a lead
order to make a residence, child care facility, school, or playground
lead-safe by complying with the lead standards and methods adopted under section
144.9508, by:
lead
contractor complying persons hired by the property
owner to comply with a lead order issued under section 144.9504; or
qualitative or quantitative analytical inspection of a residence for deteriorated paint
or bare soil and the collection of samples of deteriorated paint, bare soil,
dust, or drinking water for analysis to determine if the lead concentrations in
the samples exceed standards adopted under section 144.9508. Lead inspection
includes the clearance inspection after the completion of a lead order measurement of the lead content of paint and a visual
identification of the existence and location of bare soil.
inspecting assessing agency.
any person who is certified an
individual who performs lead abatement or lead hazard reduction and who has been
licensed by the commissioner under section 144.9505.
a person who is certified an
individual who performs swab team services and who has been licensed by the
commissioner as a lead worker under section 144.9505.
action undertaken by a
property owner with the intention to engage in lead hazard reduction or
abatement lead hazard reduction activities defined in
subdivision 17, but not undertaken in response to
the issuance of a lead order.
or other facility, or
individual performing blood lead analysis shall report the results after the
analysis of each specimen analyzed, for both capillary and venous specimens, and
epidemiologic information required in this section to the commissioner of
health, within the time frames set forth in clauses (1) and (2):
a any
capillary result or for a
venous blood lead level less than 15 micrograms of lead per deciliter of whole
blood.
The reporting requirements of this
subdivision shall expire on December 31, 1997. Beginning January 1, 1998, every
hospital, medical clinic, medical laboratory, or other facility performing blood
lead analysis shall report the results within two working days by telephone,
fax, or electronic transmission, with written or electronic confirmation within
one month, for capillary or venous blood lead level equal to the level for which
reporting is recommended by the Center for Disease Control.
elevated blood lead level, and the
person's birthdate, gender, and race.
elevated blood lead levels, including analytic results
from samples of paint, soil, dust, and drinking water taken from the
individual's home and immediate property, shall be private and may only be used
by the commissioner of health, the commissioner of labor
and industry, authorized agents of Indian tribes, and authorized employees
of local boards of health for the purposes set forth in this section.
visual
inspections lead hazard screens whenever possible
and must at least include lead hazard management reduction for deteriorated interior lead-based paint,
bare soil, and dust.
contractors persons hired to do voluntary lead abatement or lead hazard reduction must be
lead contractors by the commissioner under section 144.9505 or 144.9506.
Renters and volunteers performing lead abatement or lead hazard reduction must
be trained and licensed as lead supervisors or lead workers. If a property
owner does not use a lead contractor hire a person for voluntary lead abatement or lead hazard reduction, the property owner
shall provide the commissioner with a work plan for
lead abatement or lead hazard reduction at least ten
working days before beginning the lead abatement or
lead hazard reduction. The work plan must include the
details required in section 144.9505, and notice as to when lead abatement or lead hazard reduction activities will
begin. Within the limits of appropriations, the commissioner shall review work plans and shall approve or disapprove them as to
compliance with the requirements in section 144.9505. No penalty shall be
assessed against a property owner for discontinuing voluntary lead hazard
reduction before completion of the work plan,
provided that the property owner discontinues the plan lead hazard reduction in
a manner that leaves the property in a condition no more hazardous than its
condition before the work plan implementation.
subdivision paragraph.
inspections risk assessments
for purposes of secondary prevention, according to the provisions of this
section. A board of health not serving cities of the first class must conduct
lead inspections risk
assessments for the purposes of secondary prevention, unless they certify certified in writing
to the commissioner by January 1, 1996, that they desire desired to relinquish
these duties back to the commissioner. At the discretion
of the commissioner, a board of health may relinquish the authority and duty to
perform lead risk assessments for secondary prevention by so certifying in
writing to the commissioner by December 31, 1999. At the discretion of the
commissioner, a board of health may, upon written request to the commissioner,
resume these duties.
Inspections Lead risk assessments must be conducted by a board of
health serving a city of the first class. The commissioner must conduct lead inspections risk assessments
in any area not including cities of the first class where a board of health has
relinquished to the commissioner the responsibility for lead inspections risk assessments.
The commissioner shall coordinate with the board of health to ensure that the
requirements of this section are met.
inspections risk
assessments.
INSPECTION RISK ASSESSMENT.] (a) An inspecting assessing agency
shall conduct a lead inspection risk assessment of a residence according to the venous
blood lead level and time frame set forth in clauses (1) to (5) for purposes of
secondary prevention:
inspecting assessing agency may also conduct a lead inspection risk assessment
for children with any elevated blood lead level.
inspecting assessing agency
shall inspect the individual unit in which the conditions of this section are
met and shall also inspect all common areas. If a child visits one or more other
sites such as another residence, or a residential or commercial child care
facility, playground, or school, the inspecting assessing agency shall also inspect the other sites. The
inspecting assessing
agency shall have one additional day added to the time frame set forth in this
subdivision to complete the lead inspection risk assessment for each additional site.
inspecting assessing agency
shall identify the known addresses for the previous 12 months of the child or
pregnant female with venous blood lead levels of at least 20 micrograms per
deciliter for the child or at least ten micrograms per deciliter for the
pregnant female; notify the property owners, landlords, and tenants at those
addresses that an elevated blood lead level was found in a person who resided at
the property; and give them a copy of the lead inspection risk assessment
guide. The inspecting assessing agency shall provide the notice required by
this subdivision without identifying the child or pregnant female with the
elevated blood lead level. The inspecting assessing agency is not required to obtain the consent
of the child's parent or guardian or the consent of the pregnant female for
purposes of this subdivision. This information shall be classified as private
data on individuals as defined under section 13.02, subdivision 12.
inspecting assessing agency shall conduct the lead inspection risk assessment
according to rules adopted by the commissioner under section 144.9508. An inspecting assessing agency
shall have lead inspections risk assessments performed by lead inspectors risk assessors
licensed by the commissioner according to rules adopted under section 144.9508.
If a property owner refuses to allow an inspection a lead risk assessment, the inspecting assessing agency
shall begin legal proceedings to gain entry to the property and the time frame
for conducting a lead inspection risk assessment set forth in this subdivision no longer
applies. An inspector A lead
risk assessor or inspecting assessing agency may observe the performance of lead
hazard reduction in progress and shall enforce the provisions of this section
under section 144.9509. Deteriorated painted surfaces, bare soil, and dust, and drinking water
must be tested with appropriate analytical equipment
inspector risk assessor shall notify the commissioner and the
board of health of all violations of lead standards under section 144.9508, that
are identified in a lead inspection risk assessment conducted under this section.
inspecting assessing agency shall establish an administrative
appeal procedure which allows a property owner to contest the nature and
conditions of any lead order issued by the inspecting
assessing agency. Inspecting Assessing agencies
must consider appeals that propose lower cost methods that make the residence
lead safe.
inspecting assessing agency from charging a property owner for the
cost of a lead inspection risk
assessment.
inspection risk assessment
or following a lead order, the inspecting assessing agency shall ensure that a family will receive
a visit at their residence by a swab team worker or public health professional,
such as a nurse, sanitarian, public health educator, or other public health
professional. The swab team worker or public health professional shall inform
the property owner, landlord, and the tenant of the health-related aspects of
lead exposure; nutrition; safety measures to minimize exposure; methods to be
followed before, during, and after the lead hazard reduction process; and
community, legal, and housing resources. If a family moves to a temporary
residence during the lead hazard reduction process, lead education services
should be provided at the temporary residence whenever feasible.
INSPECTION RISK ASSESSMENT GUIDES.] (a) The commissioner of health
shall develop or purchase lead inspection risk assessment guides that enable parents and other
caregivers to assess the possible lead sources present and that suggest lead
hazard reduction actions. The guide must provide information on lead hazard
reduction and disposal methods, sources of equipment, and telephone numbers for
additional information to enable the persons to either select a lead contractor persons
licensed by the commissioner under section 144.9505 or 144.9506 to perform lead
hazard reduction or perform the lead hazard reduction themselves. The guides must explain:
inspecting assessing agency shall provide the lead inspection risk assessment
guides at no cost to:
inspecting assessing agency shall provide the lead inspection risk assessment
guides on request to owners or occupants of residential property, builders,
contractors, inspectors, and the public within the jurisdiction of the inspecting assessing agency.
inspecting assessing agency,
after conducting a lead inspection risk assessment, shall order a property owner to perform
lead hazard reduction on all lead sources that exceed a standard adopted
according to section 144.9508. If lead inspections risk assessments and lead orders are conducted at times
when weather or soil conditions do not permit the lead inspection risk assessment or
lead hazard reduction, external surfaces and soil lead shall be inspected, and
lead orders complied with, if necessary, at the first opportunity that weather
and soil conditions allow. If the paint standard under section 144.9508 is
violated, but the paint is intact, the inspecting assessing agency shall not order the paint to be removed
unless the intact paint is a known source of actual lead exposure to a specific
person. Before the inspecting assessing agency may order the intact paint to be
removed, a reasonable effort must be made to protect the child and preserve the
intact paint by the use of guards or other protective devices and methods.
Whenever windows and doors or other components covered with deteriorated
lead-based paint have sound substrate or are not rotting, those components
should be repaired, sent out for stripping or be planed down to remove
deteriorated lead-based paint or covered with protective guards instead of being
replaced, provided that such an activity is the least cost method. However, a property owner who has been ordered to perform
lead hazard reduction may choose any method to address deteriorated lead-based
paint on windows, doors, or other components, provided that the method is
approved in rules adopted under section 144.9508 and that it is appropriate to
the specific property. Lead orders must require that any source of damage,
such as leaking roofs, plumbing, and windows, be repaired or replaced, as
needed, to prevent damage to lead-containing interior surfaces. The inspecting assessing agency
is not required to pay for lead hazard reduction. Lead orders must be issued
within 30 days of receiving the blood lead level analysis. The inspecting assessing agency
shall enforce the lead orders issued to a property owner under this section. A
copy of the lead order must be forwarded to the commissioner.
inspection risk assessment or
after issuing lead orders, the inspecting assessing agency, within the limits of appropriations
and availability, shall offer the property owner the services of a swab team
free of charge and, if accepted, shall send a swab team within ten working days
to the residence to perform swab team services as defined in section 144.9501.
If the inspecting assessing agency provides swab team services after a
lead inspection risk
assessment, but before the issuance of a lead order, swab team services do
not need to be repeated after the issuance of the lead order if the swab team
services fulfilled the lead order. Swab team services are not considered
completed until the clearance inspection required under this section shows that
the property is lead safe.
inspecting assessing agency shall ensure that residents are
relocated from rooms or dwellings during a lead hazard reduction process that
generates leaded dust, such as removal or disruption of lead-based paint or
plaster that contains lead. Residents shall not remain in rooms or dwellings
where the lead hazard reduction process is occurring. An inspecting assessing agency
is not required to pay for relocation unless state or federal funding is
available for this purpose. The inspecting assessing agency shall make an effort to assist the
resident in locating resources that will provide assistance with relocation
costs. Residents shall be allowed to return to the residence or dwelling after
completion of the lead hazard reduction process. An inspecting assessing agency
shall use grant funds under section 144.9507 if available, in cooperation with
local housing agencies, to pay for moving costs and rent for a temporary
residence for any low-income resident temporarily relocated during lead hazard
reduction. For purposes of this section, "low-income resident" means any
resident whose gross household income is at or below 185 percent of federal
poverty level.
inspecting assessing
agency to vacate the premises during lead hazard reduction, notwithstanding any
rental agreement or lease provisions:
use a lead contractor hire a person licensed by the commissioner under section
144.9505 for compliance with the lead orders, the property owner shall
submit a work plan to the inspecting assessing agency
within 30 days after receiving the orders. The work
plan must include the details required in section 144.9505 as to how the
property owner intends to comply with the lead orders and notice as to when lead
hazard reduction activities will begin. Within the limits of appropriations, the
commissioner shall review plans and shall approve or disapprove them as to
compliance with the requirements in section 144.9505, subdivision 5. Renters and volunteers performing lead abatement or lead
hazard reduction must be trained and licensed as lead supervisors or lead
workers under section 144.9505.
inspecting assessing agency
shall conduct a clearance inspection by visually
inspecting the residence for visual identification
of deteriorated paint and bare soil and retest the dust lead concentration
in the residence to assure that violations of the lead standards under section
144.9508 no longer exist. The inspecting assessing agency is not required to test a dwelling unit
after lead hazard reduction that was not ordered by the inspecting assessing agency.
inspection risk assessment is
completed and the responsibility of the inspecting assessing agency ends when all of the following
conditions are met:
Lead contractors A person
shall, before performing abatement or lead hazard reduction or providing planning services for lead abatement or lead
hazard reduction, obtain a license from the commissioner as a lead supervisor, lead worker, or lead project
designer. Workers for lead contractors shall obtain
certification from the commissioner. The commissioner shall specify training
and testing requirements for licensure and certification as required in section
144.9508 and shall charge a fee for the cost of issuing a license or certificate
and for
Fees collected under this section shall be set in amounts to
be determined by the commissioner to cover but not exceed the costs of adopting
rules under section 144.9508, the costs of licensure, certification, and
training, and the costs of enforcing licenses and certificates under this
section. License fees shall be nonrefundable and must
be submitted with each application in the amount of $50 for each lead
supervisor, lead worker, or lead inspector and $100 for each lead project
designer, lead risk assessor, or certified firm. All fees received shall be
paid into the state treasury and credited to the lead abatement licensing and
certification account and are appropriated to the commissioner to cover costs
incurred under this section and section 144.9508.
Contractors Persons shall not advertise or otherwise present
themselves as lead contractors supervisors, lead workers, or lead project designers
unless they have lead contractor licenses issued by
the department of health commissioner under section 144.9505.
inspecting assessing agency.
lead
contractor person who performs lead abatement or lead
hazard reduction shall present a lead abatement or lead hazard reduction
work plan to the property owner with each bid or estimate for lead abatement or
lead hazard reduction work. The work plan does not
replace or supersede more stringent contractual agreements. A written lead
abatement or lead hazard reduction work plan must be
prepared which describes the equipment and procedures to be used throughout the
lead abatement or lead hazard reduction work project. At a minimum, the work plan must describe:
A lead contractor The work plan shall itemize the costs for each item
listed in paragraph (a) and for any other expenses associated with the lead
abatement or lead hazard reduction work and shall present
these costs be presented to the property owner
with any bid or estimate for lead abatement or lead hazard reduction work.
A lead contractor The person performing the lead abatement or lead hazard
reduction shall keep a copy of the work plan
readily available at the worksite for the duration of the project and present it
to the inspecting assessing agency on demand.
A lead contractor The person performing the lead abatement or lead hazard
reduction shall keep a copy of the work plan on
record for one year after completion of the project and shall present it to the
inspecting assessing
agency on demand.
inspecting assessing agency or providing services at no cost to a
property owner with funding under a state or federal grant.
lead inspector person shall
obtain a license as a lead inspector or a lead risk
assessor before performing lead inspections, lead
hazard screens, or lead risk assessments and shall renew it annually as required in rules
adopted under section 144.9508. The commissioner shall charge a fee and
require annual refresher
training, as specified in this section. A lead inspector or lead risk assessor shall have the lead inspector's license or lead
risk assessor's license readily available at all times at an a lead inspection site or lead risk assessment site and make it available, on
request, for inspection examination by the inspecting
assessing agency with jurisdiction over the site. A
license shall not be transferred. License fees shall be
nonrefundable and must be submitted with each application in the amount of $50
for each lead inspector and $100 for each lead risk assessor.
$50 nonrefundable fee,
in a form approved by the commissioner; and
INSPECTION RISK ASSESSMENT CONTRACTS.] The commissioner shall,
within available federal or state appropriations, contract with boards of health
to conduct lead inspections risk assessments to determine sources of lead
contamination and to issue and enforce lead orders according to section
144.9504.
LEAD CLEANUP EQUIPMENT
AND MATERIAL GRANTS TO NONPROFIT ORGANIZATIONS.]
(a) The commissioner shall, within the limits of
available state or federal appropriations, provide funds for lead cleanup
equipment and materials under a grant program to nonprofit community-based
organizations in areas at high risk for toxic lead exposure, as provided for in
section 144.9503.
visual inspection and sampling and
analysis methods for:
under section
144.9504, lead hazard screens, lead risk assessments,
and clearance inspections;
and
LEAD CONTRACTORS AND
WORKERS LICENSURE AND CERTIFICATION.] The
commissioner shall adopt rules to license lead contractors and to certify supervisors, lead workers of lead
contractors who perform lead abatement or lead hazard reduction, lead project designers, lead inspectors, and lead risk
assessors. The commissioner shall
inspecting assessing
agency in administering sections 144.9501 to 144.9509 is guilty of a petty
misdemeanor.
144.491; 144.495; 144.71 to 144.74; 144.9501 to
144.9509; 144.992; 326.37 to 326.45; 326.57 to 326.785; 327.10 to 327.131; and
327.14 to 327.28 and all rules, orders, stipulation agreements, settlements,
compliance agreements, licenses, registrations, certificates, and permits
adopted or issued by the department or under any other law now in force or later
enacted for the preservation of public health may, in addition to provisions in
other statutes, be enforced under this section.
that office these offices.
Information about how to contact the office of the ombudsman for older
Minnesotans shall be included in notices of change in client fees and in notices
where home care providers initiate transfer or discontinuation of services.
registered
licensed under sections 148.65 to 148.78 and who
independently provides physical therapy services in the home without any
contractual or employment relationship to a home care provider or other
organization;
MEDICAL
PRACTICE PHYSICAL THERAPY, DUTIES.]
medical
practice, as now or hereafter constituted, hereinafter termed "the board," in
the manner hereinafter provided, physical therapy
established under section 148.67 shall administer the
provisions of this law sections 148.65 to 148.78. As
used in sections 148.65 to 148.78, "board" means the state board of physical
therapy.
COUNCIL;
MEMBERSHIP APPOINTMENTS, VACANCIES, REMOVALS.]
board of medical
practice governor shall appoint a state board of physical therapy council in carrying out the provisions of this law to administer sections 148.65 to 148.78, regarding the
qualifications and examination of physical therapists. The council board shall consist
of seven nine members,
citizens and residents of the state of Minnesota, composed of three five physical
therapists, two one
licensed and registered doctors doctor of medicine and surgery,
one being a professor or associate or assistant professor from a program in
physical therapy approved by the board of medical practice, one aide or
assistant to a physical therapist and one public member. The council shall
expire, and the terms, compensation and removal of members shall be as provided
in section 15.059., one physical therapy assistant
and two public members. The five physical therapist members must be licensed
physical therapists in this state. Each of the five physical therapist members
must have at least five years experience in physical therapy practice, physical
therapy administration, or physical therapy education. The five years experience
must
It shall be the duty of The
board of medical practice with the advice and assistance
of the physical therapy council to pass upon physical
therapy must:
registration, licensing and continuing education requirements for reregistration, relicensing;
,;
,; and
register such applicants license
an applicant after the applicant has presented evidence satisfactory to the
board that the applicant has completed a an accredited physical therapy educational program of
education or continuing education approved by the board.
registration
licensing as a physical therapist shall file a
written application on forms provided by the board together with a fee in the
amount set by the board, no portion of which shall be
returned. No portion of the fee is refundable.
(a) (1) a minimum of 60 academic semester credits or its
equivalent from an accredited college, including courses in the biological and
physical sciences; and
(b) (2) an accredited course in physical therapy education
which has provided adequate instruction in the basic sciences, clinical
sciences, and physical therapy theory and procedures, as determined by the
board. In determining whether or not a course in physical therapy is approved,
the board may take into consideration the accreditation of such schools by the
appropriate council of the American Medical Association, the American Physical
Therapy Association, or the Canadian Medical Association.
REGISTRATION LICENSING.]
medical practice physical
therapy shall register license as a physical therapist and shall furnish a certificate of registration license to each an applicant who successfully passes an examination
provided for in sections 148.65 to 148.78 for registration licensing as a
physical therapist and who is otherwise qualified as required herein in sections 148.65 to
148.78.
registration licensing
as a physical therapist. A temporary permit to practice physical therapy under
supervision may be issued only once and cannot be renewed. It expires 90 days
after the next examination for registration licensing given by the board or on the date on which the
board, after examination of the applicant, grants or denies the applicant a registration license to
practice, whichever occurs first. A temporary permit expires on the first day
the board begins its next examination for registration license after
the permit is issued if the holder does not submit to examination on that date.
The holder of a temporary permit to practice physical therapy under supervision
may practice physical therapy as defined in section 148.65 if the entire
practice is under the supervision of a person holding a valid registration license to
practice physical therapy in this state. The supervision shall be direct,
immediate, and on premises.
registration licensing under
section 148.72 does not require supervision to practice physical therapy while
holding a temporary permit in this state. The temporary permit remains valid
only until the meeting of the board at which the application for registration licensing is
considered.
registered licensed under
subdivision 1; and
registration licensing given
by the board following successful completion of the traineeship or on the date
on which the board, after examination of the applicant, grants or denies the
applicant a registration license to practice, whichever occurs first.
registered
licensed as a physical therapist under subdivision 1.
The traineeship may be waived for a foreign-trained physical therapist who is
licensed or otherwise registered in good standing in another state and has
successfully practiced physical therapy in that state under the supervision of a
licensed or registered physical therapist for at least six months at a facility
that meets the requirements under paragraph (b), clauses (2) and (3).
REGISTRATION LICENSE WITHOUT
EXAMINATION.] On payment to the board of a fee in the amount set by the board
and on submission of a written application on forms provided by the board, the
board shall issue registration a license without examination to a person who is
licensed or otherwise registered as a physical therapist by another state of the
United States of America, its possessions, or the District of Columbia, if the board determines that the requirements for licensure licensing or
registration in the state, possession, or District are equal to, or greater
than, the requirements set forth in sections 148.65
to 148.78.
CERTIFICATE OF
REGISTRATION LICENSE.] The board may issue a certificate of registration to a physical therapist license without examination to an applicant who presents
evidence satisfactory to the board of having passed an examination recognized by
the board, if the board
determines the standards of the other state or foreign country are determined by the board to be as high as equal to those of this state. At
the time of making an Upon application, the applicant shall pay to the board a fee in the
amount set by the board,.
No portion of which shall be returned the fee is refundable.
REGISTRATION LICENSE AFTER
EXAMINATION.] The board shall issue a certificate of
registration license to each an applicant who passes
the examination in accordance with according to standards established by the board and who
is not disqualified to receive registration a license under the provisions
of section 148.75.
registered licensed physical therapist shall, during each January,
apply to the board for an extension of registration
a license and pay a fee in the amount set by the
board. The extension of registration the license is contingent upon demonstration that the
continuing education requirements set by the board under section 148.70 have
been satisfied.
is authorized to may adopt rules as may be
necessary needed to carry out the purposes of sections 148.65 to 148.78. The secretary secretary-treasurer
of the board shall keep a record of proceedings under these sections and a
register of all persons registered licensed under it. The register shall show the name,
address, date and number of registration
thereof of the license. Any
other interested person in the state may obtain a copy of such the list on request to
the board upon payment of paying an amount as may be
fixed by the board, which. The
amount shall not exceed the cost of the list so
furnished. The board shall provide blanks, books, certificates, and stationery
and assistance as is necessary for the transaction of the to
transact business of the board and the physical
therapy council hereunder, and. All money
received by the board under sections 148.65 to 148.78 shall be paid into the
state treasury as provided for by law. The board shall set by rule the amounts
of the application fee and the annual registration licensing fee. The fees collected by the board must be
sufficient to cover the costs of administering sections 148.65 to 148.78.
CERTIFICATES LICENSES; DENIAL, SUSPENSION, REVOCATION.]
medical practice physical
therapy may refuse to grant registration a license to any physical therapist, or may suspend or
revoke the registration license of any physical therapist for any of the
following grounds:
(a) (1) using drugs or intoxicating liquors to an extent
which affects professional competence;
(b) been convicted (2) conviction of a felony;
(c) (3) conviction for violating any state or federal
narcotic law;
(d) procuring, aiding or abetting
a criminal abortion;
(e) registration (4) obtaining a license or attempted registration attempting
to obtain a license by fraud or deception;
(f) (5) conduct unbecoming a person registered licensed as a
physical therapist or conduct detrimental to the best interests of the public;
(g) (6) gross negligence in the practice of physical therapy
as a physical therapist;
(h) (7) treating human ailments by physical therapy after an
initial 30-day period of patient admittance to treatment has lapsed, except by
the order or referral of a person licensed in this state to in the practice of medicine as defined in section 147.081, the practice
of chiropractic as defined in section 148.01, the practice of podiatry as
defined in section 153.01, or the practice of dentistry as defined in section
150A.05 and whose license is in good standing; or when a previous diagnosis
exists indicating an ongoing condition warranting physical therapy treatment,
subject to periodic review defined by board of medical
practice physical therapy rule;
(i) (8) treating human ailments,
without referral, by physical therapy treatment
without first having practiced one year under a physician's orders as verified
by the board's records;
(j) failure (9) failing to consult with the patient's health care
provider who prescribed the physical therapy treatment if the treatment is
altered by the physical therapist from the original written order. The provision
does not include written orders specifying orders to
"evaluate and treat";
(k) (10) treating human ailments other than by physical
therapy unless duly licensed or registered to do so under the laws of this
state;
(l) (11) inappropriate delegation to a physical therapist
assistant or inappropriate task assignment to an aide or inadequate supervision
of either level of supportive personnel;
(m) treating human ailments other
than by performing physical therapy procedures unless duly licensed or
registered to do so under the laws of this state;
(n) (12) practicing as a physical therapist performing
medical diagnosis, the practice of medicine as defined in section 147.081, or
the practice of chiropractic as defined in section 148.01;
(o) failure (13) failing to comply with a reasonable request to
obtain appropriate clearance for mental or physical conditions which that would interfere
with the ability to practice physical therapy, and which that may be potentially
harmful to patients;
(p) (14) dividing fees with, or paying or promising to pay a
commission or part of the fee to, any person who contacts the physical therapist
for consultation or sends patients to the physical therapist for treatment;
(q) (15) engaging in an incentive payment arrangement, other
than that prohibited by clause (p) (14), that tends to promote physical therapy overutilization overuse, whereby that allows the
referring person or person who controls the availability of physical therapy
services to a client profits to profit unreasonably as a result of patient treatment;
(r) (16) practicing physical therapy and failing to refer to
a licensed health care professional any a patient whose medical condition at the time of
evaluation has been determined by the physical therapist to be beyond the scope
of practice of a physical therapist; and
(s) failure (17) failing to report to the board other registered licensed physical
therapists who violate this section.
certificate of registration license to practice as a physical therapist is suspended
if (1) a guardian of the person of the physical therapist is appointed by order
of a court pursuant to sections 525.54 to 525.61, for reasons other than the
minority of the physical therapist; or (2) the physical therapist is committed
by order of a court pursuant to chapter 253B. The certificate of registration license remains suspended until the physical therapist
is restored to capacity by a court and, upon petition by the physical therapist,
the suspension is terminated by the board of medical
practice physical therapy after a hearing.
(a) (1) use the title of physical therapist without a certificate of registration license as a physical therapist issued pursuant to the provisions of under sections 148.65 to 148.78;
(b) (2) in any manner hold out as a physical therapist, or
use in connection with the person's name the words or letters Physical
Therapist, Physiotherapist, Physical Therapy Technician, Registered Physical
Therapist, Licensed Physical Therapist, P.T., P.T.T., R.P.T., L.P.T., or any
letters, words, abbreviations or insignia indicating or implying that the person
is a physical therapist, without a certificate of
registration license as a physical therapist
issued pursuant to the provisions of under sections 148.65 to 148.78. To do so is a gross
misdemeanor;
(c) (3) employ fraud or deception in applying for or
securing a certificate of registration license as a physical therapist.
contained in sections
148.65 to 148.78 shall prohibit any prohibits a person licensed or registered in this state
under another law from carrying out the therapy or practice for which the person
is duly licensed or registered.
(a) (1) treat human ailments by physical therapy after an
initial 30-day period of patient admittance to treatment has lapsed, except by
the order or referral of a person licensed in this state to practice medicine as
defined in section 147.081, the practice of chiropractic as defined in section
148.01, the practice of podiatry as defined in section 153.01, or the practice
of dentistry as defined in section 150A.05 and whose license is in good
standing; or when a previous diagnosis exists indicating an ongoing condition
warranting physical therapy treatment, subject to periodic review defined by
board of medical practice physical therapy rule;
(b) (2) treat human ailments by physical therapy treatment
without first having practiced one year under a physician's orders as verified
by the board's records;
(c) utilize (3) use any chiropractic manipulative technique whose
end is the chiropractic adjustment of an abnormal articulation of the body; and
(d) (4) treat human ailments other than by physical therapy
unless duly licensed or registered to do so under the laws of this state.
certificate
of registration license as a physical therapist,
but shall be a matter of defense to be established by the accused.
section sections 62J.041; 62J.48;
62J.71 to 62J.73; all applicable
CONTRACTORS SUPERVISOR OR CERTIFIED FIRM.] (a) Eligible
organizations and lead contractors supervisors or certified firms may participate in the
swab team program. An eligible organization receiving a grant under this section
must assure that all participating lead contractors
supervisors or certified firms are licensed and that
all swab team workers are certified by the department of health under section
144.9505. Eligible organizations and lead contractors
supervisors or certified firms may distinguish
between interior and exterior services in assigning duties and may participate
in the program by:
144.9503 144.9507, subdivision 5 4, paragraph (b) (c), to residents; or
contractors supervisors or
certified firms must:
25 31 beds, the director of
nursing services may also serve as the licensed nursing home administrator. Two
nursing homes under common ownership having a total of 150 beds or less and
located within 75 miles of each other may share the services of a licensed
administrator if the administrator divides full-time work week between the two
facilities in proportion to the number of beds in each facility. Every nursing
home shall have a person-in-charge on the premises at all times in the absence
of the licensed administrator. The name of the person in charge must be posted
in a conspicuous place in the facility. The commissioner of health shall by rule
promulgate minimum education and experience requirements for persons-in-charge,
and may promulgate rules specifying the times of day during which a licensed
administrator must be on the nursing home's premises. In the absence of rules
adopted by the commissioner governing the division of an administrator's time
between two nursing homes, the administrator shall designate and post the times
the administrator will be on site in each home on a regular basis. A nursing
home may employ as its administrator the administrator of a hospital licensed
pursuant to sections 144.50 to 144.56 if the individual is licensed as a nursing
home administrator pursuant to section 144A.20 and the nursing home and hospital
have a combined total of 150 beds or less and are located within one mile of
each other. A nonproprietary retirement home having fewer than 15 licensed
nursing home beds may share the services of a licensed administrator with a
nonproprietary nursing home, having fewer than 150 licensed nursing home beds,
that is located within 25 miles of the retirement home. A nursing home which is
located in a facility licensed as a hospital pursuant to sections 144.50 to
144.56, may employ as its administrator the administrator of the hospital if the
individual meets minimum education and long term care experience criteria set by
rule of the commissioner of health.
condemned acquired by the Minneapolis community development agency
as part of an economic redevelopment plan activities in a city of
the first class, provided the new facility is located within one mile three miles of the
site of the old facility. Operating and property costs for the new facility must
be determined and allowed under existing reimbursement
rules section 256B.431 or 256B.434;
or
.;
No rule established Sections
144A.04, subdivision 5, and 144A.18 to 144A.27, and rules adopted under
sections 144A.01 to 144A.16 other than a rule relating to sanitation and safety
of premises, to cleanliness of operation, or to physical equipment shall do not apply to a
nursing home conducted by and for the adherents of any recognized church or
religious denomination for the purpose of providing care and treatment for those
who select and depend upon spiritual means through prayer alone, in lieu of
medical care, for healing.
For the rate period Effective
October 1, 1988 1998, to
June 30, 1990 2000, the
commissioner, within the limits of available
appropriations, shall add the appropriate make available the salary adjustment per diem calculated
in clause (1) or (2) to the total operating cost payment rate of each nursing
facility reimbursed under this section or section
256B.434. The salary adjustment per diem for each nursing facility must be
determined as follows:
3.5 5
percent and then dividing the resulting amount by the nursing facility's actual
resident days; and
Each nursing facility that
receives a salary adjustment per diem pursuant to this subdivision shall adjust
nursing facility employee salaries by a minimum of the amount determined in
clause (1) or (2). The commissioner shall review allowable salary costs,
including payroll taxes and fringe benefits, for the reporting year ending
September 30, 1989, to determine whether or not each nursing facility complied
with this requirement. The commissioner shall report the extent to which each
nursing facility complied with the legislative commission on long-term care by
August 1, 1990.
and July 1, 1998, and July 1,
1999, a nursing facility licensed for 40 beds effective May 1, 1992, with a
subsequent increase of 20 Medicare/Medicaid certified beds, effective January
26, 1993, in accordance with an increase in licensure is exempt from paragraphs
(a) and (b).
and was historically funded in
part by inpatient patient
care revenues and that occurs in both either an inpatient and or ambulatory patient care settings training site.
(e) (f) "Commissioner" means the commissioner of health.
(f) (g) "Teaching institutions" means any hospital, medical
center, clinic, or other organization that currently sponsors or conducts
accredited medical education programs or clinical research in Minnesota.
program programs on whose
behalf the institution is applying for funding;
the total number, type, and
specialty orientation of eligible Minnesota-based trainees in for each accredited medical education program for which
funds are being sought the type and specialty orientation
of trainees in the program, the name, address, and medical assistance provider
number of each training site used in the program, the total number of trainees
at each site, and the total number of eligible trainees at each training
site;
a statement identifying
unfunded costs; and
(8) other supporting
information the commissioner, with advice from the advisory committee,
determines is necessary for the equitable distribution of funds.
based on the
percentage of total program training performed at each site. as specified in the commissioner's approval letter. Any
funds not distributed as directed by the commissioner's approval letter shall be
returned to the medical education and research trust fund within 30 days of a
notice from the commissioner. The commissioner shall distribute returned funds
to the appropriate entities in accordance with the commissioner's approval
letter.
annual cost and program
reports a medical education and research grant
verification report (GVR) through the sponsoring institution based on
criteria established by the commissioner. If the
sponsoring institution fails to submit the GVR by the stated deadline, or to
request and meet the deadline for an extension, the sponsoring institution is
required to return the full amount of the medical education and research trust
fund grant to the medical education and research trust fund within 30 days of a
notice from the commissioner. The commissioner shall distribute returned funds
to the appropriate entities in accordance with the commissioner's approval
letter. The reports must include:
percentage dollar amount
distributed to each training site; and
the average cost per trainee
and a detailed breakdown of the components of those costs;
(4) other state or federal
appropriations received for the purposes of clinical training;
(5) other revenue received for the
purposes of clinical training; and
(6) other information the
commissioner, with advice from the advisory committee, deems appropriate to
evaluate the effectiveness of the use of funds for clinical training.
have a bachelor's degree in one of the
behavioral sciences or related fields from an accredited college or university
and have at least 2,000 hours of supervised experience in the delivery of
services to adults with mental illness, must be skilled in the process of
identifying and assessing a wide range of client needs, and must be knowledgeable about local community
resources and how to use those resources for the benefit of the client, and must meet the qualifications for mental health
practitioners in subdivision 17. The case manager shall meet in person with
a mental health professional at least once each month to obtain
a refugee
an immigrant who does not have the qualifications
specified in this subdivision may provide case management services to adult refugees immigrants with
serious and persistent mental illness who are members of the same ethnic group
as the case manager if the person: (1) is actively pursuing credits toward the
completion of a bachelor's degree in one of the behavioral sciences or a related
field from an accredited college or university; (2) completes 40 hours of
training as specified in this subdivision; and (3) receives clinical supervision
at least once a week until the requirements of obtaining
a bachelor's degree and 2,000 hours of supervised experience this subdivision are met.
for a minimum three-hour time block by a
multidisciplinary staff under the clinical supervision of a mental health
professional. The services are aimed at stabilizing the adult's mental health
status, providing mental health services, and developing and improving the
adult's independent living and socialization skills. The goal of day treatment
is to reduce or relieve mental illness and to enable the adult to live in the
community. Day treatment services are not a part of inpatient or residential
treatment services. Day treatment services are distinguished from day care by
their structured therapeutic program of psychotherapy services. The commissioner may limit medical assistance reimbursement
for day treatment to 15 hours per week per person instead of the three hours per
day per person specified in Minnesota Rules, part 9505.0323, subpart 15.
have at least a bachelor's
degree in one of the behavioral sciences or a related field from an accredited
college or university;
(2) have at least 2,000 hours of
supervised experience in the delivery of mental health services to children;
(3) have experience and
training in identifying and assessing a wide range of children's needs; and
(4) (2) be knowledgeable about local community resources and
how to use those resources for the benefit of children and their families.
a
refugee an immigrant who does not have the
qualifications specified in this subdivision may provide case management
services to child refugees immigrants with severe emotional disturbance of the same
ethnic group as the refugee immigrant if the person:
obtaining a bachelor's degree
and 2,000 hours of supervised experience this
subdivision are met.
The
medical assistance payment rates must be based on methods and standards that the
commissioner finds are adequate to provide for the costs that must be incurred
for the care of recipients in efficiently and economically operated
hospitals. Services must meet the requirements of section 256B.04,
subdivision 15, or 256D.03, subdivision 7, paragraph (b), to be eligible for
payment.
Indian health service Facilities of the Indian health service and facilities operated by a
tribe or tribal organization under funding authorized by title III of the Indian
Self-Determination and Education Assistance Act, Public Law Number 93-638, or by
United States Code, title 25, chapter 14, subchapter II,
reimbursed at charges as limited to the amount allowed under
federal law paid according to the rate published by
the United States assistant secretary for health under authority of United
States Code, title 42, sections 248A and 248B.
(f) (i), the commissioner may
make payments to federally recognized Indian tribes with a reservation in the
state to provide medical assistance and general
assistance medical care to Indians, as defined under federal law, who reside
on or near the reservation. The payments may be made in the form of a block
grant or other payment mechanism determined in consultation with the tribe. Any
alternative payment mechanism agreed upon by the tribes and the commissioner
under this subdivision is not dependent upon county agreement but is intended to
create a direct payment mechanism between the state and the tribe for the
administration of the medical assistance program and general assistance medical care programs, and for
covered services.
110 120 percent of the official federal poverty guidelines
for the applicable family size. The income limit shall
increase to 120 percent of the official federal poverty guidelines for the
applicable family size on January 1, 1995.
or
ILLNESS 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 or
subject to federal approval, and children with
severe emotional disturbance. Services provided under
this section must meet the relevant standards in sections 245.461 to 245.4888,
the Comprehensive Adult and Children's Mental Health Acts, Minnesota Rules,
parts 9520.0900 to 9520.0926, and 9505.0322, excluding subpart 10.
subpart 6 subparts 6 and 10.
(b) In counties where fewer than
50 percent of children estimated to be eligible under medical assistance to
receive case management services for children with severe emotional disturbance
actually receive these services in state fiscal year 1995, community mental
health centers serving those counties, entities meeting program standards in
Minnesota Rules, parts 9520.0570 to 9520.0870, and other entities authorized by
the commissioner are eligible for medical assistance reimbursement for case
management services for children with severe emotional disturbance when these
services meet the program standards in Minnesota Rules, parts 9520.0900 to
9520.0926 and 9505.0322, excluding subpart 6.
By January 1, 1998, the
commissioner, in cooperation with the commissioner of administration, shall
establish an augmentative and alternative communication system purchasing
program within a state agency or by contract with a qualified private entity.
The purpose of this service is to facilitate ready availability of the
augmentative and alternative communication systems needed to meet the needs of
persons with severe expressive communication limitations in an efficient and
cost-effective manner. This program shall:
(1) coordinate purchase and rental
of augmentative and alternative communication systems;
(2) negotiate agreements with
manufacturers and vendors for purchase of components of these systems, for
warranty coverage, and for repair service;
(3) when efficient and
cost-effective, maintain and refurbish if needed, an inventory of components of
augmentative and alternative communication systems for short- or long-term loan
to recipients;
(4) facilitate training sessions
for service providers, consumers, and families on augmentative and alternative
communication systems; and
(5) develop a recycling program
for used augmentative and alternative communications systems to be reissued and
used for trials and short-term use, when appropriate.
The availability of components of
augmentative and alternative communication systems through this program is
subject to prior authorization requirements established under subdivision 25
The commissioner shall reimburse augmentative and
alternative communication manufacturers and vendors at the manufacturer's
suggested retail price for augmentative and alternative communication systems
and related components. The commissioner shall separately reimburse providers
for purchasing and integrating individual communication systems which are
unavailable as a package from an augmentative and alternative communication
vendor.
American Indian health
services facilities for outpatient medical services billed after June 30, 1990,
must be facilities of the Indian health service and
facilities operated by a tribe or tribal organization under funding authorized
by United States Code, title 25, sections 450f to 450n, or title III of the
Indian Self-Determination and Education Assistance Act, Public Law Number
93-638, shall be at the option of the facility in accordance with the rate
published by the United States Assistant Secretary for Health under the
authority of United States Code, title 42, sections 248(a) and 249(b). General
assistance medical care payments to facilities of the
American Indian health services and facilities operated by a tribe or tribal organization for the
provision of outpatient medical care services billed after June 30, 1990, must
be in accordance with the general assistance medical care rates paid for the
same services when provided in a facility other than an
American a facility of the Indian health service
or a facility operated by a
tribe or tribal organization.
when the recipient displays no significant change, the
county public health nurse has the option to review with the commissioner, or
the commissioner's designee, the service plan on record and receive
authorization for up to an additional 12 months at a time for up to three
years. after the first year, the recipient or the
responsible party, in conjunction with the public health nurse, may complete a
service update on forms developed by the commissioner. The service update may
substitute for the annual reassessment described in subdivision 1.
system shall not exceed 1-1/2 times the amount paid for providing services to one person, and shall increase incrementally by one-half the cost of serving
a single person, for each person served. A personal care assistant may not serve
more than three children in a single setting. for
three persons, the rate shall not exceed twice the rate for serving a single
individual. No more than three persons may receive shared care from a personal
care assistant in a single setting.
shall be considered payment in full, and shall not may be adjusted due to the change in eligibility. This
section applies does not
apply to both fee-for-service payments and
payments made to health plans on a prepaid capitated basis.
18 8, at the time of
application to a nursing home;
Screeners shall adhere to the
level of care criteria for admission to a certified nursing facility established
under section 144.0721.
(d) For persons who are
eligible for medical assistance or who would be eligible within 180 days of
admission to a nursing facility and who are admitted to a nursing facility, the
nursing facility must include a screener or the case manager in the discharge
planning process for those individuals who the team has determined have
discharge potential. The screener or the case manager must ensure a smooth
transition and follow-up for the individual's return to the community.
The county preadmission screening team may deny certified
nursing facility admission using the level of care criteria established under
section 144.0721 and deny medical assistance reimbursement for certified nursing
facility care. Persons receiving care in a certified nursing facility or
certified boarding care home who are reassessed by the commissioner of health
according to section 144.0722 and determined to no longer meet the level of care
criteria for a certified nursing facility or certified boarding care home may no
longer remain a resident in the certified nursing facility or certified boarding
care home and must be relocated to the community if the persons were admitted on
or after July 1, 1998.
Persons receiving services
under section 256B.0913, subdivisions 1 to 14, or 256B.0915 who are reassessed
and found to not meet the level of care criteria for admission to a certified
nursing facility or certified boarding care home may no longer receive these
services if persons were admitted to the program on or after July 1, 1998.
The commissioner shall make a request to the health care financing
administration for a waiver allowing screening team approval of Medicaid
payments for certified nursing facility care. An individual has a choice and
makes the final decision between nursing facility placement and community
placement after the screening team's recommendation, except as provided in
paragraphs (b) and (c).
1997 1999, or upon federal
approval, whichever is later.
be based on methods and standards that the
commissioner finds are adequate to provide for the costs that must be incurred
for the care of residents in efficiently and economically operated nursing
facilities and shall specify the costs that are allowable for establishing
payment rates through medical assistance.
,
and the costs that must be incurred for the care
. In developing the geographic groups for purposes of
reimbursement under this section, the commissioner shall ensure that nursing
facilities in any county contiguous to the Minneapolis-St. Paul seven-county
metropolitan area are included in the same geographic group. The limits
established by the commissioner shall not be less, in the aggregate, than the
60th percentile of total actual allowable historical operating cost per diems
for each group of nursing facilities established under subdivision 1 based on
cost reports of allowable operating costs in the previous reporting year. For
rate years beginning on or after July 1, 1989, facilities located in geographic
group I as described in Minnesota Rules, part 9549.0052, on January 1, 1989, may
choose to have the commissioner apply either the care related limits or the
other operating cost limits calculated for facilities located in geographic
group II, or both, if either of the limits calculated for the group II
facilities is higher. The efficiency incentive for geographic group I nursing
facilities must be calculated based on geographic group I limits. The phase-in
must be established utilizing the chosen limits. For purposes of these
exceptions to the geographic grouping requirements, the definitions in Minnesota
Rules, parts 9549.0050 to 9549.0059 (Emergency), and 9549.0010 to 9549.0080,
apply. The limits established under this paragraph remain in effect until the
commissioner establishes a new base period. Until the new base period is
established, the commissioner shall adjust the limits annually using the
appropriate economic change indices established in paragraph (e). In determining
allowable historical operating cost per diems for purposes of setting limits and
nursing facility payment rates, the commissioner shall divide the allowable
historical operating costs by the actual number of resident days, except that
where a nursing facility is occupied at less than 90 percent of licensed
capacity days, the commissioner may establish procedures to adjust the
computation of the per diem to an imputed occupancy level at or below 90
percent. The commissioner shall establish efficiency incentives as appropriate.
The commissioner may establish efficiency incentives for different operating
cost categories. The commissioner shall consider establishing efficiency
incentives in care related cost categories. The commissioner may combine one or
more operating cost categories and may use different methods for calculating
payment rates for each operating cost category or combination of operating cost
categories. For the rate year beginning on July 1, 1985, the commissioner shall:
(i) For the cost report year
ending September 30, 1996, and for all subsequent reporting years, certified
nursing facilities must identify, differentiate, and record resident day
statistics for residents in case mix classification A who, on or after July 1,
1996, meet the modified level of care criteria in section 144.0721. The resident
day statistics shall be separated into case mix classification A-1 for any
resident day meeting the high-function class A level of care criteria and case
mix classification A-2 for other case mix class A resident days.
Approved rates shall be established on the basis of methods
and standards that the commissioner finds adequate to provide for the costs that
must be incurred for the quality care of residents in efficiently and
economically operated facilities and services. The procedures shall specify
the costs that are allowable for payment through medical assistance. The
commissioner may use experts from outside the department in the establishment of
the procedures.
or, community
integrated service network, or accountable provider
network authorized and operating under chapter 62D or, 62N, or 62T that participates in the demonstration project
according to criteria, standards, methods, and other requirements established
for the project and approved by the commissioner. Notwithstanding the above,
Itasca county may continue to participate as a demonstration provider until July
1, 2000.
section sections 62J.041; 62J.48;
62J.71 to 62J.73; 62M.01 to 62M.16; all applicable provisions of chapter 62Q,
including sections 62Q.07; 62Q.075; 62Q.105; 62Q.1055; 62Q.106; 62Q.11; 62Q.12;
62Q.135; 62Q.14; 62Q.145; 62Q.19; 62Q.23, paragraph (c); 62Q.30; 62Q.43; 62Q.47;
62Q.50; 62Q.52 to 62Q.56; 62Q.58; 62Q.64; and 72A.201 will be met. All
enforcement and rulemaking powers available under chapters 62D and, 62J, 62M, 62N, and 62Q are hereby granted to the commissioner of
health with respect to counties that purchase medical assistance and general
assistance medical care services under this section.
and, 62N, and section 256B.692, subdivision 2, are met. All
enforcement and rulemaking powers available under chapters 62D and, 62J, 62M, 62N, and 62Q are granted to the commissioner of health with
respect to the county authorities that contract with the commissioner to
purchase services in a demonstration project for people with disabilities under
this section.
that begin implementation on July 1,
1998 designated by the commissioner under subdivision
5.
(4) (5), except as provided
in paragraph (b); and:
or
(4) (5) Beginning July 1, 1998, applicants or recipients who
meet all eligibility requirements of MinnesotaCare as defined in sections
256L.01 to 256L.16, and are:
(4) (5), may be returned to the county agency to be
forwarded to the department of human services or sent directly to the department
of human services for enrollment in MinnesotaCare. If all other eligibility
requirements of this subdivision are met, eligibility for general assistance
medical care shall be available in any month during which a MinnesotaCare
eligibility determination and enrollment are pending. Upon notification of
eligibility for MinnesotaCare, notice of termination for eligibility for general
assistance medical care shall be sent to an applicant or recipient. If all other
eligibility requirements of this subdivision are met, eligibility for general
assistance medical care shall be available until enrollment in MinnesotaCare
subject to the provisions of paragraph (d).
(4) (5), whose MinnesotaCare coverage is denied or
terminated for nonpayment of premiums as required by sections 256L.06 to
256L.08.
(j) (2) This paragraph does not apply to a child under age
18, to a Cuban or Haitian entrant as defined in Public Law Number 96-422,
section 501(e)(1) or (2)(a), or to a noncitizen who is aged, blind, or disabled
as defined in Code of Federal Regulations, title 42, sections 435.520, 435.530,
435.531, 435.540, and 435.541, or to an individual
eligible for general assistance medical care under paragraph (a), clause
(4), who cooperates with the Immigration and Naturalization Service to
pursue any applicable immigration status, including citizenship, that would
qualify the individual for medical assistance with federal financial
participation.
(k) (3) For purposes of paragraphs
(f) and (i) this paragraph, "emergency services"
has the meaning given in Code of Federal Regulations, title 42, section
440.255(b)(1), except that it also means services rendered because of suspected
or actual pesticide poisoning.
(l) (j) Notwithstanding any other provision of law, a
noncitizen who is ineligible for medical assistance due to the deeming of a
sponsor's income and resources, is ineligible for general assistance medical
care.
case management services for
a person with serious and persistent mental illness who would be eligible for
medical assistance except that the person resides in an institution for mental
diseases;
(19) psychological services,
medical supplies and equipment, and Medicare premiums, coinsurance and
deductible payments;
(20) (19) medical equipment not specifically listed in this
paragraph when the use of the equipment will prevent the need for costlier
services that are reimbursable under this subdivision;
(21) (20) services performed by a certified pediatric nurse
practitioner, a certified family nurse practitioner, a certified adult nurse
practitioner, a certified obstetric/gynecological nurse practitioner, or a
certified geriatric nurse practitioner in independent practice, if the services
are otherwise covered under this chapter as a physician service, and if the
service is within the scope of practice of the nurse practitioner's license as a
registered nurse, as defined in section 148.171; and
(22) (21) services of a certified public health nurse or a
registered nurse practicing in a public health nursing clinic that is a
department of, or that operates under the direct authority of, a unit of
government, if the service is within the scope of practice of the public health
nurse's license as a registered nurse, as defined in section 148.171.
.:
(f) (g) Any county may, from its own resources, provide
medical payments for which state payments are not made.
(g) (h) Chemical dependency services that are reimbursed
under chapter 254B must not be reimbursed under general assistance medical care.
(h) (i) The maximum payment for new vendors enrolled in the
general assistance medical care program after the base year shall be determined
from the average usual and customary charge of the same vendor type enrolled in
the base year.
(i) (j) The conditions of payment for services under this
subdivision are the same as the conditions specified in rules adopted under
chapter 256B governing the medical assistance program, unless otherwise provided
by statute or rule.
or
January 15, 1998 July 1, 2000.
who are required to apply for medical assistance according
to section 256L.03, subdivision 3, paragraph (b).
July 1, 1998 January 1, 2000, applicants or recipients who meet all
eligibility requirements of MinnesotaCare as defined in sections 256L.01 to
256L.16, and are:
July 1, 1998 January 1, 2000, Minnesota health care program
applications completed by recipients and applicants who are persons described in
paragraph (a), clause (4), may be returned to the county agency to be forwarded
to the department of human services or sent directly to the department of human
services for enrollment in MinnesotaCare. If all other eligibility requirements
of this subdivision are met, eligibility for general assistance medical care
shall be available in any month during which a MinnesotaCare eligibility
determination and enrollment are pending. Upon notification of eligibility for
MinnesotaCare, notice of termination for eligibility for general assistance
medical care shall be sent to an applicant or recipient. If all other
eligibility requirements of this subdivision are met, eligibility for general
assistance medical care shall be available until enrollment in MinnesotaCare
subject to the provisions of paragraph (d).
to 256L.08 and 256L.07.
256L.10 256L.18, the
following terms shall have the meanings given them.
a quarterly an
assessment of the expected expenditures for the covered services for the
remainder of the current biennium and for the following biennium. The estimated
expenditure, including the reserve requirements described in section 16A.76,
shall be compared to an estimate of the revenues that will be deposited available in the
health care access fund. Based on this comparison, and after consulting with the
chairs of the house ways and means committee and the senate finance committee,
and the legislative commission on health care access, the commissioner shall, as
necessary, make the adjustments specified in paragraph (b) to ensure that
expenditures remain within the limits of available revenues for the remainder of
the current biennium and for the following biennium. The commissioner shall not
hire additional staff using appropriations from the health care access fund
until the commissioner of finance makes a determination that the adjustments
implemented under paragraph (b) are sufficient to allow MinnesotaCare
expenditures to remain within the limits of available revenues for the remainder
of the current biennium and for the following biennium.
or 256L.13, with family gross income equal to or less
than 175 percent of the federal poverty guidelines. Outpatient mental health
services covered under the MinnesotaCare program are limited to diagnostic
assessments, psychological testing, explanation of findings, medication
management by a physician, day treatment, partial hospitalization, and
individual, family, and group psychotherapy.
Beginning July 1, 1993, Covered health services shall
include inpatient hospital services, including inpatient hospital mental health
services and inpatient hospital and residential chemical dependency treatment,
subject to those limitations necessary to coordinate the provision of these
services with eligibility under the medical assistance spenddown. Prior to July
1, 1997, the inpatient hospital benefit for adult enrollees is subject to an
annual benefit limit of $10,000. Effective July 1,
1997, The inpatient hospital benefit for adult enrollees who qualify under
section 256L.04, subdivision 7, or who qualify under section 256L.04,
subdivisions 1 to 6 and 2,
or 256L.13 with family gross income that exceeds 175
percent of the federal poverty guidelines and who are not pregnant, is subject
to an annual limit of $10,000.
Enrollees who qualify under
section 256L.04, subdivision 7, or who qualify under section 256L.04,
subdivisions 1 to 6, or 256L.13 with family gross income that exceeds 175
percent of the federal poverty guidelines and who are not pregnant, and are
determined by the commissioner to have a basis of eligibility for medical
assistance shall apply for and cooperate with the requirements of medical
assistance by the last day of the third month following admission to an
inpatient hospital. If an enrollee fails to apply for medical assistance within
this time period, the enrollee and the enrollee's family shall be disenrolled
from the plan and they may not reenroll until 12 calendar months have elapsed.
Enrollees and enrollees' families disenrolled for not applying for or not
cooperating with medical assistance may not reenroll.
(c) Admissions for inpatient
hospital services paid for under section 256L.11, subdivision 3, must be
certified as medically necessary in accordance with Minnesota Rules, parts
9505.0500 to 9505.0540, except as provided in clauses (1) and (2):
(d) Any enrollee or family member
of an enrollee who has previously been permanently disenrolled from
MinnesotaCare for not applying for and cooperating with medical assistance shall
be eligible to reenroll if 12 calendar months have elapsed since the date of
disenrollment.
, and shall apply to the secretary of health and
human services for any necessary federal waivers or approvals.
not eligible for
medical assistance, subject to an annual inpatient out-of-pocket maximum of
$1,000 per individual and $3,000 per family;
or 256L.13, with income equal to or less than 175
percent of the federal poverty guidelines.
Prior to July 1, 1997, enrollees
who are not eligible for medical assistance with or without a spenddown shall be
financially responsible for the coinsurance amount and amounts which exceed the
$10,000 benefit limit. Effective July 1, 1997, adult enrollees who qualify under section 256L.04, subdivision 7, or who
qualify under section 256L.04, subdivisions 1 to 6, or 256L.13 with family
gross income that exceeds 175 percent of the federal poverty guidelines and who
are not pregnant, and who are not eligible for medical
assistance with or without a spenddown, shall be financially responsible for
the coinsurance amount and amounts which exceed the $10,000 inpatient hospital
benefit limit.
CHILDREN;
EXPANSION AND CONTINUATION OF ELIGIBILITY FAMILIES
WITH CHILDREN.] (a) [CHILDREN.] Prior to October 1,
1992, "eligible persons" means children who are one year of age or older but
less than 18 years of age who have gross family incomes that are equal to or
less than 185 percent of the federal poverty guidelines and who are not eligible
for medical assistance without a spenddown under chapter 256B and who are not
otherwise insured for the covered services. The period of eligibility extends
from the first day of the month in which the child's first birthday occurs to
the last day of the month in which the child becomes 18 years old. Families with children with family income equal to or less
than 275 percent of the federal poverty guidelines for the applicable family
size shall be eligible for MinnesotaCare according to this section. All other
provisions of sections 256L.01 to 256L.18, including the insurance-related
barriers to enrollment under section 256L.07, shall apply unless otherwise
specified.
[EXPANSION OF ELIGIBILITY.]
Eligibility for MinnesotaCare shall be expanded as provided in subdivisions 3 to
7, except children who meet the criteria in this subdivision shall continue to
be enrolled pursuant to this subdivision. The enrollment requirements in this
paragraph apply to enrollment under subdivisions 1 to 7. Parents who enroll
in the MinnesotaCare program must also enroll their children and dependent
siblings, if the children and their dependent siblings are eligible. Children
and dependent siblings may be enrolled separately without enrollment by parents.
However, if one parent in the household enrolls, both parents must enroll,
unless other insurance is available. If one child from a family is enrolled, all
children must be enrolled, unless other insurance is available. If one spouse in
a household enrolls, the other spouse in the household must also enroll, unless
other insurance is available. Families cannot choose to enroll only certain
uninsured members. For purposes of this section, a
"dependent sibling" means an unmarried child who is a full-time student under
the age of 25 years who is financially dependent upon a parent. Proof of school
enrollment will be required.
(c) [CONTINUATION OF ELIGIBILITY.]
Individuals who initially enroll in the MinnesotaCare program under the
eligibility criteria in subdivisions 3 to 7 remain eligible for the
MinnesotaCare program, regardless of age, place of residence, or the presence or
absence of children in the same household, as long as all other eligibility
criteria are met and residence in Minnesota and continuous enrollment in the
MinnesotaCare program or medical assistance are maintained. In order for either
parent or either spouse in a household to remain enrolled, both must remain
enrolled, unless other insurance is available.
ADDITION OF SINGLE
ADULTS AND HOUSEHOLDS WITH NO CHILDREN.] (a) Beginning
October 1, 1994, the definition of "eligible persons" is expanded to include all
individuals and households with no children who have gross family incomes that
are equal to or less than 125 percent of the federal poverty guidelines and who
are not eligible for medical assistance without a spenddown under chapter
256B.
(b) Beginning July 1, 1997,
The definition of eligible persons is expanded to
include includes all individuals and households
with no children who have gross family incomes that are equal to or less than
175 percent of the federal poverty guidelines and who are
not eligible for medical assistance without a spenddown under chapter 256B.
(c) All eligible persons under
paragraphs (a) and (b) are eligible for coverage through the MinnesotaCare
program but must pay a premium as determined under sections 256L.07 and 256L.08.
Individuals and families whose income is greater than the limits established
under section 256L.08 may not enroll in the MinnesotaCare program.
apply for MinnesotaCare receive
supplemental security income or retirement, survivors, or disability benefits
due to a disability, or other disability-based pension, who qualify under
section 256L.04, subdivision 7, but who are potentially eligible for medical
assistance without a spenddown shall be allowed to enroll in MinnesotaCare for a
period of 60 days, so long as the applicant meets all other conditions of
eligibility. The commissioner shall identify and refer the applications of such individuals to their county
social service agency. The county and the commissioner
shall cooperate to ensure that the individuals obtain medical assistance
coverage for any months for which they are eligible.
apply for and cooperate with medical assistance
within the 60-day enrollment period, and their other
family members, shall be disenrolled from the plan within one calendar
month. Persons disenrolled for nonapplication for medical assistance may not
reenroll until they have obtained a medical assistance eligibility determination
for the family member or members who were referred to the
county agency. Persons disenrolled for noncooperation with medical
assistance may not reenroll until they have cooperated with the county agency
and have obtained a medical assistance eligibility determination.
256L.16 256L.18, the income
and resources of all noncitizens whose sponsor signed an affidavit of support as
defined under United States Code, title 8, section 1183a, shall be deemed to
include their sponsors' income and resources as defined in the Personal
Responsibility and Work Opportunity Reconciliation Act of 1996, title IV, Public
Law Number 104-193, sections 421 and 422, and subsequently set out in federal
rules. To be eligible for the program, noncitizens must
provide documentation of their immigration status.
including such as the most recent income tax return, wage slips,
or other documentation that is determined by the
commissioner as necessary to verify income eligibility. The commissioner
shall perform random audits to verify reported income and eligibility. The
commissioner may execute data sharing arrangements with the department of
revenue and any other governmental agency in order to perform income
verification related to eligibility and premium payment under the MinnesotaCare
program.
eligible
newborns or eligible newly adoptive children added to a family receiving
covered health services is the date of entry into the family. The effective date
of coverage for other new recipients added to the family receiving covered
health services is the first day of the month following the month in which
eligibility is approved and the first premium payment has
been received or at renewal, whichever the family
receiving covered health services prefers. All eligibility criteria must be met
by the family at the time the new family member is added. The income of the new
family member is included with the family's gross income and the adjusted
premium begins in the month the new family member is added. The premium must
be received eight working days prior to the end of the month for coverage to
begin the following month. Benefits are not available until the day following
discharge if an enrollee is hospitalized on the first day of coverage.
Notwithstanding any other law to the contrary, benefits under sections 256L.01
to 256L.10 256L.18 are
secondary to a plan of insurance or benefit program under which an eligible
person may have coverage and the commissioner shall use cost avoidance
techniques to ensure coordination of any other health coverage for eligible
persons. The commissioner shall identify eligible persons who may have coverage
or benefits under other plans of insurance or who become eligible for medical
assistance.
The commissioner shall make an annual
redetermination of continued eligibility and identify people who may become
eligible for medical assistance.
Families and individuals who enroll on or after October 1,
1992, are eligible for subsidized premium payments based on a sliding scale
under section 256L.08 only if the family or individual meets the requirements in
subdivisions 2 and 3. Children already enrolled in the children's health plan as
of September 30, 1992, eligible under section 256L.04, subdivision 1, paragraph
(a), children who enroll in the MinnesotaCare program after September 30, 1992,
pursuant to Laws 1992, chapter 549, article 4, section 17, and children who
enroll under section 256L.04, subdivision 6, are eligible for subsidized premium
payments without meeting these requirements, as long as they maintain continuous
coverage in the MinnesotaCare plan or medical assistance.
and individuals who
initially enrolled in MinnesotaCare under section 256L.04, and subdivision 1, whose
income increases above the limits established in section
256L.08 275 percent of the federal poverty
guidelines, may continue enrollment and pay the full cost of coverage. Individuals enrolled in MinnesotaCare under section 256L.04,
subdivision 7, whose income increases above 175 percent of the federal poverty
guidelines may continue enrollment and pay premiums according to the sliding fee
scale. These individuals must pay the full cost of coverage when their income
increases above 275 percent of the federal poverty guidelines.
, and must not have had access to
subsidized health coverage through an employer for the 18 months prior to
application for subsidized coverage under the MinnesotaCare program. The requirement that the family or individual must not have
had access to employer-subsidized coverage during the previous 18 months does
not apply if: (1) employer-subsidized coverage was lost due to the death of an
employee or divorce; (2) employer-subsidized coverage was lost because an
individual became ineligible for coverage as a child or dependent; or (3)
employer-subsidized coverage was lost for reasons that would not disqualify the
individual for unemployment benefits under section 268.09 and the family or
individual has not had access to employer-subsidized coverage since the loss of
coverage. If employer-subsidized coverage was lost for reasons that disqualify
an individual for unemployment benefits under section 268.09, children of that
individual are exempt from the requirement of no access to employer subsidized
coverage for the 18 months prior to application, as long as the children have
not had access to employer subsidized coverage since the disqualifying event.
The requirement that the. A family or individual
must not have had access to employer-subsidized coverage
during the previous 18 months does apply if whose
employer-subsidized coverage is lost due to an employer terminating health care
coverage as an employee benefit during the previous 18
months is not eligible.
, excluding
dependent coverage or dependent, or a higher
percentage as specified by the commissioner. Children are eligible for
employer-subsidized coverage through either parent, including the noncustodial
parent. The commissioner must treat employer contributions to Internal Revenue
Code Section 125 plans and any other employer benefits
intended to pay health care costs as qualified employer subsidies toward the
cost of health coverage for employees for purposes of this subdivision.
PERIOD UNINSURED OTHER HEALTH COVERAGE.] To be
eligible for subsidized premium payments based on a sliding scale, (a) Families and individuals initially enrolled in the MinnesotaCare program under section 256L.04, subdivisions 5 and 7, must have
had no health coverage while
enrolled or for at least four months prior to application and renewal. A child in a family with income equal to or
less than 150 percent of the federal poverty guidelines, who has other health
coverage, is eligible if the other health coverage meets the requirements of
Minnesota Rules, part 9506.0020, subpart 3, item B. The commissioner may
change this eligibility criterion for sliding scale premiums in order to remain
within the limits of available appropriations. The requirement of at least four months of no health coverage prior to application for the MinnesotaCare program does
not apply to: newborns.
(1) families, children, and
individuals who apply for the MinnesotaCare program upon termination from or as
required by the medical assistance program, general assistance medical care
program, or coverage under a regional demonstration project for the uninsured
funded under section 256B.73, the Hennepin county assured care program, or the
Group Health, Inc., community health plan;
(2) families and individuals
initially enrolled under section 256L.04, subdivisions 1, paragraph (a), and
3;
(3) children enrolled pursuant to
Laws 1992, chapter 549, article 4, section 17; or
(4) individuals currently serving
or who have served in the military reserves, and dependents of these
individuals, if these individuals: (i) reapply for MinnesotaCare coverage after
a period of active military service during which they had been covered by the
Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); (ii)
were covered under MinnesotaCare immediately prior to obtaining coverage under
CHAMPUS; and (iii) have maintained continuous coverage.
Prior to July 1, 1997, to be eligible for health coverage
under the MinnesotaCare program, families and individuals must be permanent
residents of Minnesota.
(b) Effective July 1, 1997, To
be eligible for health coverage under the MinnesotaCare program, adults without
children must be permanent residents of Minnesota.
(c) Effective July 1, 1997, (b) To be eligible for health coverage under the
MinnesotaCare program, pregnant women, families, and children must meet the
residency requirements as provided by Code of Federal Regulations, title 42,
section 435.403, except that the provisions of section 256B.056, subdivision 1,
shall apply upon receipt of federal approval.
all
applicants an applicant must demonstrate the
requisite intent to live in the state permanently by:
to 6 and 2, or 256L.13 with family
gross income that exceeds 175 percent of the federal poverty guidelines and who
are not pregnant, who are 18 years old or older on the date of admission to the
inpatient hospital must be in accordance with paragraphs (a) and (b). Payment
for adults who are not pregnant and are eligible under section 256L.04,
subdivisions 1 to 6 and 2,
or 256L.13, and whose incomes are equal to or less
than 175 percent of the federal poverty guidelines, shall be as provided for
under paragraph (c).
(c) (b), the hospital may
not seek payment from the enrollee for the amount of the reduction.
to 6 and 2, or 256L.13, and whose
incomes are equal to or less than 175 percent of the federal poverty guidelines,
the commissioner shall pay hospitals directly, up to the medical assistance
payment rate, for inpatient hospital benefits in excess of the $10,000 annual
inpatient benefit limit.
Contracts between the department of human services and
managed care plans must include MinnesotaCare, and medical assistance and may,
at the option of the commissioner of human services, also include general
assistance medical care. Managed care plans must
participate in the MinnesotaCare and general assistance medical care programs
under a contract with the department of human services in service areas where
they participate in the medical assistance program.
and with children enrolled according to sections 256L.13 to 256L.16 and individuals shall pay an
enrollment fee or a premium determined according to a sliding fee based on
the cost of coverage as a percentage of the family's gross family income.
Pregnant women and children under age two are exempt from the provisions of
section 256L.06, subdivision 3, paragraph (b), clause
(3), requiring disenrollment for failure to pay premiums. For pregnant women,
this exemption continues until the first day of the month following the 60th day
postpartum. Women who remain enrolled during pregnancy or the postpartum period,
despite nonpayment of premiums, shall be disenrolled on the first of the month
following the 60th day postpartum for the penalty period that otherwise applies
under section 256L.06, unless they begin paying
premiums.
Subd. 3. [EXCEPTIONS TO SLIDING
SCALE.] An annual premium of $48 is required for all children who are eligible
according to section 256L.13, subdivision 4.
;
(b) and the nonresidential child care program is conducted
in a dwelling that is located on a residential lot; and or
(c) the license holder complies
with all other requirements of sections 245A.01 to 245A.15 and the rules
governing family day care or group family day care.
and
, except that no assistance shall be paid for the period
beginning with the end of the month in which the report was due and ending with
the date the report was received by the county agency.
March 31 July 1, 1998.
, except that legal noncitizens who
are applicants or recipients must have been residents of Minnesota on March 1,
1997. Legal noncitizens who arrive in Minnesota after March 1, 1997, and become
elderly or disabled after that
. The income and assets of sponsors
of noncitizens shall be deemed available to general assistance applicants and
recipients according to the Personal Responsibility and Work Opportunity
Reconciliation Act of 1996, Public Law Number 104-193, title IV, sections 421
and 422, and subsequently set out in federal rules.
(excluding Minnesota supplemental
aid issued for current month's need) an amount equal
to the Minnesota supplemental aid standard of assistance, that is normally
disregarded or excluded under the Minnesota supplemental aid program must be
considered available to meet the emergency need.
Minnesota family investment program-statewide/TANF TANF reserve account is created in the state treasury.
Funds retained or deposited in the TANF reserve shall
include: (1) funds designated by the legislature and; (2) unexpended state funds
resulting from the acceleration of TANF expenditures under subdivision 2;
(3) earnings available from the federal TANF block grant appropriated to the
commissioner but not expended in the biennium beginning July 1, 1997, shall be retained; and (4) TANF
funds available in fiscal years 1998, 1999, 2000, and 2001 that are not spent or
not budgeted to be spent in those years.
to must be
expended for the Minnesota family investment program-statewide in fiscal year 2000 and subsequent fiscal years and directly related state programs for the purposes in
subdivision 3.
custodians custodian or
guardian, grandfather, grandmother, brother, sister, stepfather, stepmother, stepbrother, stepsister, uncle,
aunt, first cousin, nephew, niece, person of preceding generation as denoted by
prefixes of "great," "great-great," or "great-great-great," or a spouse of any
person named in the above groups even after the marriage ends by death or
divorce.